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Overall survival of cHL patients who progress after autologous stem cell transplant: results in novel agent era.

Sanjal H DesaiMichael A SpinnerAndrew M EvensAlice SýkorováVeronika BachanovaGaurav GoyalBrad S KahlKathleen A DorritieJacques AzziVaishalee P KenkreCheryl ChangJozef MichalkaStephen M AnsellBrendon FuscoNuttavut SumransubHaris HaticRaya SabaUroosa IbrahimElyse I HarrisHarsh R ShahNina D Wagner-JohnstonSally AraiGrzegorz S NowakowskiHeidi MocikovaDeepa JagadeeshKristie BlumCatherine DiefenbachSiddharth IyengarKatherine Cynthia RappazzoFiras BaidounYun ChoiVít ProcházkaRanjana H AdvaniIvana N Micallef
Published in: Blood advances (2023)
In pre-novel agent era, median post progression overall survival (PPS) of classic Hodgkin lymphoma (cHL) patients (pts) who progress after ASCT have been 2-3 years. Recently, Checkpoint inhibitors (CPI) and brentuximab vedotin (BV) have improved depth and durability of response in this population. Here we report estimate of PPS in pts with relapsed cHL after ASCT in the era of CPI and BV. In this multicenter retrospective study of 15 participating institutions, adult pts with relapsed cHL after ASCT were included. Study objective was post progression overall survival (PPS), defined at time from post-transplant progression to death or last follow up. Of 1158 pts who underwent ASCT, 367 had progressive disease. Median age was 34 years (range: 27-46), 192 were male. Median PPS was 114.57 (CI95: 91-NA) months, 9.5 years. In multivariable analysis, increasing age, progression within 6 months and pre-ASCT positive PET were associated with inferior PPS. When adjusted for these features, patients who received CPI, but not BV, as first treatment for post-ASCT progression had significantly higher PPS compared to no CPI/no BV group (HR: 3.5, CI95: 1.6-7.8, p=0.001). Receipt of alloSCT did not improve PPS. In the era of novel agents, progressive cHL after ASCT had long survival that compares favorably to prior reports. Patients who receive CPI as first treatment for progression had higher PPS. Receipt to AlloSCT was not associated with PPS in this population.
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