Brentuximab vedotin as salvage treatment in Hodgkin lymphoma naïve transplant patients or failing ASCT: the real life experience of Rete Ematologica Pugliese (REP)

Vincenzo Pavone, Anna Mele, Daniela Carlino, Giorgina Specchia, Francesco Gaudio, Tommasina Perrone, Patrizio Mazza, Giulia Palazzo, Attilio Guarini, Giacomo Loseto, Prete Eleonora, Nicola Cascavilla, Potito Scalzulli, Angela Melpignano, Giovanni Quintana, Nicola Di Renzo, Giuseppe Tarantini, Silvana Capalbo

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Abstract

Brentuximab vedotin (BV) shows a high overall response rate (ORR) in relapsed/refractory (R/R) Hodgkin lymphoma (HL) after autologous transplant (ASCT). The aim of this multicenter study, conducted in nine Hematology Departments of Rete Ematologica Pugliese, was to retrospectively evaluate the efficacy and safety of BV as salvage therapy and as bridge regimen to ASCT or allogeneic transplant (alloSCT) in R/R HL patients. Seventy patients received BV. Forty-five patients (64%) were treated with BV as bridge to transplant:16 (23%) patients as bridge to ASCT and 29 (41%) as bridge to alloSCT. Twenty-five patients (36%), not eligible for transplant, received BV as salvage treatment. The ORR was 59% (CR 26%). The ORR in transplant naïve patients was 75% (CR 31%). In patients treated with BV as bridge to alloSCT, the ORR was 62% (CR 24%). In a multivariate analysis, the ORR was lower in refractory patients (p < 0.005). The 2y-OS was 70%. The median PFS was 17 months. Ten of the 16 (63%) naïve-transplant patients received ASCT, with 50% in CR before ASCT. In the 29 patients treated with BV as bridge to alloSCT, 28 (97%) proceeded to alloSCT with 25% in CR prior to alloSCT. The most common adverse events were peripheral neuropathy (50%), neutropenia (29%) and anemia (12%). These data suggest that BV is well tolerated and very effective in R/R HL, producing a substantial level of CR. BV may also be a key therapeutic agent to achieve good disease control before transplant, improving post- transplant outcomes, also in refractory and heavily pretreated patients, without significant overlapping toxicities with prior therapies.

Original languageEnglish
Pages (from-to)1817-1824
Number of pages8
JournalAnnals of Hematology
Volume97
Issue number10
DOIs
Publication statusPublished - Oct 1 2018

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Keywords

  • Autologous and allogeneic stem cell transplant
  • Brentuximab vedotin salvage treatment
  • Relapsed/refractory Hodgkin lymphoma

ASJC Scopus subject areas

  • Hematology

Cite this

Pavone, V., Mele, A., Carlino, D., Specchia, G., Gaudio, F., Perrone, T., Mazza, P., Palazzo, G., Guarini, A., Loseto, G., Eleonora, P., Cascavilla, N., Scalzulli, P., Melpignano, A., Quintana, G., Di Renzo, N., Tarantini, G., & Capalbo, S. (2018). Brentuximab vedotin as salvage treatment in Hodgkin lymphoma naïve transplant patients or failing ASCT: the real life experience of Rete Ematologica Pugliese (REP). Annals of Hematology, 97(10), 1817-1824. https://doi.org/10.1007/s00277-018-3379-5