Polatuzumab vedotin-based salvage immunochemotherapy as third-line or beyond treatment for patients with diffuse large B-cell lymphoma: a real-world experience.
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| Abstract |
Polatuzumab vedotin (PoV) has recently shown promising activity when combined with rituximab-bendamustine (BR) in patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). However, few studies have described the prognostic factors predicting response. Here, we aimed to evaluate the efficacy and safety profile of PoV-based chemotherapy, including regimens other than BR, as third-line or beyond treatment for patients with R/R DLBCL and to explore prognostic factors. Overall, 40 patients, including 37 with de novo and 3 with transformed DLBCL, were enrolled. The overall response rate was 52.5%, and 25% and 27.5% of patients showed a complete response and partial response, respectively. With a median follow-up of 18.8 months, the median overall survival (OS) of the total cohort was 8.5 months, and that of those receiving subsequent hematopoietic stem cell transplantation (HSCT) was 24 months. Low/intermediate risk according to the revised International Prognostic Index score at diagnosis and before PoV treatment predicted better OS. Furthermore, a normal lactate dehydrogenase level and an absolute lymphocyte count/absolute monocyte count ratio > 1.5 were favorable OS prognostic factors. The most common adverse event was cytopenia, with 42.5% of patients developing febrile neutropenia. Grade 1-3 peripheral neuropathy associated with PoV was reported in 25% of patients and resolved in most patients after the cessation of treatment. In summary, we demonstrated that PoV combined with either BR or other intensive chemotherapy is an effective and well-tolerated salvage option for patients with R/R DLBCL. Subsequent HSCT has the potential to further improve survival outcomes in this high-risk population. Clinicaltrials.gov number: NCT05006534.
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| Authors | Yu-Wen Wang, Xavier Cheng-Hong Tsai, Hsin-An Hou, Feng-Ming Tien, Jia-Hau Liu, Wen-Chien Chou, Bor-Sheng Ko, Yu-Wen Chen, Chien-Chin Lin, Chieh-Lung Cheng, Min-Yen Lo, Yun-Chu Lin, Li-Chun Lu, Shang-Ju Wu, Sung-Hsin Kuo, Ruey-Long Hong, Tai-Chung Huang, Ming Yao |
| Journal | Annals of hematology (Ann Hematol) Vol. 101 Issue 2 Pg. 349-358 (Feb 2022) ISSN: 1432-0584 [Electronic] Germany |
| PMID | 34766217 (Publication Type: Clinical Trial, Journal Article) |
| Copyright | © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. |
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