Abstract
Up to 30% of patients with classical Hodgkin lymphoma (cHL) are not responsive to frontline therapy or relapse after primary treatment. In these cases, autologous hematopoietic stem cell transplantation (AHSCT) is the standard of care. The combination of brentuximab vedotin and bendamustine (BV + B) is an effective salvage regimen in this challenging subpopulation. This nationwide multicenter study investigated the real-world efficacy and safety of the BV + B regimen as a bridge to AHSCT in patients with primary refractory or relapsed cHL. A total of 41 cHL patients underwent AHSCT after receiving at least 1 cycle of BV + B (with brentuximab vedotin given at 1.8 mg/kg on day 1 and bendamustine at 90 mg/m2 on days 1–2 every 4 weeks). After a median of 3 (1–6) cycles of BV + B, the objective response rate was 78%, with 29 (70.7%) patients achieving complete remission. Twelve (29.3%) patients relapsed after AHSCT, 2 (4.9%) of them died, while 2 (4.9%) patients are lost to follow-up. After a median of 17 months of follow-up, the estimated 2-year overall- and progression-free survival after AHSCT was 93 and 62%, respectively. Features of advanced disease at recurrence (p = 0.038) and the presence of stage IV cHL at relapse (p = 0.024) are strong predictor markers of unfavorable outcomes. Twenty-four (58.5%) patients experienced adverse events of any grade, while no grade IV toxicities were reported. BV + B is an effective salvage option with a manageable toxicity profile in cHL. The real-world safety and efficacy of this combination are similar to the observations made on the study population.
Highlights
With the new risk- and response-adapted treatment modalities, classical Hodgkin lymphoma became a highly curable hematologic malignancy, with 80–90% of patients achieving long-term remission after standard first-line therapy [1, 2]
Several prognostic factors associated with an increased risk of relapse following autologous hematopoietic stem cell transplantation (AHSCT) include primary refractory classical Hodgkin lymphoma (cHL), stage IV disease at relapse, extranodal involvement, presence of B symptoms, and less than a complete remission (CR) to salvage therapy before AHSCT [4]
Achievement of CR by positron emission tomography/computed tomography (PET/CT) before AHSCT is a strong predictor for a favorable outcome [5,6,7,8,9]
Summary
With the new risk- and response-adapted treatment modalities, classical Hodgkin lymphoma (cHL) became a highly curable hematologic malignancy, with 80–90% of patients achieving long-term remission after standard first-line therapy [1, 2]. 20–30% of cHL patients have primary refractory disease or will experience recurrence. In these patients, an autologous hematopoietic stem cell transplantation (AHSCT) is the standard of care, despite the 50% relapse rate after transplantation in cHL [3]. Several prognostic factors associated with an increased risk of relapse following AHSCT include primary refractory cHL, stage IV disease at relapse, extranodal involvement, presence of B symptoms, and less than a complete remission (CR) to salvage therapy before AHSCT [4]. Achievement of CR by positron emission tomography/computed tomography (PET/CT) before AHSCT is a strong predictor for a favorable outcome [5,6,7,8,9].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
