Abstract P134

IMPACT OF PRE-TRANSPLANT BRENTUXIMAB VEDOTIN ON TOXICITIES AND OUTCOMES OF AUTOLOGOUS STEM CELL TRANSPLANTATION IN PATIENTS WITH RELAPSED/REFRACTORY HODGKIN LYMPHOMA

Background: Up to 30% of patients with Hodgkin lymphoma (HL) will relapse or are refractory to front-line therapy. Salvage chemotherapy followed by autologous stem cell transplantation (ASCT) remains the standard of care in this setting. Brentuximab vedotin (BV) is increasingly used as salvage therapy prior to ASCT in relapsed/refractory (R/R) HL. However, its impact on transplant-related toxicities and outcomes remains unclear.

Methods: We performed a retrospective single-center study including 44 adult patients with R/R HL who underwent ASCT between January 2019 and January 2026. Patients were stratified according to pre-transplant exposure to BV (BV group, n=25) or standard salvage chemotherapy (SOC group, n=19). Mobilization efficacy, engraftment kinetics, toxicities, and post-transplant outcomes were compared.

Results: Median age at transplantation was 35 years (18–62), 54.5% were male. At diagnosis, most patients presented with advanced-stage disease (Lugano stage III–IV, 75.0%), 47.7% with B symptoms and 27.3% with bulky disease. Primary refractory disease following first-line therapy (ABVD) was significantly more frequent in the BV group (80.0% vs 47.4%). Patients in the BV group more frequently received ≥3 regimens prior to ASCT, including BV combined with ESHAP, DHAP, ICE, bendamustine, or anti-PD-1-based therapies. BV-related adverse events were predominantly mild and manageable: ≤G2 peripheral neuropathy (n=2), ≥G3 infections (n=3), and transient ≤G2 hepatic toxicity (n=1). Most patients underwent BEAM conditioning (97.7%). Median infused CD34+ cell dose was comparable between groups, although poor mobilization occurred more frequently among BV-treated patients (16.0%). Median neutrophil and platelet engraftment times were similar between groups. No significant differences were observed regarding infectious complications, hospitalization duration, or transplant-related mortality. CR rates at day +100 post-ASCT were comparable between the BV and SOC groups (72.0% vs 73.7%). No statistically significant differences were observed in PFS or OS between the two groups (figure 1).

Conclusion: These findings support the use of BV-containing regimens as an effective and well-tolerated pre-transplant salvage strategy in R/R HL. BV may reduce exposure to intensive multiagent salvage chemotherapy, although further studies with larger cohorts and longer follow-up are needed to better define its impact on long-term survival outcomes and toxicities.