Brentuximab Vedotin in Transplant-Naïve Relapsed/Refractory Hodgkin Lymphoma: Experience in 30 Patients.
Pier Luigi Zinzani, Cinzia Pellegrini, Maria Cantonetti, Alessandro Re, Antonello Pinto, Vincenzo Pavone, Luigi Rigacci, Melania Celli, Alessandro Broccoli, Lisa Argnani, Alessandro Pulsoni
Author Information
Pier Luigi Zinzani: Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy pierluigi.zinzani@unibo.it.
Cinzia Pellegrini: Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy.
Maria Cantonetti: Department of Biomedicine and Prevention, University of Rome "Tor Vergata," Rome, Italy.
Alessandro Re: Division of Hematology, "Spedali Civili," Brescia, Italy.
Antonello Pinto: Hematology-Oncology and Stem Cell Transplantation Unit, Fondazione "G. Pascale," IRCCS, Naples, Italy.
Vincenzo Pavone: Division of Hematology and Transplantation, Azienda Ospedaliera "Cardinal Panico," Tricase, Italy.
Luigi Rigacci: Division of Hematology, Azienda Ospedaliera "Careggi," Florence, Italy.
Melania Celli: Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy.
Alessandro Broccoli: Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy.
Lisa Argnani: Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy.
Alessandro Pulsoni: Department of Cellular Biotechnologies and Hematology, "Sapienza" University, Rome, Italy.
BACKGROUND: Hodgkin lymphoma (HL) is characterized by the presence of CD30-positive Hodgkin Reed-Sternberg cells. Approximately 30%-40% of patients with advanced disease are refractory to frontline therapy or will relapse after first-line treatment. The standard management of these patients is salvage chemotherapy followed by high-dose chemotherapy and autologous stem cell transplant (ASCT). The best prognostic factor is the status of disease before ASCT; in particular, the normalization of positron emission tomography (PET) scan. Brentuximab vedotin (BV) has shown a high overall response rate in refractory/relapsed HL after ASCT, whereas few data are available regarding its role before ASCT. PATIENTS AND METHODS: A multicenter, retrospective, observational study was conducted. The primary endpoint of the study was the effectiveness of BV as single agent in patients with relapsed/refractory, ASCT-naïve HL, determined by the conversion of PET status from positive to negative; secondary endpoints were safety, capacity to proceed to ASCT, survival, and progression-free status. RESULTS: Thirty patients with relapsed/refractory HL- and PET-positive disease after conventional chemotherapy salvage treatments were treated with a median of 4 cycles of BV. Normalization of PET findings (Deauville score ≤2) occurred in 9 of 30 patients (30%). Those nine patients proceeded to ASCT. CONCLUSION: These data suggest that BV can normalize PET status in a subset of HL patients refractory to conventional chemotherapy salvage treatments, such as ifosfamide-containing regimens, cytarabine- and platinum-containing regimens, prior to ASCT.
