--- title: "International Journal Publication | Dr. Kai HU's Team: ASCT Associated with Better PFS Than CAR-T as Consolidation in R/R CNSL Patients Who Regain Complete Remission" url: "https://www.yyhmedical.com/en/news/asct-vs-car-t-consolidation-cns-lymphoma" type: Article inLanguage: en-US category: Medical Advances datePublished: 2026-04-27 --- # International Journal Publication | Dr. Kai HU's Team: ASCT Associated with Better PFS Than CAR-T as Consolidation in R/R CNSL Patients Who Regain Complete Remission > A study from Dr. Kai HU's team found that among chemosensitive patients with relapsed/refractory central nervous system lymphoma who regained complete remission, ASCT consolidation was associated with better 3-year progression-free survival than CAR-T therapy and a lower relapse rate. Summary: Dr. Kai HU's team at Beijing GoBroad Hospital published a study in Cancer Immunology, Immunotherapy comparing autologous hematopoietic stem cell transplantation (ASCT) with CAR-T cell therapy as consolidation in patients with relapsed/refractory central nervous system lymphoma (R/R CNSL) who had regained complete remission. The study included 60 patients. Three-year progression-free survival was significantly higher in the ASCT group than in the CAR-T group (80% vs. 64.8%), and the cumulative incidence of relapse/progression was lower (20% vs. 30.2%). The findings provide useful evidence to support consolidation-treatment decisions in this setting. Relapsed/refractory central nervous system lymphoma (R/R CNSL) is difficult to treat, and outcomes can vary considerably depending on a range of clinical factors. For some patients who respond to salvage therapy and regain remission, guideline-based care commonly includes autologous hematopoietic stem cell transplantation (ASCT) as consolidation. In recent years, CAR-T cell therapy has also shown encouraging activity with manageable toxicity in R/R CNSL. This has raised an important clinical question: for patients whose disease remains chemosensitive and who regain remission after relapse, can CAR-T consolidation achieve outcomes comparable to ASCT? Evidence directly comparing the two approaches has been limited. Recently, Dr. Kai HU's team from the Department of Lymphoma and Myeloma at Beijing GoBroad Hospital published a paper in Cancer Immunology, Immunotherapy titled "Outcomes in patients with refractory/relapsed CNS lymphoma treated in complete remission: autologous transplantation vs. CAR-T therapy." Dr. Fan YANG was the first author. The study addresses this clinical question and provides new evidence to help guide consolidation choices for R/R CNSL patients who have regained complete remission. **Study Background** Dr. Kai HU explained: Relapsed/refractory central nervous system lymphoma is particularly challenging to treat. For patients whose disease remains chemosensitive and who can still achieve complete remission, the choice of consolidation therapy is critical. A practical question in clinical care is whether CAR-T consolidation can achieve a depth and durability of remission comparable to autologous hematopoietic stem cell transplantation (ASCT), thereby reducing the risk of later relapse and supporting long-term survival. To explore this question, Dr. Fan YANG and the team retrospectively analyzed 60 patients with R/R CNSL who regained complete remission after chemotherapy. Among them, 42 patients (70%) had primary CNS lymphoma (PCNSL), while 18 (30%) had diffuse large B-cell lymphoma (DLBCL) with secondary CNS involvement. The study compared survival outcomes and relapse rates after subsequent ASCT or CAR-T consolidation. Patients who had previously undergone ASCT were excluded. **Key Findings** **1\. Compared with CAR-T, ASCT Consolidation Was Associated with Better 3-Year PFS and a Lower Cumulative Incidence of Relapse/Progression** The median follow-up was 12.1 months (range, 1.28-59.9 months). Compared with the CAR-T group, patients who received ASCT while in complete remission had superior progression-free survival (PFS): 3-year PFS was 80% (95% CI, 48.4%-93.4%) with ASCT versus 64.8% (95% CI, 38.9%-81.9%) with CAR-T (P=0.026). The cumulative incidence of relapse/progression was also lower: 20% (95% CI, 4.12%-44.39%) versus 30.2% (95% CI, 11.0%-52.2%) at 3 years (P=0.038). Among patients with primary CNS lymphoma (PCNSL), 2-year PFS was significantly higher in the ASCT group \[92.9% (95% CI, 59.1%-99.9%) vs. 65.7% (95% CI, 31.0%-86.0%); P=0.026\]. Among patients with secondary CNS lymphoma (SCNSL), 2-year PFS and overall survival (OS) numerically favored ASCT, although the differences were not statistically significant. ![31a33058-2498-4e7a-a4f3-f927c9d5ac35.png](https://gaobo-byh-h5.oss-accelerate.aliyuncs.com/images/20260914/999d5546e64c2d0362d8984f70e058d0_20260914003942.png "999d5546e64c2d0362d8984f70e058d0_20260914003942.png") Figure 1 **2\. CAR-T Cell Expansion Was Detected in Cerebrospinal Fluid, with a Manageable Safety Profile** The median CAR-T cell dose infused was 1.75 x 10^6 cells/kg (range, 0.16 x 10^6 to 10 x 10^6 cells/kg). Marked expansion of CAR-T cells in peripheral blood was observed in 36 of 37 patients after infusion (Figure 2A). The median peak level of CD19+ CAR-T cells was 7,465 lentiviral copies/μg DNA (range, 1,246-36,107), with a median time to peak of 10 days (range, 6-28 days). Cerebrospinal fluid was evaluated in 10 patients after infusion (Figure 2B), and CAR-T cells were detected in four. The peak level of CD19+ CAR-T cells in cerebrospinal fluid was 2,415 lentiviral copies/μg DNA (range, 81-2,914 copies/μg DNA). ![14d35ed5-25f5-426c-9f23-9c3711f4504f.png](https://gaobo-byh-h5.oss-accelerate.aliyuncs.com/images/20260914/3491f83f0b053741fc962f20fa35d062_20260914003958.png "3491f83f0b053741fc962f20fa35d062_20260914003958.png") Figure 2 The most common adverse event was neutropenia, reported in 57 patients (95%), followed by infection in 34 patients (56.7%) and hypogammaglobulinemia in 28 patients (46.7%). In the CAR-T group, six patients (22.3%) developed grade 1 cytokine release syndrome (CRS), and three (11.1%) experienced grade 1-2 immune effector cell-associated neurotoxicity syndrome (ICANS). Overall, the safety profile was considered manageable. **3\. Both ASCT and CAR-T Consolidation Showed Signals of Disease Control in Patients with TP53 or MYD88/CD79B Alterations** Among patients with these molecular alterations who received ASCT (n=7) or CAR-T therapy (n=11) after achieving complete remission, all patients in the ASCT group with detectable TP53 or MYD88/CD79B alterations were alive at the time of analysis. Among patients with TP53 alterations, one experienced disease progression and two remained in complete remission. Among those with MYD88/CD79B alterations, one progressed and the remaining nine were in complete remission. In the CAR-T group, all five patients with TP53 alterations were alive; one experienced progression and four remained in complete remission. Among 16 patients with MYD88/CD79B alterations, one died after disease progression, two were alive with active disease, and 13 remained in complete remission. Larger studies are needed to better understand how consolidation therapy may affect outcomes in molecularly defined subgroups. The team's preliminary findings suggest that ASCT remains a preferred consolidation strategy for R/R CNSL patients who are sensitive to second-line chemotherapy and achieve complete remission. For patients who are in complete remission but are not eligible for ASCT, CAR-T therapy may be a potentially feasible consolidation option. **Summary and Outlook** Dr. Kai HU noted that the Department of Lymphoma and Myeloma at Beijing GoBroad Hospital has accumulated substantial experience with CAR-T therapy for central nervous system lymphoma. As CAR-T use expands in real-world practice, clinicians are encountering increasingly complex treatment decisions. Identifying the right timing for CAR-T and developing individualized, precise, and longitudinal management strategies remain important priorities in hematologic oncology. In the future, integrated clinical, pathologic, molecular, and imaging assessments may help identify R/R CNSL patients who are unlikely to benefit from conventional treatment but may benefit from precision CAR-T strategies. Tools such as circulating tumor DNA (ctDNA) monitoring may also help detect signs of relapse earlier and support more timely intervention, with the goal of extending survival. --- Original (HTML):https://www.yyhmedical.com/en/news/asct-vs-car-t-consolidation-cns-lymphoma This is a clean Markdown mirror for large language models; the original page is authoritative.