Stem Cell Mobilization and Autologous Transplantation Outcomes After First-Line R-DA-EPOCH in High-Risk DLBCL and...

Area of Science:

• Hematology
• Oncology
• Stem Cell Transplantation

Background:

• High-risk diffuse large B-cell lymphoma (DLBCL) and high-grade B-cell lymphoma (HGBCL) patients have poor outcomes with standard treatments.
• Dose-adjusted R-EPOCH (R-DA-EPOCH) is utilized in high-risk settings and may aid stem cell mobilization for autologous stem cell transplantation (ASCT).

Purpose of the Study:

• To assess the impact of first-line R-DA-EPOCH on stem cell mobilization.
• To evaluate the outcomes of autologous stem cell transplantation (ASCT) following R-DA-EPOCH therapy.

Main Methods:

• Retrospective analysis of 41 adult patients with high-risk DLBCL/HGBCL treated with first-line R-DA-EPOCH (2016-2021).
• Stem cell collection was planned post-cycle 5.
• Primary endpoint: rate of poor mobilizers (<2 × 10^6 CD34+ cells/kg or requiring plerixafor [PLX]).

Main Results:

• 31.7% of patients were poor mobilizers, with 22% requiring PLX.
• 68% achieved target stem cells on first mobilization; 88% after remobilization.
• 59% proceeded to ASCT with successful engraftment and no transplant-related mortality.

Conclusions:

• First-line R-DA-EPOCH facilitates effective stem cell mobilization in most high-risk DLBCL/HGBCL patients.
• A significant proportion of patients require PLX for adequate stem cell collection.
• R-DA-EPOCH serves as a feasible platform for early mobilization and ASCT in selected patients.