EHA 2021 | Patient selection in the treatment of NHL
Ulrich Jäger, MD, Medical University of Vienna, Vienna, Austria, explains the rationale behind patient selection and treatment of non-Hodgkin lymphoma in the era of chimeric antigen receptor (CAR) T-cell therapy, highlighting risk factors for non-response such as extranodal involvement and a high number of prior lines of therapy, as well as commenting on a risk stratification model. This interview took place at the virtual European Hematology Association (EHA) Congress 2021.
Transcript (edited for clarity)
For NHL, I think, of course you have to look at the type of NHL for the diffuse large B-cell lymphomas, as I said, we have some indications what the major risk factors for a non-response are. And that, for instance, is [inaudible] disease, that’s later lines of treatment, that’s extra nodal involvement of the lymphoma. We’ve also shown that for instance, high expression of Myc in the tumor is a poor prognostic sign...
For NHL, I think, of course you have to look at the type of NHL for the diffuse large B-cell lymphomas, as I said, we have some indications what the major risk factors for a non-response are. And that, for instance, is [inaudible] disease, that’s later lines of treatment, that’s extra nodal involvement of the lymphoma. We’ve also shown that for instance, high expression of Myc in the tumor is a poor prognostic sign. And all these factors will help us to select patients. Some of the factors can even be combined like in the French [inaudible] index, [inaudible] disease plus extra nodal sites. And we have tried to combine LDH and histology and namely Myc expression into an index where for instance, patients with a low Myc expression and a normal LDH have a chance of 75% of staying in a long-term response. And so, moving forward. As I previously said, it’s the fine balance between selecting the right patient and not, let’s say, being over-restrictive to exclude patients who would actually profit.
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