Potential Survival Benefit for Patients Receiving Allogeneic Hematopoietic Stem Cell Transplantation after Nivolumab Therapy for Relapse/Refractory Hodgkin Lymphoma: Real-Life Experience in Spain

Martı́nez, Carmen; Carpio, Cecilia; Heras, Inmaculada; Ríos-Herranz, Eduardo; Buch, Joan; Gutiérrez, Antonio; Romero, Samuel; Ceberio, Izaskun; García-García, Irene; Rodriguez-Izquierdo, Antonia; Alonso, Rosalía; Bargay, Joan; Barrenetxea, Cristina; Domingo‐Domènech, Eva; Haro, Manuel Espeso de; Palomera, Luis

doi:10.1016/j.bbmt.2020.02.003

Cited by 19 publications

(19 citation statements)

References 20 publications

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“…Multivariate analysis has demonstrated that the incidence of GVHD was reduced in patients with a longer interval between CPI treatment and transplantation [14]. It was proved that the attainment of chemosensitivity before transplantation remains the main goal of our therapeutic approaches and translates into the success of the procedure [9][10][11]15]. That was also true for our small analysis.…”

Section: Discussionsupporting

confidence: 53%

“…Relapsed and refractory HL is undeniably associated with poor prognosis, and allo-SCT remains the only potentially therapeutic option. Of note, the introduction of BV/CPI induced a deeper clinical response in those who failed prior ASCT and increased the number of patients who could proceed to allotransplantation [9,10]. It was demonstrated that BV/CPI used as a "bridge" to transplantation may offer survival benefits in this poor prognosis population.…”

Section: Discussionmentioning

confidence: 99%

“…A proportion of these patients proceeded to allo-SCT and remained in sustained CR [11]. In turn, OS was higher in patients who responded to CPI and received allotransplantation [10]. It should be highlighted that BV/ CPI have only been available for Polish HL patients in recent years.…”

Section: Discussionmentioning

confidence: 99%

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Allogeneic Stem Cell Transplantation for Relapsed and Refractory Hodgkin Lymphoma: Real World Experience of a Single Center

Kopińska

Koclęga

Wieczorkiewicz-Kabut

et al. 2021

Pathol. Oncol. Res.

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Introduction: Refractory and relapsed Hodgkin lymphoma (R/R HL) is associated with poor prognosis, and allogeneic stem cell transplantation (allo-SCT) remains the only potentially curative approach.Aim: The aim of the study was to evaluate the feasibility of allotransplantation in R/R HL setting.Material: Overall, 24 patients (17 men and 7 women) at a median age of 27 years (range 18–44) underwent allo-SCT between 2002 and 2020.Results: Nineteen patients received prior autologous stem cell transplantation (ASCT1) whereas eight patients received second ASCT (ASCT2) after failure of ASCT1. Six patients received only brentuximab vedotin (BV; n = 4) or BV followed by checkpoint inhibitors (CPI; n = 2) before entering allo-SCT. Median time from ASCT1 to allo-SCT was 17.1 months. Fifteen patients received grafts from unrelated donors. Peripheral blood was a source of stem cells for 16 patients. Reduced-intensity conditioning was used for all patients. Disease status at transplant entry was as follows: complete remission (CR; n = 4), partial response (PR; n = 10), and stable disease (SD; n = 10). Acute and chronic graft-versus-host disease (GVHD) developed in 13 (54%) and 4 (16%) patients, respectively. Median follow-up for the entire cohort was 13.3 months. At the last follow-up, 17 (71%) patients died. The main causes of death were disease progression (n = 10), infectious complications (n = 6), and steroid-resistant GVHD (n = 1). Non-relapse mortality at 12 months was 25%. At the last follow-up, seven patients were alive; six patients were in CR, and one had PR. The 2-year overall survival (OS) was 40%.Conclusion: Chemosensitive disease at transplant was associated with better outcome. Allo-SCT allows for long-term survival in refractory and relapsed HL.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

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Allogeneic Stem Cell Transplantation for Relapsed and Refractory Hodgkin Lymphoma: Real World Experience of a Single Center

Kopińska

Koclęga

Wieczorkiewicz-Kabut

et al. 2021

Pathol. Oncol. Res.

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“…18 In addition, there is some evidence that CPi before allo-HSCT may be associated more frequently with liver veno-occlusive disease, severe (grade IV) GVHD, and noninfectious febrile syndrome responding to steroids. 9,[19][20][21] Within this therapeutic scenario, it could be possible to have a small subset of patients in which it was impossible to utilize auto-HSCT consolidation during their prior treatments because of refractory status and/or of poor performance status/comorbidities.…”

Section: Discussionmentioning

confidence: 99%

“…Given the complexity of both patient and timing selection, specific recommendations on the application of CPi in the context of allo‐HSCT have been published recently 18 ; experts in the field recommend to keep responder patients on CPi rather than stopping treatment and proceeding to allo‐HSCT, whereas heavily pretreated patients due to multiply refractory disease are the ones who should be considered for an early allo‐HSCT, right after the first documentation of response to CPi treatment 18 . In addition, there is some evidence that CPi before allo‐HSCT may be associated more frequently with liver veno‐occlusive disease, severe (grade IV) GVHD, and noninfectious febrile syndrome responding to steroids 9,19–21 …”

Section: Discussionmentioning

confidence: 99%

Potential survival benefit for patients receiving autologous hematopoietic stem cell transplantation after checkpoint inhibitors for relapsed/refractory Hodgkin lymphoma: A real‐life experience

Casadei

Argnani

Morigi

et al. 2020

Hematological Oncology

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In recent years, novel drugs are available for the patients with relapsed/refractory Hodgkin lymphoma (HL), like immune checkpoint inhibitors (CPi). These drugs have been able to rescue a cohort of patients who subsequently could receive an allogeneic stem-cell transplant (SCT). No data were reported for subsequent autologous SCT (ASCT) after CPi. Here, we report our real-life experience in heavily pretreated HL patients undergoing ASCT as consolidation approach after CPi treatment. A retrospective observational study was conducted. Patients had CPi therapy in the context of clinical trials (n ¼ 6) or in the named patient program (n ¼ 7) between July 2014 and November 2019: 9 out of 13 received pembrolizumab and the remaining four underwent nivolumab. A median of 12 cycles (range, 3-16) of CPi therapy were infused. Thirteen patients underwent ASCT after CPi: 11 (84.6%) patients obtained a complete response (CR) and 2 had progression of disease, with an overall response rate of 84.6%. With a median follow-up of 3.3 years (range, 1.1-5.5), only one CR patient had disease relapse after 3.9 months from ASCT, leading to an estimated disease-free survival of 87.5% at 56.9 months. The estimated 5-year progression-free survival was 73.4% and overall survival was 92.3% at 4.8 years, respectively. No unexpected or cumulative toxicity was observed. Our results indicated that ASCT may represent a further effective therapeutic option as consolidation in HL after CPi treatment that today represents the last conventionally recognized therapeutic line.

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Post‐hematopoietic stem cell transplantation relapse: Role of checkpoint inhibitors

Roshandel

Tavakoli

Parkhideh

et al. 2022

Health Science Reports

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Background and Aims Despite the revolutionary effects of hematopoietic stem cell transplantation (HSCT) in treating hematological malignancies, post‐HSCT relapse is considered a critical concern of clinicians. Residual malignant cells employ many mechanisms to evade immune surveillance and survive to cause relapse after transplantation. One of the immune‐frustrating mechanisms through which malignant cells can compromise the antitumor effects is misusing the self‐limiting system of immune response by overexpressing inhibitory molecules to interact with the immune cells, leading them to so‐called “exhausted” and ineffective. Introduction of these molecules, known as immune checkpoints, and blocking them was a prodigious step to decrease the relapses. Methods Using keywords nivolumab , pembrolizumab , and ipilimumab , we investigated the literature to figure out the role of the immune checkpoints in the HSCT setting. Studies in which these agents were administrated for relapse after transplantation were reviewed. Factors such as the interval from the transplant to relapse, previous treatment history, adverse events, and the patients’ outcome were extracted. Results Here we provided a mini‐review discussing the experiences of three immune checkpoints, including nivolumab, pembrolizumab, and ipilimumab, as well as the pros and cons of using their blockers in relapse control after HSCT. In conclusion, it seems that CI therapy seems effective for this population. Future investigations may provide detailed outlook of this curative options.

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Potential Survival Benefit for Patients Receiving Allogeneic Hematopoietic Stem Cell Transplantation after Nivolumab Therapy for Relapse/Refractory Hodgkin Lymphoma: Real-Life Experience in Spain

Cited by 19 publications

References 20 publications

Allogeneic Stem Cell Transplantation for Relapsed and Refractory Hodgkin Lymphoma: Real World Experience of a Single Center

Allogeneic Stem Cell Transplantation for Relapsed and Refractory Hodgkin Lymphoma: Real World Experience of a Single Center

Potential survival benefit for patients receiving autologous hematopoietic stem cell transplantation after checkpoint inhibitors for relapsed/refractory Hodgkin lymphoma: A real‐life experience

Post‐hematopoietic stem cell transplantation relapse: Role of checkpoint inhibitors

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