Abstract P019

Real-World Treatment Options and Outcomes of Hodgkin Lymphoma in Hungary

Background: Survival outcomes in Hodgkin lymphoma (HL) have markedly improved, with 80–90% of patients now curable. A nationwide initiative was launched in Hungary to evaluate real-world treatment patterns and compare them with international results. Since January 2021, 17 of 20 hematology centers have contributed data.

Aims: To assess epidemiology, treatment approaches, and survival outcomes of HL patients diagnosed between 2021–2023 in Hungary, with special focus on stage IV disease and the real‐world introduction of brentuximab vedotin (A) + AVD.

Methods: Patients diagnosed and treated for HL between 01/01/2021 and 12/31/2023 were analyzed. Progression-free survival (PFS) and overall survival were evaluated by stage and treatment. A+AVD was accessible only for stage IV patients through individual reimbursement requests, typically allowing its use from cycle 3 after initial ABVD. Stage IV patients were grouped into: ABVD (n=75); ABVD → AVD with negative interim PET/CT (n=15); A+AVD from cycle 1 (n=6); ABVD → A+AVD following approval (n=12). Interim PET/CT was evaluated using the Deauville score.

Results: A total of 385 HL patients were identified (204 female, 181 male). Of these, 361 had classical HL and received curative-intent therapy (187 early-stage, 149 advanced-stage). Sixteen patients received non-standard therapy due to age or comorbidities. The 2‐year PFS was 87.6% in early-stage and 79.9% in advanced-stage disease. Twenty‐seven early-stage and 32 advanced-stage patients were refractory or relapsed. In stage III, 2‐year PFS was 90.5%; in stage IV, 75.7% (p=0.024), lower than international benchmarks. In stage IV, combined ABVD/AVD groups (1+2) achieved a 2‐year PFS of 75.6%, while brentuximab-treated groups (3+4) reached 77.8%. No relapses or deaths occurred after 2 years in patients receiving any brentuximab vedotin. Group-specific 2‐year PFS was: 76% (group 1), 73.3% (group 2), 50% (group 3), and 91.7% (group 4) (p=0.04). Interim PET/CT was Deauville 4 in three patients each in groups 3 and 4.

Summary/Conclusion: Real‐world PFS of stage IV HL patients in Hungary was inferior to outcomes from clinical trials. Nevertheless, adding brentuximab vedotin improved PFS even when initiated after initial ABVD cycles. Although subgroup numbers were small, the findings provide important real‐world evidence supporting the use of brentuximab vedotin in advanced HL.