Contributions
Abstract: PB2418
Type: Publication Only
Background
Patients with Hodgkin’s lymphoma (HL) progression after autologous stem cell transplantation (SCT) have a very poor outcome. Brentuximab vedotin (BV), an anti-CD30 targeting antibody-drug conjugate, has been studied in this patients setting. Allogeneic SCT is the only strategy with a curative potential.
Aims
This study reports a retrospective analysis of the multicenter experience of the Rete Ematologica Pugliese (REP) over the past 16 years with the aim of comparing the patient characteristics and outcomes of 22 BV pre-treated patients with those of 45 patients who received reduced intensity conditioning (RIC) allogeneic SCT without prior BV, in the time period fetore the drug was available (pre-BV era).
Methods
67 patients with a histologically confirmed diagnosis of HL who underwent allogeneic SCT from 2000 to 2016 were retrospectively studied. The median age was 34 years (range 16-57 years) and 36 (54%) were male. At the time of allogeneic SCT, 28 (42%) patients had chemosensitive disease and 39 (58%) were chemorefractory. All the patients received reduced-intensity conditioning, 52% received matched sibling donor and 48% matched-unrelated donor grafts.
Results
Of the 26 patients with chemosensitive disease, 18 (70%) achieved CR, 7 (27%) had PR or stable disease and 1 (3%) had progressive disease. Of the 36 patients with chemorefractory disease 7 achieved CR (20%), 26 had PR or stable disease (72%) and 3 (8%) had progressive disease.
Following transplantation, 40 patients relapsed or progressed at a median time of 6.3 months (range 1- 59 months) post-transplant.
After a median follow-up of 38 months (range 3-195 months) 41 patients remain alive and 26 have died. There were no significant differences between groups in terms of engraftment or acute/chronic GVHD incidence.
For the BV-treated group, the 2-year PFS was 59%, 2-year OS was 72%, 1-year NRM was 10%, and the 2-year relapse/progression incidence was 24%. In the no-BV group the 2-year PFS was 42%, 2-year OS was 60%, 1-year NRM was 18%. The cumulative incidence of relapse/progression at two years was 58%. Patients in the BV group had a lower median SCT-CI score, higher percentages of patients in CR and fewer peri-transplant toxicities.
Conclusion
Allogeneic SCT may be an effective salvage strategy for patients who suffer relapse after autologous SCT. Use of the salvage treatment BV yields improved responses over conventional multi-agent chemotherapy with less toxicity, thereby providing better candidates for allogeneic SCT
The impressive activity of novel regimens, such as PD1 inhibitors, has the potential to further enhance responses and survival in HL patient
Session topic: 23. Stem cell transplantation - Clinical
Abstract: PB2418
Type: Publication Only
Background
Patients with Hodgkin’s lymphoma (HL) progression after autologous stem cell transplantation (SCT) have a very poor outcome. Brentuximab vedotin (BV), an anti-CD30 targeting antibody-drug conjugate, has been studied in this patients setting. Allogeneic SCT is the only strategy with a curative potential.
Aims
This study reports a retrospective analysis of the multicenter experience of the Rete Ematologica Pugliese (REP) over the past 16 years with the aim of comparing the patient characteristics and outcomes of 22 BV pre-treated patients with those of 45 patients who received reduced intensity conditioning (RIC) allogeneic SCT without prior BV, in the time period fetore the drug was available (pre-BV era).
Methods
67 patients with a histologically confirmed diagnosis of HL who underwent allogeneic SCT from 2000 to 2016 were retrospectively studied. The median age was 34 years (range 16-57 years) and 36 (54%) were male. At the time of allogeneic SCT, 28 (42%) patients had chemosensitive disease and 39 (58%) were chemorefractory. All the patients received reduced-intensity conditioning, 52% received matched sibling donor and 48% matched-unrelated donor grafts.
Results
Of the 26 patients with chemosensitive disease, 18 (70%) achieved CR, 7 (27%) had PR or stable disease and 1 (3%) had progressive disease. Of the 36 patients with chemorefractory disease 7 achieved CR (20%), 26 had PR or stable disease (72%) and 3 (8%) had progressive disease.
Following transplantation, 40 patients relapsed or progressed at a median time of 6.3 months (range 1- 59 months) post-transplant.
After a median follow-up of 38 months (range 3-195 months) 41 patients remain alive and 26 have died. There were no significant differences between groups in terms of engraftment or acute/chronic GVHD incidence.
For the BV-treated group, the 2-year PFS was 59%, 2-year OS was 72%, 1-year NRM was 10%, and the 2-year relapse/progression incidence was 24%. In the no-BV group the 2-year PFS was 42%, 2-year OS was 60%, 1-year NRM was 18%. The cumulative incidence of relapse/progression at two years was 58%. Patients in the BV group had a lower median SCT-CI score, higher percentages of patients in CR and fewer peri-transplant toxicities.
Conclusion
Allogeneic SCT may be an effective salvage strategy for patients who suffer relapse after autologous SCT. Use of the salvage treatment BV yields improved responses over conventional multi-agent chemotherapy with less toxicity, thereby providing better candidates for allogeneic SCT
The impressive activity of novel regimens, such as PD1 inhibitors, has the potential to further enhance responses and survival in HL patient
Session topic: 23. Stem cell transplantation - Clinical