Combination Of Cellular Immunotherapy And Rituximab-Based Regimens In Patients With Diffuse Large B Cell Lymphoma: A Pilot Cohort Study

e15044 Background: Preclinical studies showed that antibody-dependent cell-mediated cytotoxicity mediated by CD56+natural killer (NK) cells contributed to the activity of rituximab (R) in patients (pts) with diffuse large B-cell lymphoma (DLBCL). We investigated the efficacy and safety of combination of cellular immunotherapy (CIT) and R-based regimens. Methods: Eligible pts should be newly diagnosed as DLBCL, be at least 18 years, and have a life expectancy ≥ 3 months during January 2010 and May 2017 in the First Hospital of Jilin University. Pts were treated with the combination therapy (study group, SG) or R-based regimens alone (control group, CG). Autologous peripheral blood mononuclear cells were collected by apheresis, and were induced into NK, γδT, or CIK cells, then the expanded immunocytes were infused back into pts after 14 days culture ex vivo. One course of CIT contained six times of infusion. The primary endpoint was progression free survival (PFS), the secondary endpoints were overall survival (OS) and safety. Results: In the SG, there are 20 pts with median age of 58 (33-80) years old, while 47 pts in CG with median age of 57 (21-87) years old. The median follow-up time was 36 months. The characteristics including age, sex, performance status, Ann Arbor stage, IPI score, serum lactate dehydrogenase, extranodal sites and chemotherapy courses had no significant difference between the two groups. But pts presenting with B symptoms were more in the CG than those in SG (X2= 5.376, P = 0.020). The 3-year PFS rates of the study and control group were 83.1% and 69.9%, respectively. And the 3-year OS rates of the study and control group were 87.7% and 75.4%, respectively. Compared with CG, the improvement in 3-year PFS was 13.2% (13-13.4) for SG, and OS rate improved by 12.3% (12.1-12.5) after combination with CIT.Among the pts receiving CIT, one patient had skin rash. Conclusions: Combination of CIT and R-based regimens was well tolerated and showed a great potential to improve the PFS and OS of the pts with newly-diagnosed DLBCL. This study provided a novel strategy for the treatment of DLBCL, and it is worthwhile to study this combination strategy in multi-center randomized clinical trials.