Declining Stem Cell Transplants for Lymphoma Amid CAR-T Advancement

A recent study presented at the ASH Annual Meeting and Exhibition has shown a significant decline in hematopoietic stem cell transplantation (HSCT) procedures for advanced diffuse large B-cell lymphoma since 2019. The analysis, based in Europe, revealed a decrease in both autologous and allogeneic HSCT, coinciding with the rise in commercially available chimeric antigen receptor T-cell (CAR-T) therapies. Despite the decline in HSCT procedures, treatment outcomes improved over the study period, highlighting the effectiveness of both transplant modalities. The introduction of CAR-T cells has challenged the role of HSCT and is contributing to a shift in treatment options for this type of lymphoma.

The study, conducted by researchers from the University Hospital Muenster in Germany, used data from the European Society of Bone Marrow Transplantation and included both retrospective and clinical outcome analysis. The results showed a significant increase in the number of auto-HSCT procedures performed over time, with corresponding improvements in treatment outcomes. Similarly, the volume of allo-HSCT procedures increased, along with improved patient survival rates. Notably, since 2019, the number of HSCT procedures has declined each year, while the frequency of CAR-T cell infusions has increased.

These findings have important clinical implications, as they provide real-world data on treatment modalities for over 40,000 patients with diffuse large B-cell lymphoma. The study highlights the need to reassess the role of HSCT in light of the increasing use of CAR-T therapies. These results may serve as a benchmark for evaluating emerging treatment modalities and contribute to the development of more effective and personalized treatment approaches for this type of lymphoma.

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