The standard management for relapsed or refractory classical Hodgkin lymphoma (cHL) is salvage therapy followed by autologous stem cell transplantation (ASCT). This strategy allows almost 50% of patients to be cured. Post-ASCT maintenance treatment with brentuximab vedotin (BV) confers improved progression-free survival (PFS) to cHL patients at high risk of relapse. We investigated the outcome of 105 cHL patients receiving post-ASCT BV maintenance in the real-life setting of 23 Italian hematology centers. This population included naïve patients and those previously exposed to BV. Median follow-up was 20 months. Patients presented a median of two lines of treatment pre-ASCT, with 51% receiving BV. Twenty-nine percent of patients had at least two high-risk factors (refractory disease, complete response [CR] less than 12 months, extranodal disease at relapse), while 16% presented none. At PET-CT, a Deauville score (DS) of 1–3 was reported in 75% and 78% of pre- and post-ASCT evaluations, respectively. Grade 3–4 adverse events (AEs), mainly peripheral neuropathy, were observed in 16% of patients. Three-year PFS and overall survival (OS) were 62% and 86%, respectively. According to BV exposure, 3-year PFS and OS were 54% and 71%, respectively, for naïve and 77% and 96%, respectively, for previously exposed patients. Refractory disease (hazard ratio [HR] 4.46; p = 0.003) and post-ASCT DS 4–5 (HR 3.14; p = 0.005) were the only two factors significantly associated with PFS reduction in multivariable analysis. Post-ASCT BV maintenance is an effective, safe treatment option for cHL naïve patients and those previously exposed to BV.

Brentuximab vedotin consolidation after autologous stem cell transplantation for Hodgkin lymphoma: A Fondazione Italiana Linfomi real-life experience / Massaro, F.; Pavone, V.; Stefani, P. M.; Botto, B.; Pulsoni, A.; Patti, C.; Cantonetti, M.; Visentin, A.; Scalzulli, P. R.; Rossi, A.; Galimberti, S.; Cimminiello, M.; Gini, G.; Musso, M.; Sorio, M.; Arcari, A.; Zilioli, V. R.; Luppi, M.; Mannina, D.; Fabbri, A.; Pietrantuono, G.; Annibali, O.; Tafuri, A.; Prete, E.; Mule, A.; Barbolini, E.; Marcheselli, L.; Luminari, S.; Merli, F.. - In: HEMATOLOGICAL ONCOLOGY. - ISSN 0278-0232. - 40:1(2022), pp. 31-39. [10.1002/hon.2939]

Brentuximab vedotin consolidation after autologous stem cell transplantation for Hodgkin lymphoma: A Fondazione Italiana Linfomi real-life experience

Massaro F.
Writing – Original Draft Preparation
;
Patti C.;Luppi M.;Luminari S.;
2022-01-01

Abstract

The standard management for relapsed or refractory classical Hodgkin lymphoma (cHL) is salvage therapy followed by autologous stem cell transplantation (ASCT). This strategy allows almost 50% of patients to be cured. Post-ASCT maintenance treatment with brentuximab vedotin (BV) confers improved progression-free survival (PFS) to cHL patients at high risk of relapse. We investigated the outcome of 105 cHL patients receiving post-ASCT BV maintenance in the real-life setting of 23 Italian hematology centers. This population included naïve patients and those previously exposed to BV. Median follow-up was 20 months. Patients presented a median of two lines of treatment pre-ASCT, with 51% receiving BV. Twenty-nine percent of patients had at least two high-risk factors (refractory disease, complete response [CR] less than 12 months, extranodal disease at relapse), while 16% presented none. At PET-CT, a Deauville score (DS) of 1–3 was reported in 75% and 78% of pre- and post-ASCT evaluations, respectively. Grade 3–4 adverse events (AEs), mainly peripheral neuropathy, were observed in 16% of patients. Three-year PFS and overall survival (OS) were 62% and 86%, respectively. According to BV exposure, 3-year PFS and OS were 54% and 71%, respectively, for naïve and 77% and 96%, respectively, for previously exposed patients. Refractory disease (hazard ratio [HR] 4.46; p = 0.003) and post-ASCT DS 4–5 (HR 3.14; p = 0.005) were the only two factors significantly associated with PFS reduction in multivariable analysis. Post-ASCT BV maintenance is an effective, safe treatment option for cHL naïve patients and those previously exposed to BV.
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Brentuximab vedotin consolidation after autologous stem cell transplantation for Hodgkin lymphoma: A Fondazione Italiana Linfomi real-life experience / Massaro, F.; Pavone, V.; Stefani, P. M.; Botto, B.; Pulsoni, A.; Patti, C.; Cantonetti, M.; Visentin, A.; Scalzulli, P. R.; Rossi, A.; Galimberti, S.; Cimminiello, M.; Gini, G.; Musso, M.; Sorio, M.; Arcari, A.; Zilioli, V. R.; Luppi, M.; Mannina, D.; Fabbri, A.; Pietrantuono, G.; Annibali, O.; Tafuri, A.; Prete, E.; Mule, A.; Barbolini, E.; Marcheselli, L.; Luminari, S.; Merli, F.. - In: HEMATOLOGICAL ONCOLOGY. - ISSN 0278-0232. - 40:1(2022), pp. 31-39. [10.1002/hon.2939]
Massaro, F.; Pavone, V.; Stefani, P. M.; Botto, B.; Pulsoni, A.; Patti, C.; Cantonetti, M.; Visentin, A.; Scalzulli, P. R.; Rossi, A.; Galimberti, S.; Cimminiello, M.; Gini, G.; Musso, M.; Sorio, M.; Arcari, A.; Zilioli, V. R.; Luppi, M.; Mannina, D.; Fabbri, A.; Pietrantuono, G.; Annibali, O.; Tafuri, A.; Prete, E.; Mule, A.; Barbolini, E.; Marcheselli, L.; Luminari, S.; Merli, F.
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