ASCT remains the standard treatment for chemosensitive relapsing LBCL. Here, we report the first case of a patient with severe cold agglutinin disease, transfusion-dependent and under anti-complement therapy, who required ASCT for LBCL. @m-drinkwater.bsky.social #lymsm

doi.org/10.1111/trf....

ECHELON-3 is out !
Another option for multiple r/r DLBCL, however doesn’t seem to be a curative. Interestingly, efficacy was not affected by CD30 status.
Specific congrats to Isabelle Fleury, an amazing lymphoma doctor here in Montreal ! #lymsm

doi.org/10.1200/JCO-...

Siltuximab, a new therapeutic option for ICANS and tocilizumab-refractory CRS associated with CAR-T? Great work by Bajwa et al. We need to incorporate new corticosteroid-sparing agents for severe ICANS into treatment algorithms (Anakinra, siltuximab, others?). #lymsm

doi.org/10.1182/bloo...

Excellent review of current knowledge, challenges and clinical trials regarding immunotherapies (CAR-T) for T-cell malignancies by Maciocia and al. Very exciting time ahead for lymphoma doctors #lymsm

doi.org/10.1182/bloo...

Tafa +/- R² RCT #ASH24 LBA
- 548 pts, 32% POD24, 55% 1 prior LOT
- superior PFS w/ tafa, including POD24
- look at that tafa TTNT curve!
- slightly more tafa & len d/c in tafa arm
- more PD deaths in pbo arm
OS analysis planned at 5 yrs, trend towards tafa. #lymsm

3-yr F/U fixed-duration glofi @mike_dickinson1 #ASH24
- 53% of pts w/ CR had ongoing CR
- ctDNA: 3/4 of pts with EOT CR had ongoing uMRD
- B-cell fxn & IgG recover ~12-18 mos after ETO
- 2 new G5 AEs: COVID & AML
Important updated data for 40% of pts who get into CR. #lymsm

Neelapu: long term Zuma5 FU (Axi-cel FL)
- 127 efficacy pts, R/R FL 2+ prior lines
- at >5y FU, >50% alive, no further Rx
- PFS at 5y approx 50%
- NRM approx 15%
- only 1 PD event after 4y
- Apply to high risk incl POD24
Does support curative potential in FL
#ASH24 #lymsm

Lewis et al: ENRICH study in 1L MCL
- Ibr+ritux vs R-chemo (RCHOP or R-benda)
- 400 pts, >60y
-PFS: prolonged with IR
- Largely driven by benefit over R-CHOP
- Blastoid did not benefit from IR
- OS the same
- 22% cardiac AEs with IR
1st trial to show benefit chemo-free in 1L MCL.
#ASH24 #lymsm

Jerkeman - acala+ritux in older MCL
• MRD guided - 56% of low risk stopped due to MRD neg
• safe, although 2 deaths due to aplastic anaemia (v odd?)
• low risk had excellent outcomes (less so if p53, blastic / high Ki67)
#ASH24 #lymsm

Le Gouill - OASIS II
• IBR + R v I-Ven-R 1L MCL
• DDPCR for MRD at 6mo
• MRD- rate 82% with IVR, higher than any other regimen incl immunochemo
• some excess AE: diarrhoea, neutrop, arrhyth
IVR clearly a hugely active triplet
#ASH24 #lymsm

Low VAF TP53 CLL #ASH24:
- 961 pts, 1/3 had low VAF TP53mut (<10%)
- OS similar for low VAF TP53 & WT
- TP53mut associated with worse TT1T
- if 1L tx targeted agents: low VAF group did not have worse TT2T (v WT)
No diff in OS between high VAF & WT in targeted agent era! #leusm

Overall response rate (ORR) of 100%! Now with long term data showing 5-yr-Progression Free Survival (PFS) of 91%.

Neither Pembro nor GVD alone is as efficacious, begging the mechanistic question of “synergy” - that is, how do immunotherapy and chemotherapy combine to become more than either alone?

Excellent presentation by Dr. Dreyling at #ASH2024. A trend in favor of A+I vs. I for high-risk MCL (including highP53), which contrasts with previous data suggesting no benefice of ASCT in TP53mut MCLs. I believe we should not (yet?) abandon consolidation ASCT in MCL pts with poor pronostic. #lymsm

Looking forward to attending this presentation at #ASH24.
MRD is neither standardized nor universally accessible for the treatment of MCL, but now it might have decision making impact! #lymsm

ASCT in CR1 MCL MRD-adapted #ASH24 @timfenske:
650 pts, 73% AraC induction, mFU 2.7 yr
- A: uMRD6 ASCT + MR x 3 yr
- B: uMRD6 MR x 3 yr
3-yr PFS/OS:
- A: 76.6%/82.1%
- B: 77.4%/82.7%
No difference in OS based on futility analysis. CR1 with MRD-neg at 10-6 do not need ASCT! #lymsm

Important paper: Comparing axi-cel and liso-cel in patients receiving 3L+ therapy for relapsed large b-cell lymphoma. Outcomes similar to trials, but liso-cel takes longer and when matched, axi-cel improved PFS. @oncoalert.bsky.social
#lymsm #medsky #oncsky