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Background <p>Autologous hematopoietic cell transplantation (ASCT) is a reasonable consolidation therapy for eligible patients with chemosensitive relapsed central nervous system lymphoma (CNSL) who have achieved complete remission (CR) and maintained the CR. Chimeric antigen receptor T-cell (CAR-T) therapy is an effective treatment option for patients with relapsed CNSL, although evidence on outcomes in patients who achieve CR is limited.</p> Aim <p>To compare the efficacy of ASCT versus CAR-T therapy as consolidation therapy in patients with relapsed CNSL once CR had been re-achieved.</p> Methods <p>A retrospective observational study was conducted on patients who underwent ASCT or CAR-T therapy at the Department of Lymphoma, Beijing Gobroad Hospital, between 2021 and 2024. CAR-T therapy was part of the clinical trial “Different B-cell-targeted CAR-T cells for relapsed/refractory CNSL (ChiCTR2200058972)”.</p> Results <p>Sixty patients, including 42 (70%) with primary CNSL and 18 (30%) with diffuse large B-cell lymphoma (DLBCL) with secondary CNS involvement, were enrolled. The median follow-up duration was 12.1&#xa0;months (1.28–59.9&#xa0;months). Compared with patients in the CAR-T group, patients who received ASCT while in CR had superior progression-free survival (PFS) [3-year PFS 80% (95% CI: 48.4–93.4) vs. 64.8% (95% CI: 38.9–81.9); <i>P</i> = 0.026] and a lower cumulative incidence of relapse/progression [3-year relapse rate 20% (95% CI: 4.12–44.39) vs. 30.2% (95% CI: 11.0–52.2); <i>P</i> = 0.038].</p> Conclusion <p>Compared with CAR-T therapy, ASCT was associated with improved PFS in patients with relapsed CNSL who had achieved CR.</p>

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Outcomes in patients with refractory/relapsed CNS lymphoma treated in complete remission: autologous transplantation vs. CAR-T therapy

  • 期刊论文

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  • 发表日期：

    2026年3月24日

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  • Fan Yang,
  • Rui Liu,
  • Zhonghua Fu,
  • Yuelu Guo,
  • Lixia Ma,
  • Miaomiao Cao,
  • Biping Deng,
  • Haifeng Wu,
  • Chen Chen,
  • Xiaoyan Ke,
  • Kai Hu

摘要

Background

Autologous hematopoietic cell transplantation (ASCT) is a reasonable consolidation therapy for eligible patients with chemosensitive relapsed central nervous system lymphoma (CNSL) who have achieved complete remission (CR) and maintained the CR. Chimeric antigen receptor T-cell (CAR-T) therapy is an effective treatment option for patients with relapsed CNSL, although evidence on outcomes in patients who achieve CR is limited.

Aim

To compare the efficacy of ASCT versus CAR-T therapy as consolidation therapy in patients with relapsed CNSL once CR had been re-achieved.

Methods

A retrospective observational study was conducted on patients who underwent ASCT or CAR-T therapy at the Department of Lymphoma, Beijing Gobroad Hospital, between 2021 and 2024. CAR-T therapy was part of the clinical trial “Different B-cell-targeted CAR-T cells for relapsed/refractory CNSL (ChiCTR2200058972)”.

Results

Sixty patients, including 42 (70%) with primary CNSL and 18 (30%) with diffuse large B-cell lymphoma (DLBCL) with secondary CNS involvement, were enrolled. The median follow-up duration was 12.1 months (1.28–59.9 months). Compared with patients in the CAR-T group, patients who received ASCT while in CR had superior progression-free survival (PFS) [3-year PFS 80% (95% CI: 48.4–93.4) vs. 64.8% (95% CI: 38.9–81.9); P = 0.026] and a lower cumulative incidence of relapse/progression [3-year relapse rate 20% (95% CI: 4.12–44.39) vs. 30.2% (95% CI: 11.0–52.2); P = 0.038].

Conclusion

Compared with CAR-T therapy, ASCT was associated with improved PFS in patients with relapsed CNSL who had achieved CR.