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Blood. 2017 May 4;129(18):2471-2478. doi: 10.1182/blood-2016-11-749556. Epub 2017 Mar 7.

Efficacy and tolerability of nivolumab after allogeneic transplantation for relapsed Hodgkin lymphoma.

Author information

1
Centre Hospitalier Universitaire (CHU) Lille, Service des Maladies du Sang, Lille, France.
2
Service d'Onco-hématologie, CHU Paris Saint-Louis, Lariboisière, Paris, France.
3
Université Lille Nord de France, Equipe Biostatistique, Lille, France.
4
Département d'Hématologie Oncopole, Toulouse, France.
5
Service d'Onco-hématologie, CHU de Tours, Tours, France.
6
Service d'Onco-hématologie, CHU de Strasbourg, Strasbourg, France.
7
Service des Maladies du Sang, Hôpital Haut-Lévèque, Pessac, France.
8
Department of Hematology, CHU Rennes, Rennes, France.
9
Service d'Onco-hématologie, Unicancer, Lyon, France.
10
Service d'Onco-hématologie, CHU de Bordeaux, Bordeaux, France.
11
Service d'Onco-hématologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France.
12
Service des Maladies du Sang, Institut Gustave Roussy, Villejuif, France.
13
Service des Maladies du Sang, CHU de Grenoble, Grenoble, France.
14
Service d'Onco-hématologie, CHU de Besançon, Besançon, France.
15
Lille Inflammation Research International Center INSERM U995, Lille, France; and.
16
Université de Lille, Groupe de Recherche sur les Formes Injectables et les Technologies Associées, Lille, France.

Abstract

Allogeneic hematopoietic cell transplantation (allo-HCT) is indicated for patients with relapsed or refractory Hodgkin lymphoma (HL). Although long-term disease control can be achieved, relapse is still frequent. The programmed cell death protein 1 (PD-1) pathway-blocking antibody nivolumab has shown substantial therapeutic activity and an acceptable safety profile in patients with relapsed or refractory HL who did not receive allo-HCT. However, PD-1 blocking strategy can increase the risk of graft-versus-host disease (GVHD) in murine models. We retrospectively assessed the efficacy and toxicity of nivolumab as a single agent in 20 HL patients relapsing after allo-HCT. GVHD occurred in 6 patients (30%) after nivolumab initiation. All 6 patients had prior history of acute GVHD. The patients with nivolumab-induced GVHD were managed by standard treatment for acute GVHD. Two patients died as a result of GVHD, 1 of progressive disease and 1 of complications related to a second allo-HCT. Overall response rate was 95%. At a median follow-up of 370 days, the 1-year progression-free survival rate was 58.2% (95% CI, 33.1%-76.7%) and the overall survival rate was 78.7% (95% CI, 52.4%-91.5%). Among 13 patients still in response, 6 received a single dose of nivolumab and 7 remain on nivolumab. Compared with standard options for this indication, our results show that nivolumab is effective with an acceptable safety profile.

PMID:
28270452
DOI:
10.1182/blood-2016-11-749556
[Indexed for MEDLINE]
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