P109: One-Day Brentuximab-Bendamustine (120mg/m2) every 21 days is a feasible and safe treatment for relapsed/refractory Hodgkin lymphoma

Abstract

Brentuximab(1.8 mg/kg day 1) plus Bendamustine (90mg/m2 day 1 and 2) every 28 days is a new therapeutic combination for relapsed/refractory (R/R) Hodgkin lymphoma (HL), mainly as salvage therapy and bridge to autologous stem-cell transplantation (ASCT) but is associated to high toxicity. We conducted a retrospective study in St Louis Hospital in Paris between 2015 and 2021 to assess the feasibility and tolerance of one-day Brentuximab-Bendamustine (120mg/m2) every 21 days for R/R HL. All patients for whom one-day Brentuximab-Bendamustine (120mg/m2) every 21 days was prescribed between 2015 and 2021 were identified from the Chimioweb platform and medical data were collected from Middlecare software. Characteristics of population were detailed. Feasibility and toxicities were reported. Progression-free survival (PFS) and overall survival (OS) were calculated. Three patients were excluded (one in complete response at beginning, one who refused therapy and one lost to follow-up with second cancer). Forty-three patients were included, with a median age of 45 years old (19 to 76) at time of treatment. Relapse or progression was of advanced stage for 63% of patients and occurred after a median of 2 former lines. Sixteen patients (37%) had only one line before. Eleven (26%) patients already had an ASCT and 2 (5%) an allogenic stem cell transplantation. Twenty-seven patients (63%) and 12 (28%) had respectively a relapsed or refractory HL. Four patients (9%) had a secondary HL. A median of 5 cycles was administered. For 32 patients (74,4% [95%CI, 74 to 74,8]) treatment was conducted until its end and did not need any adaptation for toxicity. Main causes of adaptation were anaphylaxis (7%), neutropenia (2%), infection (2%) and peripheral neuropathy (2%). Anaphylactic reactions occurred in 16 patients (37%), of which one was grade 3 and no grade 4. For 8 of these patients (50%), reaction was resolved after prescription of pre-medication. Grade 3–4 neutropenia and thrombocytopenia occurred in respectively 3 (7%) and 2 (5%) patients. Only one febrile neutropenia was reported. After treatment, overall response rate was of 84%, with 31 (72%) complete responses, 5 (12%) partial responses, 1 (2%) stable disease and 5 (12%) progressive diseases. We suggest that one-day Brentuximab-Bendamustine (120mg/m2) ever 21 days is a safe and feasible treatment for R/R HL. Main limiting toxicity was anaphylactic reaction, which was well managed with premedication.