High efficacy of BGD (bendamustine, gemcitabine, and dexamethasone) in relapsed/refractory Hodgkin Lymphoma

• Published in: Annals of hematology 2021-07, Vol.100 (7), p.1755-1767
• Main Authors: Swoboda, Ryszard, Giebel, Sebastian, Knopińska-Posłuszny, Wanda, Chmielowska, Ewa, Drozd-Sokołowska, Joanna, Paszkiewicz-Kozik, Ewa, Kulikowski, Waldemar, Taszner, Michał, Mendrek, Włodzimierz, Najda, Jacek, Czerw, Tomasz, Olszewska-Szopa, Magdalena, Czyż, Anna, Giza, Agnieszka, Spychałowicz, Wojciech, Subocz, Edyta, Szwedyk, Paweł, Krzywon, Aleksandra, Wilk, Agata, Zaucha, Jan Maciej
• Format: Article
• Language: English
• Subjects: Chemotherapy; Hematology; Lymphoma; Medicine; Medicine & Public Health; Oncology; Original; Original Article; Steroids
• ISSN: 0939-5555; 1432-0584
• DOI: 10.1007/s00277-021-04448-5

The optimal salvage therapy in relapsed/refractory Hodgkin lymphoma (R/R HL) has not been defined so far. The goal of this multicenter retrospective study was to evaluate efficacy and safety of BGD (bendamustine, gemcitabine, dexamethasone) as a second or subsequent line of therapy in classical R/R HL. We have evaluated 92 consecutive R/R HL patients treated with BGD. Median age was 34.5 (19–82) years. Fifty-eight patients (63%) had received 2 or more lines of chemotherapy, 32 patients (34.8%) radiotherapy, and 21 patients (22.8%) an autologous hematopoietic stem cell transplantation (autoHCT). Forty-four patients (47.8%) were resistant to first line of chemotherapy. BGD therapy consisted of bendamustine 90 mg/m 2 on days 1 and 2, gemcitabine 800 mg/m 2 on days 1 and 4, dexamethasone 40 mg on days 1–4. Median number of BGD cycles was 4 (2–7). The following adverse events ≥ 3 grade were noted: neutropenia (22.8%), thrombocytopenia (20.7%), anemia (15.2%), infections (10.9%), AST/ALT increase (2.2%), and skin rush (1.1%). After BGD therapy, 51 (55.4%) patients achieved complete remission, 23 (25%)—partial response, 7 (7.6%)—stable disease, and 11 (12%) patients experienced progression disease. AutoHCT was conducted in 42 (45.7%) patients after BGD therapy, and allogeneic HCT (alloHCT) in 16 (17.4%) patients. Median progression-free survival was 21 months. BGD is a highly effective, well-tolerated salvage regimen for patients with R/R HL, providing an excellent bridge to auto- or alloHCT.