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Multicenter Study
. 2022 Feb;40(1):31-39.
doi: 10.1002/hon.2939. Epub 2021 Nov 1.

Brentuximab vedotin consolidation after autologous stem cell transplantation for Hodgkin lymphoma: A Fondazione Italiana Linfomi real-life experience

Fulvio Massaro  1   2 , Vincenzo Pavone  3 , Piero Maria Stefani  4 , Barbara Botto  5 , Alessandro Pulsoni  6 , Caterina Patti  7 , Maria Cantonetti  8 , Andrea Visentin  9 , Potito Rosario Scalzulli  10 , Andrea Rossi  11 , Sara Galimberti  12 , Michele Cimminiello  13 , Guido Gini  14 , Maurizio Musso  15 , Marco Sorio  16 , Annalisa Arcari  17 , Vittorio Ruggero Zilioli  18 , Mario Luppi  19 , Donato Mannina  20 , Alberto Fabbri  21 , Giuseppe Pietrantuono  22 , Ombretta Annibali  23 , Agostino Tafuri  24 , Eleonora Prete  3 , Antonino Mulè  7 , Elisa Barbolini  25 , Luigi Marcheselli  26 , Stefano Luminari  2 , Francesco Merli  2
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Multicenter Study

Brentuximab vedotin consolidation after autologous stem cell transplantation for Hodgkin lymphoma: A Fondazione Italiana Linfomi real-life experience

Fulvio Massaro et al. Hematol Oncol. 2022 Feb.

Abstract

The standard management for relapsed or refractory classical Hodgkin lymphoma (cHL) is salvage therapy followed by autologous stem cell transplantation (ASCT). This strategy allows almost 50% of patients to be cured. Post-ASCT maintenance treatment with brentuximab vedotin (BV) confers improved progression-free survival (PFS) to cHL patients at high risk of relapse. We investigated the outcome of 105 cHL patients receiving post-ASCT BV maintenance in the real-life setting of 23 Italian hematology centers. This population included naïve patients and those previously exposed to BV. Median follow-up was 20 months. Patients presented a median of two lines of treatment pre-ASCT, with 51% receiving BV. Twenty-nine percent of patients had at least two high-risk factors (refractory disease, complete response [CR] less than 12 months, extranodal disease at relapse), while 16% presented none. At PET-CT, a Deauville score (DS) of 1-3 was reported in 75% and 78% of pre- and post-ASCT evaluations, respectively. Grade 3-4 adverse events (AEs), mainly peripheral neuropathy, were observed in 16% of patients. Three-year PFS and overall survival (OS) were 62% and 86%, respectively. According to BV exposure, 3-year PFS and OS were 54% and 71%, respectively, for naïve and 77% and 96%, respectively, for previously exposed patients. Refractory disease (hazard ratio [HR] 4.46; p = 0.003) and post-ASCT DS 4-5 (HR 3.14; p = 0.005) were the only two factors significantly associated with PFS reduction in multivariable analysis. Post-ASCT BV maintenance is an effective, safe treatment option for cHL naïve patients and those previously exposed to BV.

Keywords: AETHERA trial; autologous stem cell transplantation; brentuximab vedotin; hodgkin lymphoma.

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Conflict of interest statement

A. Pulsoni, M. Cantonetti, A. Rossi, V.R. Zilioli, A. Fabbri, F. Merli have a consultant or advisory role for Takeda; M. Cantonetti, A. Visentin, A. Fabbri received educational grant from Takeda.

Figures

FIGURE 1
FIGURE 1
Kaplan–Meier plots showing OS and PFS (red lines represent 95% CI). CI, confidence interval; OS, overall survival; PFS, progression‐free survival
FIGURE 2
FIGURE 2
Kaplan–Meier plots showing OS and PFS according to BV exposure. BV, brentuximab vedotin; OS, overall survival; PFS, progression‐free survival
See this image and copyright information in PMC

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