Prompt Autologous Hematopoietic Stem Cell Transplant in Patients With Large B-Cell Lymphoma Is Associated With Lower Rates of Progression of Disease Prior to Transplant.

Introduction: To ensure response is preserved, it is common practice to continue chemotherapy in patients with large B-cell lymphoma (LBCL) awaiting autologous hematopoietic stem cell transplant (HSCT), even after they have achieved complete or partial response (CR/PR). Methods: We conducted a retrospective chart review of patients with LBCL evaluated at our institution between 2011 and 2022 to examine the effect of delay of transplant and continuation of chemotherapy past CR/PR on progression of disease (PD) prior to transplant. The association of PD prior to transplant with delayed transplant and additional chemotherapy was modeled using logistic regression. Results: Out of the 87 patients included, 74 (85%) had relapsed/refractory LBCL. Transplant was delayed in 20 (23%) patients, and 22 (25%) patients received chemotherapy after CR/PR. Delay of transplant was associated with higher odds of PD prior to transplant (odds ratio [OR] = 4.0, Conclusion: Proceeding to autologous HSCT as soon as adequate response is achieved in LBLC was associated with a lower likelihood of progression of disease prior to transplant regardless of additional chemotherapy receipt. Trial Registration: The authors have confirmed that clinical trial registration is not needed for this submission.