The 18th International Conference on Malignant Lymphoma (ICML), hosted by the Institute of Oncology Research (IOR), took place in Lugano, Switzerland, from June 17 to 21, 2025. As one of the most prestigious global events in hematologic malignancies, ICML brought together thousands of hematologists, clinical oncologists, radiation oncologists, and basic researchers from around the world to explore the evolving landscape of lymphoma biology, translational medicine, and clinical innovation.At the conference, Professor Ali Bazarbachi from the American University of Beirut Medical Center presented updated findings on the long-term outcomes of autologous and allogeneic stem cell transplantation for relapsed Hodgkin lymphoma. Based on extensive data from the EBMT Lymphoma Working Party, his presentation revealed a consistent improvement in transplant outcomes over time and identified key factors driving this progress. In an exclusive interview with Oncology Frontier – Hematology Frontier, Prof. Bazarbachi shared insights into the clinical impact and future direction of these advancements.Oncology Frontier – Hematology Frontier: Based on EBMT data, what are the core drivers behind the improved transplant outcomes for relapsed Hodgkin lymphoma in the past decade? How much of this is due to new drugs versus transplant technique innovations?
Prof. Ali Bazarbachi: Representing the EBMT Lymphoma Working Party, this study comprehensively analyzed long-term follow-up data from over 16,000 patients who underwent autologous and 4,000 patients who underwent allogeneic hematopoietic stem cell transplantation for Hodgkin lymphoma. Both strategies showed a steady improvement in clinical outcomes, particularly in progression-free survival (PFS) and overall survival (OS), largely due to a marked reduction in relapse rates.
In autologous transplantation, two main factors have driven this progress. First, an increasing proportion of patients are in complete remission (CR) at the time of transplant, with a rising rate of PET-negative scans before the procedure. This means fewer patients with active disease or refractory lymphoma are undergoing transplantation. Second, there has been a significant shift in pre-transplant treatment regimens, most notably the growing use of brentuximab vedotin (BV), which has contributed to higher CR rates at transplant and improved post-transplant survival. Importantly, for patients already in CR at the time of transplant, long-term outcomes have remained relatively stable, suggesting that improved patient selection is the primary driver of better results in this setting.
In contrast, the improvements seen in allogeneic transplantation are more multifactorial. While the proportion of CR patients has also increased, and the use of checkpoint inhibitors and BV in the pre-transplant phase has grown, these factors alone do not fully account for the observed survival benefits. The data show that technical advances in transplant procedures themselves are playing a crucial role. For example, pre-transplant checkpoint blockade has been associated with reduced relapse rates and improved PFS and OS. Furthermore, the increasing use of post-transplant cyclophosphamide for GVHD prophylaxis correlates with both lower relapse risk and higher survival rates.
In summary, the improved outcomes in allogeneic transplantation result from a combination of optimized disease status at transplant, the clinical integration of novel pre-transplant agents, and significant progress in post-transplant management. These findings provide strong evidence to support the continued evolution of transplant strategies in relapsed Hodgkin lymphoma.
Oncology Frontier – Hematology Frontier: Your team has extensive experience with CAR-T therapy in B-cell lymphomas. What CAR-T products are currently available for treating B-cell lymphomas, and what are their respective characteristics?
Prof. Ali Bazarbachi: In the current landscape of CAR-T therapy for B-cell non-Hodgkin lymphoma, both commercial products and investigational academic products coexist. Among the commercial options, CD19 remains the most critical target antigen for B-cell malignancies. Several CD19-directed CAR-T products have been widely adopted in clinical practice: for instance, Tisa-cel, Axi-cel, and Liso-cel are commonly used for diffuse large B-cell lymphoma (DLBCL), while Brexu-cel is approved for mantle cell lymphoma.
Meanwhile, multiple academic institutions around the world are actively developing new-generation CAR-T products. A notable example is the varnimcabtagene autoleucel (ARI-0001) developed by a team in Barcelona, Spain.
These CAR-T products differ significantly in their technological design. Key differences lie in the lentiviral vector construction strategies, intracellular signaling domain architecture, and expression profiles of T-cell activation markers. Clinically, some products may offer enhanced anti-tumor efficacy but come with a higher risk of toxicities. However, we currently lack direct, head-to-head randomized controlled trial data comparing these products. Most available evidence comes from retrospective studies or indirect cross-trial comparisons, which inherently carry a lower level of evidence and less robust conclusions than prospective randomized trials.
Therefore, when interpreting data on efficacy and safety across different CAR-T therapies, it is essential to recognize the limitations of the study designs. Going forward, well-designed comparative trials will be crucial for defining the precise clinical value of each product.
Ali Bazarbachi American University of Beirut Medical Center
- Professor of Medicine in Hematology and Oncology
- Professor of Anatomy, Cell Biology, and Physiological Sciences
- Associate Dean for Basic Research
- Director of the Bone Marrow Transplantation Program
Dr. Bazarbachi earned both his MD and PhD degrees from Université Paris VII in France, where he also completed his residency and specialty training.
His research focuses on oncogene-targeted therapies for human leukemias and lymphomas, as well as pharmacologic interventions following stem cell transplantation. He has authored over 300 publications in top-tier journals such as The New England Journal of Medicine, Science, Journal of Experimental Medicine, The Lancet Oncology, Journal of Clinical Oncology, Blood, Nature Communications, Leukemia, Cell Death and Differentiation, Oncogene, and Cancer Research, and serves as a reviewer for many of them.
His accolades include the Ligue Nationale Contre le Cancer Research Award, the CEDRE Award, the 2008 Académie Nationale de Médecine Prize (France), the Distinguished Investigator Award from the National Council for Scientific Research in Lebanon, the Clinical/Translational Research Award from the International Retrovirology Conference, and the Lifetime Achievement Award in Scientific Excellence from the Lebanese Association for the Advancement of Science.
He is a former President of the Lebanese Society of Hematology, past Chair of the EBMT Lymphoma Working Party, and served as Chair of the NCCN Middle East and North Africa Lymphoma Group. He is also Deputy Editor of the journal Bone Marrow Transplantation.
