Hodgkin’s lymphoma: post- autologous transplantation consolidation therapy
Keywords:
Hodgkin Lymphoma, consolidation therapy, post-autologous trasplantationAbstract
A first-line chemotherapy program based on the ABVD regimen is currently considered the golden standard by most hematologists, being able to achieve a cure without any need of subsequent therapies in >70% of patients with advanced-stage Hodgkin’s lymphoma (HL). To increase this percentage, efforts in recent decades focused on the development of new therapeutic strategies. A first major effort was the introduction of the BEACOPP chemotherapy regimen, which is able to increase the response rate and to reduce the need of salvage therapies. However, this result did not demonstrate an advantage in terms of overall survival compared to ABVD, mainly due to an excess of non lymphoma-related events in the follow-up phase. Here we describe three clinical cases of young HL patients who had relapsed/refractory disease after the induction chemotherapy. These three clinical cases provide practical and real world evidence in favor of the use of BV in monotherapy as consolidation treatment after autologous stem cells transplantation in patients with relapsed/refractory HL.
References
1. Viviani S, Zinzani PL, Rambaldi A, et al; Intergruppo Italiano Linfomi. ABVD versus BEACOPP for Hodgkin’s lymphoma when high-dose salvage is planned. N Engl J Med. 2011;365(3):203-212.
2. Merli F, Luminari S, Gobbi PG, et al. Long-term results of the HD2000 trial comparing ABVD versus BEACOPP versus COPP-EBV-CAD in untreated patients with advanced Hodgkin lymphoma: a study by Fon- dazione Italiana Linfomi. J Clin Oncol. 2016;34(11):1175-1181.
3. Johnson P, Federico M, Kirkwood A, et al. Adapted treatment guided by interim PET-CT scan in advanced Hodgkin’s lymphoma. N Engl J Med. 2016;374(25):2419-2429.
4. Radford J, Illidge T, Counsell N, et al. Results of a trial of PET-di- rected therapy for early- stage Hodgkin’s lymphoma. N Engl J Med. 2015;372(17):1598-1607.
5. Schmitz N, Pfistner B, Sextro M, et al; Lym- phoma Working Party of the European Group for Blood and Marrow Transplantation. Ag- gressive conventional chemotherapy compared with high-dose chemo- therapy with autologous haemopoietic stem-cell trans- plantation for relapsed chemosensitive Hodgkin’s disease: a randomised trial. Lancet. 2002;359(9323):2065-2071.
6. Linch DC, Winfield D, Goldstone AH, et al. Dose intensification with autologous bone- marrow transplantation in relapsed and re- sistant Hodgkin’s disease: results of a BNLI randomised trial. Lancet. 1993;341(8852): 1051-1054
7. Younes A, Gopal AK, Smith SE, et al. Results of a pivotal phase II study of brentuximab vedotin for patients with relapsed or refractory Hodg- kin’s lymphoma. J Clin Oncol. 2012; 30(18):2183-2189.
8. Chen R, Gopal AK, Smith SE, et al. Five-year survival and durability results of brentuximab vedotin in patients with relapsed or refractory Hodgkin lymphoma. Blood. 2016;128(12): 1562-1566.
9. Moskowitz CH, Nademanee A, Masszi T, et al; AETHERA Study Group. Brentuximab vedotin as consolidation therapy after autologous stem-cell transplantation in patients with Hodgkin’s lymphoma at risk of relapse or progression (AETHERA): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2015;385(9980):1853-1862.
10. Sweetenham JW, Walewski J, Nadamanee A, et al. Updated efficacy and safety data from the AETHERA Trial of consolidation with brentuxi- mab vedotin after autologous stem cell transplant (ASCT) in Hodgkin lymphoma patients at high risk of relapse. Biol Blood Marrow Trans- plant. 2016;22(3):S36-S37.
11. Moskowitz C. Novel agents and strategies in transplant-eligible patients with relapsed and refractory Hodgkin lymphoma. Hematology Am Soc Hematol Educ Program. 2016; 2016(1):331-338.
12. Ramsey SD, Nademanee A, Masszi T, et al. Quality of life results from a phase 3 study of brentuximab vedotin consolidation following autolo- gous haematopoietic stem cell trans- plant for persons with Hodgkin lymphoma. Br J Haematol. 2016;175(5):860-867.
13. Moskowitz AJ, Yahalom J, Kewalramani T, et al. Pretransplantation functional imaging predicts outcome following autologous stem cell transplantation for relapsed and refractory Hodgkin lymphoma. Blood. 2010;116(23): 4934-4937.
14. Shah GL, Yahalom J, Matasar MJ, et al. Risk factors predicting out- comes for primary re- fractory Hodgkin lymphoma patients treated with salvage chemotherapy and autologous stem cell transplantation. Br J Haematol. 2016;175(3):1-8.
15. Chen R, Palmer JM, Martin P, et al. Results of a multicenter phase II trial of brentuximab vedotin as second-line therapy before auto- logous transplantation in relapsed/refractory Hodgkin lymphoma. Biol Blood Marrow Transplant. 2015;21(12):2136-2140.
16. Hui L, von Keudell G, Wang R, Zeidan AM, Gore SD, Ma X, Davidoff AJ, Huntington SF Cost-effectiveness analysis of consolidation with brentuximab vedotin for high-risk Hodgkin lymphoma after autologous stem cell transplantation. Cancer. 2017 Oct;123(19):3763-3771.
17. Barrington SF, Mikhaeel NG, Kostakoglu L, Meignan M, Hutchings M, Mueller SP, et al. Role of imaging in the staging and response as- sessment of lymphoma: consensus of the International Conference on Malignant Lymphomas Imaging Working Group. J Clin Oncol 2014;32(27):3048–58.
18. Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Lister TA. Recommendations for initial evaluation, staging, and response as- sessment of Hodgkinand non-Hodgkin lymphoma: the Lugano classifi- cation. J Clin Oncol 2014;32(27):3059–68.
19. Adams HJ, Kwee TC, Fijnheer R, Dubois SV, Nievelstein RA, de Klerk JM Diffusely increased bone marrow FDG uptake in recently untreated lymphoma: incidence and relevance. Eur J Haematol 2014.
20. Swerdlow SH, Campo E,Harris N, et al., eds. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: In-
ternational Agency for Research on Cancer; 2008.
21. Adams HJ, Nievelstein RA, Kwee TC. Opportunities and limitations of bone marrow biopsy and bone marrow FDG-PET in lymphoma. Blood Rev. 2015 Nov;29(6):417-25.
22. Gopal AK, Chen R, Smith SE, Ansell SM, Rosenblatt JD, Savage KJ, Connors JM, Engert A, Larsen EK, Chi X, Sievers EL, Younes A Durable remissions in a pivotal phase 2 study of brentuximab ve- dotin in relapsed or refractory Hodgkin lymphoma. Blood. 2015 Feb 19;125(8):1236-43.
23. Garciaz S, Coso D, Peyrade F, et al. Brentuximab vedotin followed by allogeneic transplantation as salvage regimen in patients with re- lapsed and/or refractory Hodgkin’s lymphoma. Hematol Oncol. 2014;32(4):187-191.
24. Gibb A, Jones C, Bloor A, et al. Brentuximab vedotin in refractory CD301 lymphomas: a bridge to allogeneic transplantation in approxi- mately one quarter of patients treated on a Named Patient Programme at a single UK center. Haematologica. 2013;98(4):611-614.
25. Gautam A, Zhu Y, Ma E, Lee SY, Zagadailov E, Teasell J, Richhariya A, Bonthapally V, Huebner D Brentuximab vedotin consolidation post- autologous stem cell transplant in Hodgkin lymphoma patients at risk of residual disease: number needed to treat. Leuk Lymphoma. 2018 Jan;59(1):69-76
26. Jiang Y, Chen Y, Huang R, et al. Comparison of the efficiency of ABVD versus BEACOPP for Hodgkin lymphoma treatment: a meta-analysis. Int J Hematol. 2016; 104(4):413-419.
27. Santoro A, Mazza R, Pulsoni A, et al. Bendamustine in Combination With Gemcitabine and Vinorelbine Is an Effective Regimen As Induc- tion Chemotherapy Before Autologous Stem-Cell Transplantation for Relapsed or Refractory Hodgkin Lymphoma: Final Results of a Multi- center Phase II Study. J Clin Oncol. 2016;34(27):3293-9.
28. Bekoz H, Karadurmus N, Paydas S, et al. Nivolumab for relapsed or refractory Hodgkin lymphoma: real-life experience. Ann Oncol. 2017; 28(10):2496-2502.
29. Chen R, Zinzani PL, Fanale MA, et al. Phase II study of the efficacy and safety of Pembrolizumab for relapsed/refractory classic Hodgkin lym- phoma. J Clin Oncol. 2017; 35(19):2125-2132.
30. Ijaz A, Khan AY, Malik SU, et al. Significant risk of graft-versus-host disease with exposure to checkpoint inhibitors before and after alloge- neic transplantation. Biol Blood Marrow Tranplant. 2019; 25(1):94-99.
31. Bazarbachi A, Boumendil A, Finel H, et al. Brentuximab vedotin prior to allogeneic stem cell transplantation in Hodgkin lymphoma: a report from the EBMT Lymphoma Working Party. Br J Haematol. 2018; 181(1):86-96. Joseph M. Connors JM, Jurczak W, Straus DJ, et al. Brentuximab Vedotin with Chemotherapy for Stage III or IV Hodgkin’s Lymphoma. N Engl J Med 2018; 378:331-344
32. Joseph M. Connors JM, Jurczak W, Straus DJ, et al. Brentuximab Ve- dotin with Chemotherapy for Stage III or IV Hodgkin’s Lymphoma. N Engl J Med 2018; 378:331-344
2. Merli F, Luminari S, Gobbi PG, et al. Long-term results of the HD2000 trial comparing ABVD versus BEACOPP versus COPP-EBV-CAD in untreated patients with advanced Hodgkin lymphoma: a study by Fon- dazione Italiana Linfomi. J Clin Oncol. 2016;34(11):1175-1181.
3. Johnson P, Federico M, Kirkwood A, et al. Adapted treatment guided by interim PET-CT scan in advanced Hodgkin’s lymphoma. N Engl J Med. 2016;374(25):2419-2429.
4. Radford J, Illidge T, Counsell N, et al. Results of a trial of PET-di- rected therapy for early- stage Hodgkin’s lymphoma. N Engl J Med. 2015;372(17):1598-1607.
5. Schmitz N, Pfistner B, Sextro M, et al; Lym- phoma Working Party of the European Group for Blood and Marrow Transplantation. Ag- gressive conventional chemotherapy compared with high-dose chemo- therapy with autologous haemopoietic stem-cell trans- plantation for relapsed chemosensitive Hodgkin’s disease: a randomised trial. Lancet. 2002;359(9323):2065-2071.
6. Linch DC, Winfield D, Goldstone AH, et al. Dose intensification with autologous bone- marrow transplantation in relapsed and re- sistant Hodgkin’s disease: results of a BNLI randomised trial. Lancet. 1993;341(8852): 1051-1054
7. Younes A, Gopal AK, Smith SE, et al. Results of a pivotal phase II study of brentuximab vedotin for patients with relapsed or refractory Hodg- kin’s lymphoma. J Clin Oncol. 2012; 30(18):2183-2189.
8. Chen R, Gopal AK, Smith SE, et al. Five-year survival and durability results of brentuximab vedotin in patients with relapsed or refractory Hodgkin lymphoma. Blood. 2016;128(12): 1562-1566.
9. Moskowitz CH, Nademanee A, Masszi T, et al; AETHERA Study Group. Brentuximab vedotin as consolidation therapy after autologous stem-cell transplantation in patients with Hodgkin’s lymphoma at risk of relapse or progression (AETHERA): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2015;385(9980):1853-1862.
10. Sweetenham JW, Walewski J, Nadamanee A, et al. Updated efficacy and safety data from the AETHERA Trial of consolidation with brentuxi- mab vedotin after autologous stem cell transplant (ASCT) in Hodgkin lymphoma patients at high risk of relapse. Biol Blood Marrow Trans- plant. 2016;22(3):S36-S37.
11. Moskowitz C. Novel agents and strategies in transplant-eligible patients with relapsed and refractory Hodgkin lymphoma. Hematology Am Soc Hematol Educ Program. 2016; 2016(1):331-338.
12. Ramsey SD, Nademanee A, Masszi T, et al. Quality of life results from a phase 3 study of brentuximab vedotin consolidation following autolo- gous haematopoietic stem cell trans- plant for persons with Hodgkin lymphoma. Br J Haematol. 2016;175(5):860-867.
13. Moskowitz AJ, Yahalom J, Kewalramani T, et al. Pretransplantation functional imaging predicts outcome following autologous stem cell transplantation for relapsed and refractory Hodgkin lymphoma. Blood. 2010;116(23): 4934-4937.
14. Shah GL, Yahalom J, Matasar MJ, et al. Risk factors predicting out- comes for primary re- fractory Hodgkin lymphoma patients treated with salvage chemotherapy and autologous stem cell transplantation. Br J Haematol. 2016;175(3):1-8.
15. Chen R, Palmer JM, Martin P, et al. Results of a multicenter phase II trial of brentuximab vedotin as second-line therapy before auto- logous transplantation in relapsed/refractory Hodgkin lymphoma. Biol Blood Marrow Transplant. 2015;21(12):2136-2140.
16. Hui L, von Keudell G, Wang R, Zeidan AM, Gore SD, Ma X, Davidoff AJ, Huntington SF Cost-effectiveness analysis of consolidation with brentuximab vedotin for high-risk Hodgkin lymphoma after autologous stem cell transplantation. Cancer. 2017 Oct;123(19):3763-3771.
17. Barrington SF, Mikhaeel NG, Kostakoglu L, Meignan M, Hutchings M, Mueller SP, et al. Role of imaging in the staging and response as- sessment of lymphoma: consensus of the International Conference on Malignant Lymphomas Imaging Working Group. J Clin Oncol 2014;32(27):3048–58.
18. Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Lister TA. Recommendations for initial evaluation, staging, and response as- sessment of Hodgkinand non-Hodgkin lymphoma: the Lugano classifi- cation. J Clin Oncol 2014;32(27):3059–68.
19. Adams HJ, Kwee TC, Fijnheer R, Dubois SV, Nievelstein RA, de Klerk JM Diffusely increased bone marrow FDG uptake in recently untreated lymphoma: incidence and relevance. Eur J Haematol 2014.
20. Swerdlow SH, Campo E,Harris N, et al., eds. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: In-
ternational Agency for Research on Cancer; 2008.
21. Adams HJ, Nievelstein RA, Kwee TC. Opportunities and limitations of bone marrow biopsy and bone marrow FDG-PET in lymphoma. Blood Rev. 2015 Nov;29(6):417-25.
22. Gopal AK, Chen R, Smith SE, Ansell SM, Rosenblatt JD, Savage KJ, Connors JM, Engert A, Larsen EK, Chi X, Sievers EL, Younes A Durable remissions in a pivotal phase 2 study of brentuximab ve- dotin in relapsed or refractory Hodgkin lymphoma. Blood. 2015 Feb 19;125(8):1236-43.
23. Garciaz S, Coso D, Peyrade F, et al. Brentuximab vedotin followed by allogeneic transplantation as salvage regimen in patients with re- lapsed and/or refractory Hodgkin’s lymphoma. Hematol Oncol. 2014;32(4):187-191.
24. Gibb A, Jones C, Bloor A, et al. Brentuximab vedotin in refractory CD301 lymphomas: a bridge to allogeneic transplantation in approxi- mately one quarter of patients treated on a Named Patient Programme at a single UK center. Haematologica. 2013;98(4):611-614.
25. Gautam A, Zhu Y, Ma E, Lee SY, Zagadailov E, Teasell J, Richhariya A, Bonthapally V, Huebner D Brentuximab vedotin consolidation post- autologous stem cell transplant in Hodgkin lymphoma patients at risk of residual disease: number needed to treat. Leuk Lymphoma. 2018 Jan;59(1):69-76
26. Jiang Y, Chen Y, Huang R, et al. Comparison of the efficiency of ABVD versus BEACOPP for Hodgkin lymphoma treatment: a meta-analysis. Int J Hematol. 2016; 104(4):413-419.
27. Santoro A, Mazza R, Pulsoni A, et al. Bendamustine in Combination With Gemcitabine and Vinorelbine Is an Effective Regimen As Induc- tion Chemotherapy Before Autologous Stem-Cell Transplantation for Relapsed or Refractory Hodgkin Lymphoma: Final Results of a Multi- center Phase II Study. J Clin Oncol. 2016;34(27):3293-9.
28. Bekoz H, Karadurmus N, Paydas S, et al. Nivolumab for relapsed or refractory Hodgkin lymphoma: real-life experience. Ann Oncol. 2017; 28(10):2496-2502.
29. Chen R, Zinzani PL, Fanale MA, et al. Phase II study of the efficacy and safety of Pembrolizumab for relapsed/refractory classic Hodgkin lym- phoma. J Clin Oncol. 2017; 35(19):2125-2132.
30. Ijaz A, Khan AY, Malik SU, et al. Significant risk of graft-versus-host disease with exposure to checkpoint inhibitors before and after alloge- neic transplantation. Biol Blood Marrow Tranplant. 2019; 25(1):94-99.
31. Bazarbachi A, Boumendil A, Finel H, et al. Brentuximab vedotin prior to allogeneic stem cell transplantation in Hodgkin lymphoma: a report from the EBMT Lymphoma Working Party. Br J Haematol. 2018; 181(1):86-96. Joseph M. Connors JM, Jurczak W, Straus DJ, et al. Brentuximab Vedotin with Chemotherapy for Stage III or IV Hodgkin’s Lymphoma. N Engl J Med 2018; 378:331-344
32. Joseph M. Connors JM, Jurczak W, Straus DJ, et al. Brentuximab Ve- dotin with Chemotherapy for Stage III or IV Hodgkin’s Lymphoma. N Engl J Med 2018; 378:331-344
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Merli F, Ballerini F, Botto B, Gotti M, Pavone V, Pulsoni A, et al. Hodgkin’s lymphoma: post- autologous transplantation consolidation therapy. Acta Biomed [Internet]. 2020 May 25 [cited 2024 Jul. 27];91(S-5):23-9. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/9914
