The Efficacy of Hematopoietic Cell Transplantation for DLBCL-Type Richter Syndrome

Hematopoietic cell transplantation (HCT) may benefit therapy-sensitive patients with diffuse large B-cell lymphoma Richter syndrome (DLBCL-RS) according to a study published in Blood Advances.

“Studies reporting HCT outcomes in patients with DLBCL-RS have been small, have not evaluated the prognostic impact of cytogenetic risk factors, and were conducted prior to the era of novel, targeted therapy,” the researchers wrote.

In this registry study, researchers analyzed the outcomes of 173 patients after receiving autologous (auto, n=53) and allogeneic (allo, n=118) HCT.

The results showed that in the auto-HCT cohort, the three-year relapse incidence, progression-free survival (PFS), and overall survival (OS) were 37%, 48%, and 57%, respectively. The researchers observed that among allo-HCT recipients, the three-year relapse incidence, PFS, and OS were 30%, 43%, and 52%, respectively.

They noted that in the allo-HCT cohort, deeper response to HCT was associated with outcomes. In patients who achieved a complete response, three-year PFS and OS were 66% and 77%, respectively. On the other hand, three-year PFS and OS were 43% and 57%, respectively, for those who achieved a partial response. For patients who were resistant to treatment with HCT, three-year PFS and OS were 5% and 15%, respectively. Cytogenetic abnormalities and prior novel therapy did not impact outcomes.

“In our study, HCT resulted in durable remissions in therapy-sensitive patients with DLBCL-RS…including patients with high-risk features,” the researchers concluded.