Pembrolizumab for relapsed anaplastic large cell lymphoma after allogeneic haematopoietic stem cell transplantation: efficacy and safety
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Antibody treatment targeting the programmed cell death protein 1 (PD1) is rapidly becoming an important strategy against Hodgkin lymphoma . However, recipients of allogeneic haematopoietic stem cell transplantation (HSCT) are typically excluded from clinical trials. Negative signalling via PD1 after ligation with its ligand PDL1 is regarded to play an important part in ameliorating cytotoxic T cell-mediated graft-versus-host disease (GVHD) , implying that PD1 blockade after allogeneic HSCT might incite or exacerbate GVHD.
Notwithstanding these concerns, PD1 blockade has been tested in allogeneic HSCT recipients, which to date is confined to relapsed Hodgkin lymphoma. Two anti-PD1 antibodies nivolumab and pembrolizumab have been used. For nivolumab, in 10 of 14 reported cases who were evaluable [3, 4, 5], 3 patients developed GVHD, 1 case grade IV in severity. Four patients achieved complete response (CR). For pembrolizumab, only three patients have been reported. In...
KeywordsHodgkin Lymphoma Bendamustine Anaplastic Large Cell Lymphoma Haematopoietic Stem Cell Transplantation Brentuximab Vedotin
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The authors declare that they have no conflict of interest.
- 3.Angenendt L, Schliemann C, Lutz M, Rebber E, Schulze AB, Weckesser M, Stegger L, Schäfers M, Groth C, Kessler T, Lenz G, Stelljes M, Berdel WE (2016) Nivolumab in a patient with refractory Hodgkin’s lymphoma after allogeneic stem cell transplantation. Bone Marrow Transplant 51(3):443–5CrossRefPubMedGoogle Scholar
- 4.Yared JA, Hardy N, Singh Z, Hajj S, Badros AZ, Kocoglu M, Yanovich S, Sausville EA, Ujjani C, Ruehle K, Goecke C, Landau M, Rapoport AP (2016) Major clinical response to nivolumab in relapsed/refractory Hodgkin lymphoma after allogeneic stem cell transplantation. Bone Marrow Transplant(Feb 1) [Epub ahead of print]Google Scholar
- 5.Herbaux C, Gauthier J, Brice P, Fornecker L, Bouabdallah K, Manson G, Ghesquières H, Thiebaut-Bertrand A, Demarquette H, Boyle E, Ysebaert L, Houot R, Yakoub-Agha I, Morschhauser F (2015) Preliminary results of a Phase I study of Nivolumab (BMS-936558) in patients with relapsed or refractory lymphoid malignancies. Blood 126:3979Google Scholar
- 7.Singh AK, Porrata LF, Aljitawi O, Lin T, Shune L, Ganguly S, McGuirk JP, Abhyankar S (2016). Fatal GvHD induced by PD-1 inhibitor pembrolizumab in a patient with Hodgkin’s lymphoma. Bone Marrow Transplant Apr 25 [Epub ahead of print]Google Scholar
- 9.Armand P, Shipp MA, Ribrag V, Michot JM, Zinzani PL, Gutierrez M, Snyder E, Ricart AD, Balakumaran A, Moskowitz CH (2015) PD-1 blockade with pembrolizumab in patients with classical hodgkin lymphoma after brentuximab vedotin failure: safety, efficacy, and biomarker assessment. Blood 126:584Google Scholar
- 10.Kwong YL, Lopes D, Khong PL (2016). Low-dose pembrolizumab induced remission in patients with refractory classical Hodgkin lymphoma. Br J Haematol Jan 15 [Epub ahead of print]Google Scholar