Outcomes associated with allogeneic hematopoietic stem cell transplantation for relapsed and refractory Hodgkin lymphoma in the era of novel agents

Abstract

Background Relapsed or refractory Hodgkin lymphoma (R/R HL) is a challenging disease with limited treatment options beyond brentuximab vedotin and checkpoint inhibitors. Herein we present the time‐trend analysis of R/R HL patients who received allogeneic hematopoietic cell transplantation (allo‐HCT) at our center from 2001–2017. Methods The patients were divided into two distinct treatment cohorts: era1 (2001–2010), and era2 (2011–2017). The primary endpoint was overall survival (OS). Secondary endpoints included progression‐free survival (PFS), non‐relapse mortality (NRM), and cumulative incidence of acute and chronic graft versus host disease (GVHD). Results Among the 51 patients included in the study, 29 were in era1, and 22 were in era2. There was decreased use of myeloablative conditioning in era2 (18% vs. 31%) compared to era1 and 95% of patients in era2 previously received brentuximab Vedotin (BV). Haploidentical donors were seen exclusively in era2 (0% vs. 14%) and more patients received alternative donor transplants (7% vs. 32%) in era2. The 4‐year OS (34% vs. 83%, p < 0.001) and 4‐year PFS (28% vs. 62%, p = 0.001) were significantly inferior in era1 compared to era2. The incidence of 1‐year NRM was lower in era2 compared to era1 (5% vs. 34%, p = 0.06). The cumulative incidence of acute GVHD at day 100 was similar in both eras (p = 0.50), but the incidence of chronic GVHD at 1 year was higher in era2 compared to era1 (55% vs. 21%, p = 0.03). Conclusions Despite the advent of novel therapies, allo‐HCT remains an important therapeutic option for patients with R/R HL.

Peripherally inserted central catheter insertion and management in Hodgkin and non-Hodgkin lymphomas: a 13-year monocentric experience

“…Despite the different therapeutic approaches, treatments for NHL (3)(4)(5) and HL (6)(7)(8) patients require the administration of immunochemotherapy and radiotherapy with different schedules (depending on histotype, stage, age, and fitness), often on an outpatient basis. Autologous (9)(10)(11) and allogeneic peripheral hematopoietic stem cell transplantation (12,13) (HSCT) may also be an important option for both populations, especially in relapsed/ refractory (R/R) patients. Recently, chimeric antigen T-cell therapy (14-17) and bispecific antibodies (18) have shown high efficacy in R/R NHL patients and have been included in algorithms for the treatment of patients with mantle cell lymphoma (MCL) and diffuse large B-cell lymphoma (DLBCL).…”