Allogeneic & Autologous Stem Cell Transplant for Follicular Lymphoma | Yasmina Serroukh, MD | #ASH24

Hi everyone! My name is Yasmina Serroukh. I am a internist-hematologist practicing in Rotterdam in the Netherlands. I was trained in Belgium and Canada, but now I, practice only in the Netherlands. And I'm, mostly involved in patient care for inpatient care for lymphoma. But also, for cellular therapy and transplant options.

Today, in this Conference, today I just presented a study, from the European Bone Marrow Transplant Association. So it's EBMT, and I reported on the outcome of, autologous and allogeneic stem cell transplantation for follicular lymphoma. So fortunately, nowadays, for follicular lymphoma, we have many options. So, even patients that fail the first, lines of therapy can access a lot of, new, very effective treatment.

But these new effective treatments, they are not available in every country so far. So it was important to us to also check where we stand and what the outcome is of, autologous and allogeneic stem cell transplantation, because these are established and broadly available therapies. So we checked, in the EBMT registry. So it's a large database of, patient data.

All the patients agreed at the time of transplant to share their data in the, EBMT registry and in the registry we identified from 2010 to 2022, seven more than 7000 patients that received a autologous stem cell transplantation. And we could report that this led to durable responses and also to an acceptable toxicity. But, that's in this cohort, most of the patients still experienced relapsed after a few years.

So this leads to durable responses. But probably, in the vast majority of patients not to cure. And then we also, analyzed the outcome of allogeneic stem cell transplantation in the same time period from 2010 to 2022. In this, database, we had, almost 2000 patients, so 1700 or something. And all these patients underwent, the allogeneic stem cell transplantation.

And most of the time when they exhausted all other options. And the good news here is that allogeneic transplant is still a curative option, because we observed a plateau, what we call a plateau means that at some point we observe that patients don't relapse anymore, so they are cured. And this we observed at five years in, in more than the half of the patients.

The problem with allogeneic transplant is that it's a toxic procedure, very intensive for patients and that, we observe what we call non relapse mortalities or mortality that is attributable to the therapy, above 30% at five years. So there is progress there to be made. But my point is that this is still, for eligible patients, a good option when all the rest of the options are exhausted are not available.

Because this is a curative option, when people are going to die from their lymphoma, then this is really, an option that we can propose. So this is basically what I had to say today. During the, the presentation about transplant option for follicular lymphoma. This is, a procedure that we have been doing for a very long time, for decades.

So we know how to manage these patients. But this is a procedure that has a major impact on quality of life and on, survival. So the side effects of allogeneic transplant is mostly, related to infections and to graft versus host disease. So we know that the graft so the, the cells of the donor are going to fight the lymphoma, so are going to provide what we call graft versus lymphoma effect.

And that is what we want. That is what's cures the patient. But it's also, responsible for graft versus host disease. And this is characterized by changes or abnormalities in any organ due to the activity of the donor cells against the healthy organs. And this can lead to, to this is manageable.

We we have medication for that, but this can lead to, impaired quality of life. Therefore, we also, needs to go on with, you know, clinical trials with the new therapies. And we also need to get them approved in any countries to make them available for the broad, the vast majority of patients.