Abstract P127

(Bv)DHAP + G-CSF as an effective peripheral stem cell mobilization regimen in adult patients with relapsed/refractory Hodgkin lymphoma

High-dose chemotherapy with autologous stem cell transplantation (auto-HSCT) remains the accepted standard of care for patients with Hodgkin lymphoma (HL) that has failed or relapsed after first-line chemotherapy. Mobilization of hematopoietic stem cells (HSCs, CD34+ cells) into the peripheral blood is a crucial step. In 5-40% of patients with relapsed or refractory HL, mobilization is ineffective. The use of chemomobilization regimens (chemotherapy followed by the administration of G-GSF) can be highly effective.

Aim: to determine the dynamics of CD34+ cells in peripheral blood and evaluate the effectiveness using peripheral stem cell mobilization regimen (Bv)DHAP + G-CSF in adult patients with HL.

Material and methods: the study included 115 adult patients with refractory form or a relapse of HL, treated at the Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology from 2019 to 2025. As a peripheral stem cell mobilization regimen (Bv)DHAP + G-HSF (10 mcg/kg/day from the 9th day until the mobilization effect was achieved) was administered. The number of CD34+ cells in peripheral blood was determined from days 14 to 17 using flow cytometry. Mobilization was considered effective when the CD34+ cell level reached 10 cells/μl. Continuous and categorical variables are presented as median (interquartile range) and abs. (%); for categorical variables, when demonstrating differences in the compared groups, the odds ratio (OR) is determined.

Results: 60 women (52.2%), 55 men (47.8%); median age 35 years. After salvage therapy 73 (63,5%) patients had a complete response. The number of previous lines of therapy in patients ranged from 2 to 5. Mobilization effect was achieved in 93 patients (80.9%) from days 14 to 17, while no effect was achieved in 22 (19.1%). The median maximum number of circulating CD34+ cells in peripheral blood using the (Bv)DHAP + G-CSF HSC mobilization regimen is shown in Figure. The following statistically significant risk factors for unsatisfactory mobilization were identified: 3 or more lines of chemotherapy (OR 4.26 [1.6 – 11.8]), platelet count less 200 (OR 2.9 [1 – 8.5]); leukocyte count 4.5 or less (OR 3.26 [1.15 – 8.5]) in patients before the mobilization regimen.

Conclusion: (Bv)DHAP + G-CSF was found to be an effective peripheral stem cell mobilization regimen in adult patients with relapsed/refractory Hodgkin lymphoma. The mobilization effect may be achieved in 80.9%.