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Bispecific antibodies followed by allogeneic hematopoietic stem cell transplantation as rescue therapy in refractory/relapsed B cell non-Hodgkin lymphoma: a real-life experience

March 09, 2026
March 09, 2026 Stem-cell research : nature.com subject feeds

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TO THE EDITOR:

Novel immunotherapeutic strategies using chimeric antigen receptor T cells (CAR-T) and bispecific antibodies (BiAbs) have shown high complete response (CR) rates even in refractory or heavily pretreated relapsed B cell lymphomas (RR-BCL) [1, 2]. However, extended follow-up from pivotal trials indicates that only a minority of patients achieve long-term disease control: in the setting of ≥ 3rd line therapy for DLBCL, PFS was 31% at 5 years in the ZUMA-1 trial and 31% at 42 months in the JULIET study [2, 3]. A recent meta-analysis comparing CAR-T and BiAbs reported CR rates and 1-year progression-free survival (PFS) of 51% and 44% for CAR-T and 36% and 32% for BiAbs, respectively [4]. Moreover, sequencing of CAR-T and BiAbs has been shown to be successful, since BiAbs have demonstrated activity as salvage therapy post-CAR-T failure (e.g., Glofitamab achieved 34% CR), and CAR-T remains feasible following prior BiAb exposure, achieving CR in 43–46% of patients [5,6,7]. Prior to the advent of new immunotherapies, allogeneic hematopoietic cell transplantation (allo-HCT) was the standard consolidation procedure for all RR-BCL failing autologous HCT. However, in the new scenario, only limited data were reported on allo-HCT as consolidation after salvage with BiAb or CAR-T [7,8,9,10,11], raising concern about feasibility and safety, especially due to high risk of infections [7,8,9].

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Data availability

The datasets analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank the patients and the nursing and support staff at the Hematology and SCT Unit, Ospedale S. Maria della Misericordia di Udine, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.

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Authors and Affiliations

  1. Hematology and SCT Unit, Ospedale S. Maria della Misericordia di Udine, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy

    Gabriele Facchin, Marta Lisa Battista, Jacopo Olivieri, Raffaella Pasquale, Pietro Lauzzana, Giuseppe Petruzzellis, Antonella Geromin, Renato Fanin & Francesca Patriarca

  2. Department of Medicine (DMED), University of Udine, Udine, Italy

    Maria De Martino, Giuseppe Petruzzellis, Miriam Isola, Renato Fanin & Francesca Patriarca

Authors
  1. Gabriele Facchin
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  2. Marta Lisa Battista
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  3. Jacopo Olivieri
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  4. Raffaella Pasquale
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  5. Maria De Martino
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  6. Pietro Lauzzana
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  7. Giuseppe Petruzzellis
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  8. Antonella Geromin
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  9. Miriam Isola
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  10. Renato Fanin
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  11. Francesca Patriarca
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Contributions

GF designed the study, collected and analyzed data, wrote the manuscript; FP, JO, MLB and RF designed the study and performed manuscript revision; RP contributed to data collection, data interpretation and manuscript revision; JO, MDM and MI contributed to statistical analysis; PL, GP and AG participated in data interpretation. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Gabriele Facchin.

Ethics declarations

Competing interests

FP participated in the advisory Board of Menarini, Sanofi, Bristol Meyer Squibb and received lecture honoraria from Johnson & Johnson and Novartis. JO participated in the advisory Board of AbbVie, Kite and Bristol Meyer Squibb. All other authors declared no potential competing interests in relation to this study.

Ethics approval and consent to participate

The study was approved by the Institutional Review Board (IRB) of Department of Medicine (University of Udine) and was conducted in accordance with the Declaration of Helsinki.

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Facchin, G., Battista, M.L., Olivieri, J. et al. Bispecific antibodies followed by allogeneic hematopoietic stem cell transplantation as rescue therapy in refractory/relapsed B cell non-Hodgkin lymphoma: a real-life experience. Bone Marrow Transplant (2026). https://doi.org/10.1038/s41409-026-02812-5

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  • DOI: https://doi.org/10.1038/s41409-026-02812-5

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