Brentuximab vedotin prior to allogeneic stem cell transplantation increases survival in chemorefractory Hodgkin's lymphoma patients

Ann Hematol. 2019 Jun;98(6):1449-1455. doi: 10.1007/s00277-019-03662-6. Epub 2019 Mar 14.

Abstract

This study reports a retrospective multicenter experience by the Rete Ematologica Pugliese (REP) over the past 16 years, aiming to compare the patients characteristics and outcomes of 21 brentuximab vedotin (BV)-pre-treated patients to 51 patients who received reduced-intensity conditioning (RIC) allogeneic stem cell transplantation (SCT) without prior BV. In total, 72 patients with classical Hodgkin's lymphomas who received allogeneic SCT were retrospectively studied. Prior use of BV had no effect on either engraftment or the incidence and severity of acute graft versus host disease (GVHD). Indeed, a lower incidence of chronic GVHD was observed in the BV group, with a 43% cumulative incidence at 3 years versus 47% in the no BV group, although this was not statistically significant. Despite the low incidence of chronic GVHD, survival was not worse in the BV-treated group: 3-year progression-free survival (PFS) was 53%, 3-year overall survival (OS) was 62%, 3-year non-relapse mortality (NRM) was 24%. In the no BV group, the 3-year PFS was 33%, 3-year OS was 44%, and 3-year NRM was 14%. In chemorefractory patients at the time of transplant, we found a statistically significant difference in PFS between the BV and no BV groups (51% vs. 10%, p = 0.013).

Keywords: Allogeneic stem cell transplant; Brentuximab vedotin; Hodgkin lymphoma.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Agents, Immunological / administration & dosage
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Marrow Transplantation
  • Brentuximab Vedotin
  • Combined Modality Therapy
  • Drug Resistance, Neoplasm
  • Female
  • Graft vs Host Disease / epidemiology
  • Graft vs Host Disease / etiology
  • Hematopoietic Stem Cell Transplantation*
  • Hodgkin Disease / drug therapy
  • Hodgkin Disease / mortality
  • Hodgkin Disease / therapy*
  • Humans
  • Immunoconjugates / administration & dosage
  • Immunoconjugates / therapeutic use*
  • Male
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation
  • Premedication
  • Progression-Free Survival
  • Retrospective Studies
  • Salvage Therapy
  • Transplantation Conditioning / methods
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult

Substances

  • Antineoplastic Agents, Immunological
  • Immunoconjugates
  • Brentuximab Vedotin