Overall survival of patients with cHL who progress after autologous stem cell transplant: results in the novel agent era

• Type of Material: Article
• Authors: Sanjal H. Desai, University of Minnesota, Minneapolis; Michael A. Spinner, University of California, San Francisco; Andrew M. Evens, Rutgers Cancer Institute of new Jersey; Alice Sykorova, University Hospital, Hradec Kralove; veronika Bachanova, University of Minnesota, Minneapolis; Gaurav Goyal, University of Alabama, Birmingham; Brad Kahl, Washington University, St. Louis; Kathleen Dorritie, UPMC Hillman Cancer Center; Jacues Azzi, Icahn School of Medicine Mount Sinai; Vaishalee P. Kenkre, University of Wisconsin, Madison; Cheryl Chang, Stanford University; Jozef Michalka, University Hospital Brno; Stephen M. Ansell, Mayo Clinic, Rochester; Brendon Fusco, Rutgers Cancer Institute of New Jersey; Nuttavut Sumransub, University of Minnesota, Minneapolis; Haris hatic, University of Alabama, Birmingham; raya Saba, Washington University, St. Louis; Uroosa Ibrahim, Icahn School of Medicine Mount Sinai; Elyse I. Harris, University of Wisconsin, Madison; Harsh Shah, University of Utah, Salt Lake City; Nina Wagner-Johnston, The Sidney Kimmer Comprehensive Cancer Center; Sally Arai, Stanford University; Grzegorz S. Nowakowski, Mayo Clinic, Rochester; Heidi Mocikova, Charles University; Deepa Jagadeesh, Cleveland Clinic Foundation; Kristie A. Blum, Emory University; Catherine Diefenbach, New York University; Siddharth Iyengar, University of Utah, Salt Lake City; K.C. Rappazzo, The Sidney Kimmel Comprehensive Cancer Center; Firas Baidoun, Cleveland Clinic Foundation; Yun Choi, New York University; Vit Prochazka, Palacky University; Ranjana H. Advani, Stanford University; Ivana Micallef, Mayo Clinic, Rochester
• Language: English
• Date: 2023-09-22
• Publisher: American Society of Hematology
• Publication Version: Final Published Version
• Copyright Statement: © 2023 by The American Society of Hematology.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1182/bloodadvances.2023011205
• Title of Journal or Parent Work: Blood Advances
• Volume: 7
• Issue: 23
• Start Page: 7295
• End Page: 7303
• Keywords: autologous stem cell transplant; postprogression; classic Hodgkin lymphoma; hematology
• Research Categories: Health Sciences, Public Health; Health Sciences, Oncology; Health Sciences, Immunology

Abstract

In the pre–novel agent era, the median postprogression overall survival (PPS) of patients with classic Hodgkin lymphoma (cHL) who progress after autologous stem cell transplant (ASCT) was 2 to 3 years. Recently, checkpoint inhibitors (CPI) and brentuximab vedotin (BV) have improved the depth and durability of response in this population. Here, we report the estimate of PPS in patients with relapsed cHL after ASCT in the era of CPI and BV. In this multicenter retrospective study of 15 participating institutions, adult patients with relapsed cHL after ASCT were included. Study objective was postprogression overall survival (PPS), defined as the time from posttransplant progression to death or last follow-up. Of 1158 patients who underwent ASCT, 367 had progressive disease. Median age was 34 years (range, 27-46) and 192 were male. Median PPS was 114.57 months (95% confidence interval [CI], 91-not achieved) or 9.5 years. In multivariate analysis, increasing age, progression within 6 months, and pre-ASCT positive positron emission tomography scan were associated with inferior PPS. When adjusted for these features, patients who received CPI, but not BV, as first treatment for post-ASCT progression had significantly higher PPS than the no CPI/no BV group (hazard ratio, 3.5; 95% CI, 1.6-7.8; P = .001). Receipt of allogeneic SCT (Allo-SCT) did not improve PPS. In the era of novel agents, progressive cHL after ASCT had long survival that compares favorably with previous reports. Patients who receive CPI as first treatment for progression had higher PPS. Receipt to Allo-SCT was not associated with PPS in this population.