Allogeneic Hematopoietic Cell Transplantation for Relapsed / Refractory Hodgkin Lymphoma: A Multicenter Real-World Experience

OpenAlex İngilizce

Objective: Allogeneic hematopoietic cell transplantation (allo-HCT) remains a curative option for relapsed or refractory (R/R) Hodgkin lymphoma despite advances with novel therapeutic agents such as brentuximab vedotin (BV) and immune checkpoint inhibitors (CPIs). This study aimed to assess the benefit of prior exposure to novel therapeutic agents prior to allo-HCT in patients with R/R Hodgkin lymphoma. Materials and Methods: This study’s retrospective multicentric analysis involved 70 patients with R/R classical Hodgkin lymphoma who underwent allo-HCT. Results: The analyzed patients were split into two main treatment cohorts: Era 1 (2004-2010) included 16 patients, while Era 2 (2011-2021) included 54 patients. Within the total patient cohort, 63 patients had previously received autologous stem cell transplantation. Forty patients were administered only BV (n=29) or BV preceding CPI (n=11) before allo-HCT. A median follow-up duration of 64 months (range: 40.7-87.3) revealed a 100-day non-relapse mortality (NRM) rate of 26%, with 3-year overall survival (OS) and progression-free survival (PFS) rates of 39% and 28%, respectively. Allo-HCT with haplotype-matched donors was linked to better OS and PFS. Post-transplant cyclophosphamide as a prophylactic approach for graft-versus-host disease significantly improved OS and PFS. A complete response during the post-transplant period significantly improved OS and PFS. Better OS, better PFS, and reduced NRM were observed both before and after allo-HCT in patients receiving BV and CPIs, although statistical significance was not reached. The OS and PFS curves and the NRM rates were similar between Era 1 and Era 2. Conclusion: Allo-HCT is a potentially practical therapeutic approach for the treatment of patients with R/R Hodgkin lymphoma.