Author:
Nieto Yago,Gruschkus Stephen,Valdez Benigno C,Jones Roy B,Anderlini Paolo,Hosing Chitra,Popat Uday,Qazilbash Muzaffar,Kebriaei Partow,Alousi Amin,Saini Neeraj,Srour Samer,Rezvani Katayoun,Ramdial Jeremy,Barnett Melissa,Gulbis Alison,Shigle Terri Lynn,Ahmed Sairah,Iyer Swaminathan,Lee Hun,Nair Ranjit,Parmar Simrit,Steiner Raphael,Dabaja Bouthaina,Pinnix Chelsea,Gunther Jillian,Cuglievan Branko,Mahadeo Kris,Khazal Sajad,Chuang Hubert,Champlin Richard,Shpall Elizabeth J,Andersson Borje S
Abstract
High-dose chemotherapy and autologous stem-cell transplant (HDC/ASCT) is standard treatment of chemosensitive relapsed classical Hodgkin lymphoma (cHL), although outcomes of high-risk relapse (HRR) patients remain suboptimal. We retrospectively analyzed all HRR cHL patients treated with HDC/ASCT at our institution between 01/01/2005-12/31/2019. HRR criteria included primary refractory disease/relapse within 1 year, extranodal extension, B symptoms, requiring > 1 salvage line, or PET+ disease at ASCT. All patients met the same ASCT eligibility criteria. We treated 501 patients with BEAM (N=146), BuMel (N=38), GemBuMel (N=189) and vorinostat/GemBuMel (N=128). The GemBuMel and vorinostat/GemBuMel cohorts had more HRR criteria and more patients with PET+ disease at ASCT. Pre-ASCT BV, anti-PD1, PET-negative disease at ASCT, and maintenance BV increased over time. BEAM and BuMel predominated in earlier years (2005-2007), GemBuMel and BEAM in middle years (2008-2015), and vorinostat/GemBuMel and BEAM in later years (2016-2019). Median follow-up is 50 months (6-186). Outcomes improved over time, with 2-year PFS/OS rates of 58%/82% (2005-2007), 59%/83% (2008-2011), 71%/94% (2012-2015) and 86%/99% (2016-2019) (P
Publisher
Ferrata Storti Foundation (Haematologica)