Abstract:
Objective Evaluating the efficacy and outcomes of autologous hematopoietic stem cell transplantation (ASCT) for patients with relapsed or refractory (R/R) classical Hodgkin's lymphoma (cHL) using novel agents.
Methods Fifty-six patients diagnosed with R/R cHL exhibiting sensitivity to salvage therapy underwent ASCT at the Institute of Hematology & Blood Diseases Hospital from January 2010 to December 2022 participated in our review. The patients were assigned into two groups based on whether they received brentuximab vedotin (BV) or programmed death-1 (PD-1) inhibitors pre-transplantation: the novel agent group (n=32) and no novel agent group (n=24). Their characteristics and outcomes were analyzed retrospectively, and survival was assessed using Kaplan-Meier method.
Results Median age of transplantation for 56 patients with R/R cHL was 29 years (range: 11-55 years), with 35 male and 21 female patients. With a median follow-up of 56 (2-137) months, the 5-year overall survival (OS) and progression-free survival (PFS) rates post-transplantation were estimated to be 94.3% and 75.8%, respectively. The 5-year PFS was superior for patients using novel agents pre-transplantation (90.1% vs. 59.1%, hazard ratio HR=0.23, 95% confidence intervals CI: 0.07-0.71, P=0.011) without a statistically significant difference in OS (93.5% vs. 95.5%, HR=1.2, 95%CI: 0.14–10.34, P=0.873).
Conclusions ASCT remains the standard consolidation therapy for patients with salvage-sensitive R/R cHL. The incorporation of novel agents pre-and post-transplantation enhances the outcomes of patients who have undergone ASCT for R/R cHL.