Annals of Hematology

, Volume 95, Issue 11, pp 1913–1915 | Cite as

Pembrolizumab for relapsed anaplastic large cell lymphoma after allogeneic haematopoietic stem cell transplantation: efficacy and safety

  • Thomas S. Y. Chan
  • Pek-Lan Khong
  • Yok-Lam Kwong
Letter to the Editor

Dear Editor,

Antibody treatment targeting the programmed cell death protein 1 (PD1) is rapidly becoming an important strategy against Hodgkin lymphoma [1]. 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) [2], 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...


Hodgkin Lymphoma Bendamustine Anaplastic Large Cell Lymphoma Haematopoietic Stem Cell Transplantation Brentuximab Vedotin 
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The authors have no acknowledgements to make.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Batlevi CL, Matsuki E, Brentjens RJ, Younes A (2016) Novel immunotherapies in lymphoid malignancies. Nat Rev Clin Oncol 13(1):25–40CrossRefPubMedGoogle Scholar
  2. 2.
    Michonneau D, Sagoo P, Breart B, Garcia Z, Celli S, Bousso P (2016) The PD-1 axis enforces an anatomical segregation of CTL activity that creates tumor niches after allogeneic hematopoietic stem cell transplantation. Immunity 44(1):143–54CrossRefPubMedGoogle Scholar
  3. 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. 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. 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
  6. 6.
    Villasboas JC, Ansell SM, Witzig TE (2016) Targeting the PD-1 pathway in patients with relapsed classic Hodgkin lymphoma following allogeneic stem cell transplant is safe and effective. Oncotarget 7(11):13260–13264PubMedPubMedCentralGoogle Scholar
  7. 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
  8. 8.
    Kwong YL (2016) Safety of pembrolizumab after allogeneic haematopoietic stem cell transplantation. Ann Hematol 95(7):1191–2CrossRefPubMedGoogle Scholar
  9. 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. 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

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Thomas S. Y. Chan
    • 1
  • Pek-Lan Khong
    • 2
  • Yok-Lam Kwong
    • 1
  1. 1.Department of MedicineQueen Mary HospitalPok Fu LamHong Kong
  2. 2.Department of Diagnostic RadiologyQueen Mary HospitalPok Fu LamHong Kong

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