Double-hit (DHL) and double expressor (DEL) DLBCL have poor prognosis with standard therapy but CART may overcome this poor prognostic impact. In this multicenter retrospective study, we sought to confirm this observation by evaluating survival outcomes among patients with relapsed/refractory DHL and DEL treated with CART and evaluate outcomes of relapse post-CART. A total of 408 adult patients with relapsed/refractory DLBCL from 13 academic centers were included based on the availability of DHL and DEL. All 408 patients were included in the DHL (n = 80) vs non-DHL (n = 328) analysis, while 333 patients were included in the analysis of DHL (n = 80) vs DEL (n = 74) vs non (n = 179). On MVA, there were no differences for PFS for DHL vs non-DHL (HR 0.8, 95%CI 0.5–1.3, p = 0.35) or DHL vs DEL vs other (three-way p value, p = 0.5). Response rates and toxicities were similar among groups. Patients with DEL had the highest relapse rates post-CART, while DHL had the worst overall survival after CART relapse. In sum, our data support the notion that CART cell therapy can overcome the poor prognostic impact of DHL and DEL DLBCL in the relapsed/refractory setting. Additionally, patients with DHL that relapse after CART have a very poor prognosis.
双重打击淋巴瘤（DHL）和双表达淋巴瘤（DEL）在接受标准治疗时预后较差，但CAR-T细胞疗法可能克服这一不良预后影响。在这项多中心回顾性研究中，我们旨在通过评估接受CAR-T治疗的复发/难治性DHL和DEL患者的生存结局，并分析CAR-T治疗后复发的结局，以验证这一观察结果。研究共纳入来自13个学术中心的408例复发/难治性DLBCL成年患者，所有患者均具有DHL和DEL状态数据。全部408例患者被纳入DHL（80例）与非DHL（328例）的比较分析；其中333例患者被纳入DHL（80例）对比DEL（74例）对比非DHL/DEL（179例）的三组分析。多变量分析显示，DHL与非DHL在无进展生存期上无显著差异（风险比0.8，95%置信区间0.5–1.3，p=0.35），三组比较（DHL、DEL、其他）也无显著差异（三方p值p=0.5）。各组间缓解率和毒性反应相似。DEL患者在CAR-T治疗后复发率最高，而DHL患者在CAR-T治疗后复发时总生存期最差。总之，我们的数据支持以下观点：在复发/难治性背景下，CAR-T细胞疗法能够克服DHL和DEL型DLBCL的不良预后影响。此外，CAR-T治疗后复发的DHL患者预后极差。
肿瘤(癌症)患者之家