Trends in postrelapse survival in classic Hodgkin lymphoma patients after experiencing therapy failure following auto-HCT

Talha Badar, Narendranath Epperla, Aniko Szabo, Steven Borson, John Vaughn, Gemlyn George, Neeraj Saini, Abdul Rashid Shah, Romil D. Patel, Sairah Ahmed, Nirav N. Shah, Amanda F. Cashen, Mehdi Hamadani, Timothy S. Fenske

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)41-54
Number of pages14
JournalBlood Advances
Volume4
Issue number1
DOIs
StatePublished - Jan 14 2020

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