Outcomes of patients with relapsed/refractory Hodgkin lymphoma progressing after autologous stem cell transplant in the current era of novel therapeutics: A retrospective analysis

Am J Hematol. 2017 Sep;92(9):879-884. doi: 10.1002/ajh.24792. Epub 2017 Jun 9.

Abstract

Patients with relapsed/refractory Hodgkin lymphoma (RR-HL) who progress or relapse following autologous stem cell transplantation (ASCT) have historically had a poor prognosis. Several novel agents, particularly brentuximab vedotin, have shown efficacy in this setting. However, there remains a paucity of data characterizing outcomes outside of clinical trials and how these novel agents have impacted prognosis in general population of patients with RR-HL. Here, we conducted a retrospective analysis to evaluate outcomes in 87 patients with RR-HL with relapse post-ASCT. Treatment with novel agents (including brentuximab vedotin) was associated with significant improvement in median overall survival (OS) compared to patients who did not receive novel agents (85.6 vs 17.1 months; P < .001). Additional factors associated with improved OS in univariate analysis include treatment with radiation therapy post-ASCT (34.1 vs 17.0 months; P = .015), chemosensitivity (i.e., relapsed compared to primary refractory disease; 51.8 vs 25.6 months; p = 0.013), initial response to ASCT (i.e., CR/PR compared to SD/PD; 46.1 vs 20.4 months; P = .011), and transplantation in 2010 and later compared to prior to 2010 (not reached vs 24.5 months; P = .025). The current study demonstrates markedly improved OS in RR-HL patients treated with novel therapeutics and lends "real world" credence to the role of these agents in improving outcomes in the current era.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Autografts
  • Brentuximab Vedotin
  • Disease-Free Survival
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Hodgkin Disease / mortality*
  • Hodgkin Disease / therapy*
  • Humans
  • Immunoconjugates / administration & dosage*
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Survival Rate

Substances

  • Immunoconjugates
  • Brentuximab Vedotin