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Impact of pre- and/or post-autologous stem cell transplantation exposure to brentuximab vedotin on survival outcomes in patients with high-risk Hodgkin lymphoma

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Abstract

The AETHERA trial demonstrated that brentuximab vedotin (BV) consolidation after autologous stem cell transplantation (ASCT) in patients with Hodgkin lymphoma (HL) at high risk of relapse/progression increases progression-free survival (PFS). Patients previously exposed to BV were excluded from that trial. However, BV alone or in combination with chemotherapy is frequently used as front-line treatment and/or pre-ASCT salvage therapy. We analyzed data from 156 patients with high-risk HL who underwent ASCT with (BV-CON, n = 62) or without (non-BV, n = 94) BV consolidation. Fifty-seven patients received BV-based salvage regimens before ASCT. The 3-year overall survival and PFS for all patients were 91.6% and 70.0%, respectively. Multivariate analysis showed that BV-CON was associated with better PFS (HR 0.39, p = 0.01), whereas positive PET at transplant leaded to worse PFS (HR 2.71, p = 0.001). BV-CON improved PFS in PET-positive patients (72.2% vs. 43.0%, p = 0.05), with a beneficial trend observed in PET negative (88.8% vs. 75.2%, p = 0.09). BV-CON patients with or without BV exposure pre-ASCT had a significantly better PFS than non-BV with or without BV pretransplant treatment (HR 0.36, p = 0.004). The efficacy of real-life BV consolidation therapy was similar to that in the AETHERA trial. This therapeutic strategy improves survival independently of BV exposure prior to ASCT.

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Acknowledgements

We acknowledge the kind support of all physicians and data managers who participated in this study.

Author information

Authors and Affiliations

  1. Hematology Department, Institute of Hematology and Oncology, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain

    Carmen Martínez & Arturo Pereira

  2. Hospital Regional Universitario, Málaga, Spain

    Manuel Espeso de Haro

  3. Hospital La Fe, Valencia, Spain

    Samuel Romero

  4. Hospital Universitario Son Espases, IdISBa de Palma de Mallorca, Palma, Spain

    Antonio Gutiérrez

  5. Institut Català d’Oncologia, Hospital Duran i Reynals, Hospitalet de Llobregat, L’Hospitalet de Llobregat, Spain

    Eva Domingo-Domènech

  6. Hospital Universitario Central de Asturias, Oviedo, Spain

    Ana P. González-Rodríguez

  7. Hospital Universitario de Donostia, San Sebastián, Spain

    Izaskun Zeberio

  8. Complejo Asistencial de Ávila, Ávila, Spain

    María Paz Martínez-Badas

  9. Hospital 12 de Octubre, Madrid, Spain

    Antonia Rodríguez-Izquierdo

  10. Hospital Vall d’Hebron, Barcelona, Spain

    Cecilia Carpio

  11. Hospital Gregorio Marañón (IsSGM), Madrid, Spain

    Mariana Bastos-Oreiro

  12. Hospital Universitario Infanta Leonor, Madrid, Spain

    José Ángel Hernández-Rivas

  13. Institut Català d’Oncologia, Hospital Universitari Joan XXIII, Tarragona, Spain

    Rolando Vallansot

  14. Institut Català d’Oncologia, Hospital Josep Trueta, Girona, Spain

    Nicholas Kelleher

  15. Hospital Universitario de Burgos, Burgos, Spain

    Francisco J. Díaz-Gálvez

  16. Hospital Álvaro Cunqueiro, Vigo, Spain

    Tamara Torrado

  17. Hospital Universitario de Salamanca, Universidad de Salamanca, Salamanca, Spain

    Ramón García-Sanz

Authors
  1. Carmen Martínez
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  2. Manuel Espeso de Haro
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  3. Samuel Romero
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  4. Antonio Gutiérrez
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  5. Eva Domingo-Domènech
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  6. Ana P. González-Rodríguez
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  7. Izaskun Zeberio
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  8. María Paz Martínez-Badas
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  9. Antonia Rodríguez-Izquierdo
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  10. Cecilia Carpio
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  11. Mariana Bastos-Oreiro
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  12. José Ángel Hernández-Rivas
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  13. Rolando Vallansot
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  14. Nicholas Kelleher
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  15. Francisco J. Díaz-Gálvez
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  16. Tamara Torrado
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  17. Arturo Pereira
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  18. Ramón García-Sanz
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Consortia

on behalf of Grupo Español de Linfoma y Trasplante de Médula Ósea (GELTAMO) y Grupo Español de Trasplante (GETH)

Contributions

C.M. conceived and designed the study, collected and assembled data, and wrote the manuscript; C.M. and A. P. performed the statistical analysis and interpreted the results; and all coauthors are physicians from GELTAMO-GETH centers who performed the transplants, took care of the patients, collected local data of patients, and made significant contributions to the discussion of the results. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Carmen Martínez.

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Competing interests

C.M. declares consultancy for and honoraria from Takeda and Bristol Myers Squibb; M.E.H. declares honoraria from Takeda, Roche, Janssen, Kite/Gilead, Amgen, Pfizer, EusaPharma, and Servier; S.R. declares honoraria from Takeda; E.D.D. has received honoraria from Takeda and Bristol Myers Squibb; A.P.G.R. declares consultancy for and honoraria from Takeda; I.Z. declares consultancy for and honoraria from Takeda; M.P.M.B. declares honoraria from Takeda; A.R.I. declares honoraria from Takeda; C.C. declares honoraria and/or non-financial support from Takeda, Regeneron, Novartis, and Bristol Myers Squibb; J.A.H.R. declares consultancy for and speaker’s bureau from Takeda; R.G.S. declares research support by the Spanish National Healthy System, Regional Healthy System (Castilla y León), Asociación Española Contra el Cancer (AECC), Takeda, Gilead, Astellas, honoraria from Amgen, Millennium/Takeda, Janssen, Incyte, Astellas, BeiGene, Astra Zeneca, Pfizer, and Speakers Bureau/Scientific Advisory Board for Amgen, Pharmacyclics, Millennium/Takeda. F.J.D.G., M.B., R.V., N.K., and T.T. declare no conflict of interest.

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Martínez, C., de Haro, M.E., Romero, S. et al. Impact of pre- and/or post-autologous stem cell transplantation exposure to brentuximab vedotin on survival outcomes in patients with high-risk Hodgkin lymphoma. Ann Hematol 102, 429–437 (2023). https://doi.org/10.1007/s00277-022-05011-6

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  • DOI: https://doi.org/10.1007/s00277-022-05011-6

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