Consolidation Therapy with Brentuximab Vedotin after Autologous Stem Cell Transplantation for Relapsed/Refractory Hodgkin Lymphoma in the Czech Republic.
Consolidation therapy with brentuximab vedotin (BV) following autologous stem cell transplantation (ASCT) has demonstrated improved progression-free survival (PFS) in high-risk patients (pts) with relapsed/refractory classic Hodgkin lymphoma (cHL) in the AETHERA trial. We have analysed data from seven centres of intensive haematological care in the Czech Republic between January 2015 and December 2021 based on real-life experience with the treatment. The primary goals included basic statistical decription, assessment of the PFS and toxicity of the treatment.
Patients and methods:
All of the pts were treated with high-dose chemotherapy and ASCT in the first relapse, all had at least one of the risk factors as per AETHERA and no previous treatment with BV. We have analysed 39 pts treated with BV 1.8 mg/kg i.v. every 3 weeks for a maximum of 16 cycles.
Median age was 37 years (range 19-65) at the time of the first dose of BV. Nearly 80% of pts were initially treated as advanced stage cHL and eBEACOPP was administered in 59% of pts in the frontline setting. Primary refractory or early relapsed (within 12 months after the frontline therapy) cHL pts represented 69% of the analysed cohort. Two different salvage regimens were administered in 30.8% and failure to achieve a complete response (CR) after salvage chemotherapies prior ASCT was seen in 64% of pts. The median number of BV administered was 8 (1-16), with 16 completed cycles in 20.5% pts. Main reasons for early discontinuation were neuropathy and relapsed or progressive disease, both in 15.4%. Overall, 82% of pts achieved CR during the treatment. With a median follow-up 28 months the 2-year PFS was 66.2% (95% CI 0.52-0.85) and the 2-year overall survival was 95% (95% CI 0.82-1.00). Two pts died, one of progressive lymphoma and one of severe bacterial infection. Peripheral sensory neuropathy occurred in 38.5% (grade 3-4 in 10.3%), neutropenia in 28.2% (grade 3-4 in 17.9%) and respiratory infections in 28.5% (grade 3-4 in 2.6%).
Despite some differences in the analysed groups, our results are comparable with a few real-world data published lately and support the notion that BV consolidation improves PFS in patients with at least one risk factor for subsequent relapse of cHL and has a feasible and manageable toxicity.
Supported by following grants:
MH CZ – DRO (FNOl, 00098892)