Real-world efficacy of brentuximab vedotin plus bendamustine as a bridge to autologous hematopoietic stem cell transplantation in primary refractory or relapsed classical Hodgkin lymphoma

• Published in: Annals of hematology 2020-10, Vol.99 (10), p.2385-2392
• Main Authors: Pinczés, László Imre, Szabó, Roxána, Illés, Árpád, Földeák, Dóra, Piukovics, Klára, Szomor, Árpád, Gopcsa, László, Miltényi, Zsófia
• Format: Article
• Language: English
• Subjects: Hematology; Immunotherapy; Lymphoma; Medicine; Medicine & Public Health; Monoclonal antibodies; Oncology; Original; Original Article; Stem cell transplantation; Stem cells; Targeted cancer therapy
• ISSN: 0939-5555; 1432-0584
• DOI: 10.1007/s00277-020-04204-1

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/m 2 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.