Early relapse, regardless of interim imaging, suggests chemorefractory disease. It may be that we selected a more chemo/rituxan resistant clone that comprised a smaller % initially that has now become dominant. Regardless of pathophysiology, I think for today we are stuck with the same paradigm: sal...

At this time, based on the data from the ZUMA-7 and TRANSFORM studies, for those with early relapse who obtained a CR, if they are otherwise medically eligible, CAR T-cell therapy is recommended. For those that had a longer remission prior to relapse, they may still have chemo-sensitive disease and ...

I agree with the above. Other factors that need to be considered are the DH/TH status by FISH, sites of extranodal disease (and high risk IPI), and the age of the patient (for an early allo-consideration). If you are considering salvage followed by HDT-, I agree with the choices; if the salvage cont...

For patients who achieved CR and relapse within 6 to 12 months, I perform a biopsy to confirm the diagnosis. Once confirmed, I usually recommend CD19 CAR-T therapy with liso-cel (for older and medically unfit patients as it is associated with less toxicity) or axi-cel, if available, rather than salv...