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EBMT 2026 | Rescuing patients with high-grade transformation of Waldenström’s with transplantation or CAR-T

In this interview, Charalampia Kyriakou, MD, PhD, University College London Hospitals NHS Trust (UCLH), London, UK, shares the findings of a retrospective EBMT registry study that aimed to analyze the results of autologous and allogeneic stem cell transplantation and CAR T-cell therapy in patients with high-grade transformation of Waldenström’s macroglobulinemia (tWM). This interview took place at the 52nd Annual Meeting of the EBMT in Madrid, Spain.

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Transcript

As you know, Waldenstrom’s macroglobulinemia is quite a rare disorder and transformation of Waldenstrom’s is an even more rare entity and the opportunity we had within the EBMT community was to collect all cases with confirmed transformed Waldenstrom’s that have been reported to the European Bone Marrow Transplant Lymphoma Working Party Registry. And we analyzed the data...

As you know, Waldenstrom’s macroglobulinemia is quite a rare disorder and transformation of Waldenstrom’s is an even more rare entity and the opportunity we had within the EBMT community was to collect all cases with confirmed transformed Waldenstrom’s that have been reported to the European Bone Marrow Transplant Lymphoma Working Party Registry. And we analyzed the data. We had almost 310 patients having transplantation for transformed Waldenstrom’s from different European centers. And it was quite interesting to see that these patients received treatment that obviously is applied for high-grade lymphoma, and the majority of our cohort is patients who receive autologous transplantation with quite satisfactory progression-free and overall survival as reported from the autograft for high-grade lymphomas as well. But the other interesting part that is even more difficult to find in these cases is that we had 45 patients who received CAR T-cell therapy with, again, good trend and signal that these people can be rescued with the CAR-T approach as per the high-grade lymphomas. As well, we had another cohort with 49 patients who received allograft as rescue therapy for the transformed Waldenstrom’s. And there was good result, although, as we know, this transplant approach is associated with higher toxicity, so the progression-free and the overall survival have been a bit more compromised as compared to the other two groups. But it’s quite promising results that guide us in the real-world community not to get disappointed and to be able to offer other options for our patients who transform from the low-grade Waldenstrom’s to high-grade disease.

 

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