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Cancer. 2019 Jan 1;125(1):90-98. doi: 10.1002/cncr.31755. Epub 2018 Oct 23.

Brentuximab vedotin for recurrent Hodgkin lymphoma after allogeneic hematopoietic stem cell transplantation: A report from the EBMT Lymphoma Working Party.

Author information

1
Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
2
European Society for Blood and Marrow Transplantation Lymphoma Working Party Paris Office, Saint-Antoine Hospital, Paris, France.
3
Department of Hematology and Cell Therapy, Saint Antoine Hospital, Sorbonne University, Paris, France.
4
Department of Hematology and Oncology, Humanitas Clinic Institute, Rozzano Milan, Italy.
5
Department of Hematology, Paoli Calmettes Institute, Marseille, France.
6
Department of Hematology, University College London Hospital, London, United Kingdom.
7
Department of Hematology, First State Pavlov Medical University of St. Petersburg, St. Petersburg, Russia.
8
Department of Hematology, Gregorio Maranon Hospital, Madrid, Spain.
9
Department of Hematology, IRCCS National Cancer Institute, University of Milan, Milan, Italy.
10
Department of Hematology and Stem Cell Transplant, St. Louis Hospital, Paris, France.
11
Department of Hematology and Oncology, University Hospital Bristol, Bristol, United Kingdom.
12
Department of Hematology and Oncology, Hospital Clinic, Barcelona, Spain.
13
Department of Hematology and Medical Oncology, Hematology Department "Seragnoli," S. Orsola-Malpighi University Hospital, Bologna, Italy.
14
Department of Hematology, Lille Regional Hospital Center, LIRIC INSERM U995, Lille University, Lille, France.
15
Department of Hematologic Oncology and Bone Marrow Transplantation, Anadolu Medical Center Hospital, Kocaeli, Turkey.
16
Department of Hematology and Stem Cell Transplant, Christie NHS Foundation Trust, Manchester, United Kingdom.
17
Department of Clinical Hematology, Lapeyronie Regional Hospital Center, Montpellier, France.
18
Department of Hematology, Santa Creu i Sant Pau Hospital, Barcelona, Spain.
19
Department of Hematology, Queen Elizabeth Hospital, Birmingham, United Kingdom.
20
Department of Internal Medicine, University of Cologne, Cologne, Germany.
21
Department of Hematology, South Lyon Medical Center, Lyon, France.
22
Department of Haemato-oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.
23
Department of Medicine V, University of Heidelberg, Heidelberg, Germany.
24
Department of Haematology, Catala Oncology Institute, Barcelona, Spain.

Abstract

BACKGROUND:

The treatment of patients with Hodgkin lymphoma (HL) who develop disease progression after undergoing allogeneic stem cell transplantation (allo-SCT) remains challenging.

METHODS:

The authors assessed outcomes in 184 adult patients with HL who developed disease recurrence or progression after a matched related or unrelated allo-SCT at European Society for Blood and Marrow Transplantation-participating centers between 2010 and 2014.

RESULTS:

Eighty patients who received brentuximab vedotin (BV) salvage therapy were compared with 104 patients who did not. Patients in the BV group were younger (median age of 30 years vs 34 years) and were more likely to receive pretransplant BV (65% vs 46%) or posttransplant donor lymphocyte infusion (66% vs 33%). The 2 groups otherwise were comparable. Patients in the BV group received a median of 6 doses of posttransplant BV, resulting in a complete remission rate of 29%, a partial response rate of 45%, and a stable disease rate of 26%. Response to BV after allo-SCT did not appear to be affected by receipt of pretransplant BV. Despite a longer median follow-up for surviving patients in the BV group (33 months vs 23 months; P<.001), approximately 34% of the original BV cohort were alive and in CR at the time of last follow-up versus 18% in the group that did not receive BV (P=.003). The use of BV before donor lymphocyte infusion was found to be associated with the highest probability of being alive and in CR (40%) at the time of last follow-up. Salvage BV appeared to have no effect on chronic graft-versus-host disease or 1-year overall survival from the time of disease recurrence after allo-SCT (76% vs 67%).

CONCLUSIONS:

BV is a safe and effective salvage therapy for patients with HL who develop disease recurrence or progression after undergoing allo-SCT, even after prior exposure to BV.

KEYWORDS:

Hodgkin lymphoma; allogeneic stem cell transplantation (allo-SCT); brentuximab vedotin; donor lymphocyte infusion; recurrence

PMID:
30351488
DOI:
10.1002/cncr.31755
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