TP53-Altered Aggressive Large B-Cell Lymphoma (LBCL) Outcomes by Treatment Modality: A Multicenter Cohort From 14 US Centers
In brief
First-line chemoimmunotherapy can cure TP53-altered aggressive large B-cell lymphoma
In the largest multicenter cohort of TP53-altered LBCL, standard chemoimmunotherapy given with curative intent achieved durable remissions, indicating many patients can be cured without novel agents. In second- and third-line settings, outcomes were similar across therapies, although CAR-T improved progression-free survival for double-hit cases. The results suggest early use of conventional therapy remains appropriate, while the role of newer treatments in relapsed disease warrants further study.
- Journal
- European journal of haematology (Q1)
- Published
- 18 September 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Cassandra Duarte, Grace N Bosma, Diana Abbott, Gaston Jean-Louis, Maciej Kabat, Daniel Stapor, et al.
- PMID
- 42758055
- DOI
- 10.1111/ejh.70330
Why clinicians should know about it
- Picked for Hematology (paper of the day, 21 September 2026): Outcomes of TP53‑altered LBCL across treatment lines
Abstract
Advances in the treatment of large B-cell lymphoma (LBCL) have expanded therapeutic options beyond conventional chemoimmunotherapy to include cellular and targeted therapies. There is growing interest in identifying subsets of LBCL that may benefit from these novel approaches based on histopathologic and molecular features. Molecular subclassification has identified an LBCL A53 phenotype characterized by TP53 alterations, a subgroup historically associated with poor outcomes following standard therapy. To better define progression-free and overall survival outcomes in TP53-altered LBCL in the contemporary treatment era, we conducted a multicenter cohort study evaluating responses to first-, second-, and third-line therapies. Our findings demonstrate that TP53-altered LBCL can be cured with first-line curative intent chemoimmunotherapy. In the second and third-line setting, outcomes did not significantly differ between different treatment approaches, though improved PFS was seen with CAR-T in the second line for double hit patients. This study represents the largest reported cohort of patients with TP53-altered LBCL and provides important insights into treatment outcomes across lines of therapy in the era of novel agents.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.