TY - JOUR
T1 - Trends in postrelapse survival in classic Hodgkin lymphoma patients after experiencing therapy failure following auto-HCT
AU - Badar, Talha
AU - Epperla, Narendranath
AU - Szabo, Aniko
AU - Borson, Steven
AU - Vaughn, John
AU - George, Gemlyn
AU - Saini, Neeraj
AU - Shah, Abdul Rashid
AU - Patel, Romil D.
AU - Ahmed, Sairah
AU - Shah, Nirav N.
AU - Cashen, Amanda F.
AU - Hamadani, Mehdi
AU - Fenske, Timothy S.
N1 - Funding Information:
Conflict-of-interest disclosure: T.S.F. has received prior research funding from Millennium, Kyowa, TG Therapeutics, Portola, and Curis; has served as a consultant for Genentech, Adaptive Biotechnologies, AbbVie, and Verastem; and has been a speaker for Seattle Genetics, Sanofi, Genentech, AstraZeneca, Celgene, and Adaptive Biotechnologies. N.N.S. has received honoraria and/or travel support from Incyte, Celgene, and Lentigen Technology; has served on scientific advisory boards for Kite, Celgene, and Cellec-tar; and has received institutional research support for clinical trials from BMS and Miltenyi Biotec. A.F.C. has served as a speaker for Seattle Genetics. The remaining authors declare no competing financial interests.
Publisher Copyright:
© 2020 by The American Society of Hematology.
PY - 2020/1/14
Y1 - 2020/1/14
N2 - Patients with classic Hodgkin lymphoma (cHL) who relapse after autologous hematopoietic cell transplantation (auto-HCT) historically have had poor outcomes. We hypothesized that, post-auto-HCT relapse, overall survival (PR-OS) has improved in recent years as a result of more widespread use of novel therapies and allogeneic HCT (allo-HCT). We conducted a retrospective study in 4 US academic centers, evaluating 215 patients who underwent auto- HCT from 2005 to 2016 and relapsed thereafter. Patients were divided into 2 cohorts based on timing of auto-HCT, 2005 through 2010 (cohort 1; n5118) and 2011 to 2016 (cohort 2; n597), to compare differences in clinical outcomes. The median age and disease status at auto-HCT were similar in cohorts 1 and 2. The proportions of patients who received brentuximab vedotin (Bv; 55% vs 69%; P = .07), checkpoint inhibitors (CPIs; 3% vs 36%; P ≤ .001), and allogeneic-HCT (22%vs 35%, P5 .03) were significantly different between cohorts 1 and 2, respectively. At the 5-year follow-up after auto relapse, 32% and 50% of patients were alive in cohorts 1 and 2, respectively (P = .01). Inmultivariate analysis for PR-OS, cohort 1 vs 2 (hazard ratio [HR], 2.3; 95% confidence interval [CI], 1.14-4.60; P = .01), age at auto-HCT (HR, 1.48; 95% CI, 1.18-1.87; P ≤ .001), and time to relapse from auto-HCT (HR, 0.59; 95% CI, 0.47-74; P ≤ .0001), retained independent prognostic significance for PR-OS. Our study supports the hypothesis that survival of cHL patients after auto-HCT failure has significantly improved in recent years, most likely because of incorporation of novel therapies andmore widespread use of allo-HCT.
AB - Patients with classic Hodgkin lymphoma (cHL) who relapse after autologous hematopoietic cell transplantation (auto-HCT) historically have had poor outcomes. We hypothesized that, post-auto-HCT relapse, overall survival (PR-OS) has improved in recent years as a result of more widespread use of novel therapies and allogeneic HCT (allo-HCT). We conducted a retrospective study in 4 US academic centers, evaluating 215 patients who underwent auto- HCT from 2005 to 2016 and relapsed thereafter. Patients were divided into 2 cohorts based on timing of auto-HCT, 2005 through 2010 (cohort 1; n5118) and 2011 to 2016 (cohort 2; n597), to compare differences in clinical outcomes. The median age and disease status at auto-HCT were similar in cohorts 1 and 2. The proportions of patients who received brentuximab vedotin (Bv; 55% vs 69%; P = .07), checkpoint inhibitors (CPIs; 3% vs 36%; P ≤ .001), and allogeneic-HCT (22%vs 35%, P5 .03) were significantly different between cohorts 1 and 2, respectively. At the 5-year follow-up after auto relapse, 32% and 50% of patients were alive in cohorts 1 and 2, respectively (P = .01). Inmultivariate analysis for PR-OS, cohort 1 vs 2 (hazard ratio [HR], 2.3; 95% confidence interval [CI], 1.14-4.60; P = .01), age at auto-HCT (HR, 1.48; 95% CI, 1.18-1.87; P ≤ .001), and time to relapse from auto-HCT (HR, 0.59; 95% CI, 0.47-74; P ≤ .0001), retained independent prognostic significance for PR-OS. Our study supports the hypothesis that survival of cHL patients after auto-HCT failure has significantly improved in recent years, most likely because of incorporation of novel therapies andmore widespread use of allo-HCT.
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U2 - 10.1182/bloodadvances.2019000736
DO - 10.1182/bloodadvances.2019000736
M3 - Article
C2 - 31899797
AN - SCOPUS:85078133666
SN - 2473-9529
VL - 4
SP - 41
EP - 54
JO - Blood Advances
JF - Blood Advances
IS - 1
ER -