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

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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.

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Acknowledgments

The authors would like to thank Dr. Stefania Citiso who contributed to the collection of clinical data, Dr. Melania Biasi for her collaboration, all the patients, families, caregivers, clinicians of REP, especially Dr. Giuseppina Greco, nurses, and AIL staff who contributed to this study.

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Authors and Affiliations

  1. Department of Hematology and Bone Marrow Transplant, Hospital Card. G. Panico, Via San Pio X, 73039, Tricase, Italy

    Vincenzo Pavone, Anna Mele, Daniela Carlino & Prete Eleonora

  2. Department of Hematology and Bone Marrow Transplant, University of Bari, Policlinico, Bari, Italy

    Giorgina Specchia, Francesco Gaudio & Tommasina Perrone

  3. Department of Hematology and Bone Marrow Transplant, Hospital G.Moscati, Taranto, Italy

    Patrizio Mazza & Giulia Palazzo

  4. Department of Hematology, Hospital IRCCS Oncologico, Bari, Italy

    Attilio Guarini & Giacomo Loseto

  5. Department of Hematology and Bone Marrow Transplant, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy

    Nicola Cascavilla & Potito Scalzulli

  6. Department of Hematology, Hospital Perrino, Brindisi, Italy

    Angela Melpignano & Giovanni Quintana

  7. Department of Hematology, Hospital Vito Fazzi, Lecce, Italy

    Nicola Di Renzo

  8. Department of Hematology, ASL BT, Barletta, Italy

    Giuseppe Tarantini

  9. Department of Hematology, Hospital University Riuniti, Foggia, Italy

    Silvana Capalbo

Authors
  1. Vincenzo Pavone
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  2. Anna Mele
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  4. Giorgina Specchia
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  10. Giacomo Loseto
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  11. Prete Eleonora
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  12. Nicola Cascavilla
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  14. Angela Melpignano
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  15. Giovanni Quintana
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  16. Nicola Di Renzo
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  17. Giuseppe Tarantini
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  18. Silvana Capalbo
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Correspondence to Anna Mele.

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Pavone, V., Mele, A., Carlino, D. et al. Brentuximab vedotin as salvage treatment in Hodgkin lymphoma naïve transplant patients or failing ASCT: the real life experience of Rete Ematologica Pugliese (REP). Ann Hematol 97, 1817–1824 (2018). https://doi.org/10.1007/s00277-018-3379-5

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