Lymphoma

In this daily highlights video, Dr Guillaume Dachy, clinical hematologist at the Cliniques Universitaires Saint-Luc in Brussels shares his key take-aways from EBMT 2025 related to lymphoma.

In a first presentation, Yasmina Serroukh zoomed in on the outcomes of follicular lymphoma (FL) patients in the EBMT registry who were treated with an allogenic stem cell transplantation (alloSCT). The current FL landscape that is increasingly being dominated by bispecific antibodies and CAR-T therapy and as a result, alloSCT has become a rarity in this setting. Nevertheless, the results of this study, including close to 1,800 patients, showed good outcomes after alloSCT. In fact, the 5-year graft versus host and relapse free survival rate was reported at 36%, with a cumulative relapse incidence of 20% and a non-relapse mortality rate of 30% at 5 years. A closer look into these data learned that older patients tend to do worse than their younger counterparts. Interestingly, patients receiving the alloSCT in later treatment lines (beyond 3 prior treatment lines) had a better outcome than patients receiving this treatment modality earlier in the disease course.¹

Clearance of circulating tumor DNA (ctDNA) is a strong prognostic factor in patients with diffuse large B-cell lymphoma (DLBCL). A presentation at EBMT 2025 assessed the predictive value of ctDNA in relapsed or refractory (R/R) DLBCL patients treated with either lisocabtagene maraleucel (liso-cel) or standard of care (SoC). As could be expected, obtaining ctDNA was associated with a better outcome in both treatment arms. However, among ctDNA negative patients, liso-cel proved to be associated with a significantly better EFS than SoC, underscoring the deeper responses that can be obtained with CAR-T therapy compared to SoC in this setting.²

Also in the context of CAR-T therapy for R/R DLBCL, data from the Memorial Sloan Kettering Cancer Center showed that a lower expression of CD19 was associated with a worse outcome following CD19-directed CAR-T therapy. Interestingly, patients with a relapse after CAR-T therapy displayed a lower level of CD19 expression at relapse. This reduced CD19 expression also proved to be associated with a pro-inflammatory gene signature, suggesting that inflammation likely plays a role in the development of CAR-T resistance.³

Finally, Dr Dachy underscored the importance of the recently published recommendations and guidelines for the management of rare CAR-T complications developed by the EBMT transplant complications working group. These publications provide guidance for phyicians on how to deal with non-ICANS adverse events such as stroke or myelitis and address the management of non-CRS systemic toxicities such as GVHD, cognitive problems and secondary malignancies.