Brentuximab vedotin for recurrent Hodgkin lymphoma after allogeneic hematopoietic stem cell transplantation: A report from the EBMT Lymphoma Working Party

Ali Bazarbachi (1) , Ariane Boumendil (2) , Hervé Finel (2) , Mohamad Mohty (2, 3) , Luca Castagna (4) , Didier Blaise (5) , Karl S Peggs (6) , Boris Afanasyev , J.L. L Diez-Martin (7) , Paolo Corradini (8) , David Michonneau (9) , Stephen Robinson (10) , Gonzalo Gutiérrez García , Francesca Bonifazi , Ibrahim Yakoub-Agha (11, 12) , Zafer Gülbas , Adrian Bloor , Jeremy Delage (13, 14) , Albert Esquirol , Ram Malladi (15) , Christof Scheid (16) , Jean El-Cheikh (1) , Hervé Ghesquieres (17) , Silvia Montoto , Peter Dreger (18) , Anna Sureda

1 AUB - American University of Beirut [Beyrouth]
2 CHU Saint-Antoine [AP-HP]
3 SU - Sorbonne Université
4 IRCCS Milan - Istituto Clinico Humanitas [Milan]
5 IPC - Institut Paoli-Calmettes
6 UCLH - University College London Hospitals
7 Hospital General Universitario "Gregorio Marañón" [Madrid]
8 Fondazione IRCCS Istituto Nazionale Tumori - National Cancer Institute [Milan]
9 AP-HP - Hopital Saint-Louis [AP-HP]
10 University Hospitals Bristol
11 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
12 LIRIC - Lille Inflammation Research International Center - U 995
13 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
14 CHU - Hôpital Lapeyronie [Montpellier]
15 Queens Elizabeth Hospital [Birmingham]
16 University Hospital of Cologne [Cologne]
17 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
18 Heidelberg University Hospital [Heidelberg]

BACKGROUND: The treatment of patients with Hodgkin lymphoma (HL) who develop disease progression after undergoing allogeneic stem cell transplantation (allo-SCT) remains challenging. METHODS: The authors assessed outcomes in 184 adult patients with HL who developed disease recurrence or progression after a matched related or unrelated allo-SCT at European Society for Blood and Marrow Transplantation-participating centers between 2010 and 2014. RESULTS: Eighty patients who received brentuximab vedotin (BV) salvage therapy were compared with 104 patients who did not. Patients in the BV group were younger (median age of 30 years vs 34 years) and were more likely to receive pretransplant BV (65% vs 46%) or posttransplant donor lymphocyte infusion (66% vs 33%). The 2 groups otherwise were comparable. Patients in the BV group received a median of 6 doses of posttransplant BV, resulting in a complete remission rate of 29%, a partial response rate of 45%, and a stable disease rate of 26%. Response to BV after allo-SCT did not appear to be affected by receipt of pretransplant BV. Despite a longer median follow-up for surviving patients in the BV group (33 months vs 23 months; P<.001), approximately 34% of the original BV cohort were alive and in CR at the time of last follow-up versus 18% in the group that did not receive BV (P=.003). The use of BV before donor lymphocyte infusion was found to be associated with the highest probability of being alive and in CR (40%) at the time of last follow-up. Salvage BV appeared to have no effect on chronic graft-versus-host disease or 1-year overall survival from the time of disease recurrence after allo-SCT (76% vs 67%). CONCLUSIONS: BV is a safe and effective salvage therapy for patients with HL who develop disease recurrence or progression after undergoing allo-SCT, even after prior exposure to BV.

Mots clés: Hodgkin lymphoma; allogeneic stem cell transplantation (allo-SCT); brentuximab vedotin; donor lymphocyte infusion; recurrence

Domaines: Cancer; Hématologie; Immunothérapie

Ali Bazarbachi, Ariane Boumendil, Hervé Finel, Mohamad Mohty, Luca Castagna, et al.. Brentuximab vedotin for recurrent Hodgkin lymphoma after allogeneic hematopoietic stem cell transplantation: A report from the EBMT Lymphoma Working Party. Cancer, 2019, 125 (1), pp.90-98. ⟨10.1002/cncr.31755⟩. ⟨hal-01981651⟩