Brentuximab vedotin prior to allogeneic stem cell transplantation in Hodgkin lymphoma: a report from the EBMT Lymphoma Working Party
Por:
Bazarbachi, A, Boumendil, A, Finel, H, Mohty, M, Castagna, L, Peggs, KS, Blaise, D, Afanasyev, B, Diez-Martin, JL, Sierra, J, Bloor, A, Martinez, C, Robinson, S, Malladi, R, El-Cheikh, J, Corradini, P, Montoto, S, Dreger, P, Sureda, A
Publicada:
1 abr 2018
Resumen:
Brentuximab vedotin (BV) is an anti-CD30 antibody-drug conjugate. Preliminary data suggest that BV might improve outcomes after allogeneic stem cell transplantation (SCT) for Hodgkin lymphoma (HL) when used as pre-transplant salvage therapy. Between 2010 and 2014, 428 adult patients underwent an allogeneic SCT for classical HL at participating centres of the European Society for Blood and Marrow Transplantation. We compared the outcomes of 210 patients who received BV prior to allogeneic SCT with that of 218 patients who did not receive BV. The median follow-up for survivors was 41 months. Patients in the BV group were more heavily pre-treated (median pre-allograft treatment lines: 4 vs. 3). The two groups were comparable in terms of disease status, performance status, comorbidities, prior autologous SCT, type of donor, conditioning and invivo T cell depletion. In multivariate analysis, pre-allograft BV had no impact on acute graft-versus-host disease (GVHD), non-relapse mortality, cumulative incidence of relapse, progression-free survival or overall survival (OS), but significantly reduced the risk of chronic GVHD (hazard ratio = 0.64; 95% confidence interval = 0.45-0.92; P < 0.02). Older age, poor performance status, use of pre-transplant radiotherapy and active disease at SCT adversely affected OS. Patients allografted for HL after prior exposure to BV do not have a superior outcome after allogeneic SCT except for a lower risk of chronic GVHD. However, BV may improve the outlook of allogeneic SCT by helping otherwise refractory patients to achieve a more favourable disease status, facilitating allotransplant success.
Filiaciones:
Bazarbachi, A:
Amer Univ Beirut, Dept Internal Med, Beirut, Lebanon
Boumendil, A:
Hop St Antoine, EBMT LWP Paris Off, Paris, France
Finel, H:
Hop St Antoine, EBMT LWP Paris Off, Paris, France
Mohty, M:
Hop St Antoine, Serv Hematol & Therapie Cellulaire, Paris, France
Castagna, L:
Ist Clin Humanitas, Dept Oncol & Haematol, Transplantat Unit, Milan, Italy
Peggs, KS:
UCL, Canc Inst, Dept Haematol, London, England
Blaise, D:
Inst Paoli Calmettes, Ctr Rech Cancerol Marseille, Programme Transplantat & Therapie Cellulaire, Marseille, France
Afanasyev, B:
First State Pavlov Med Univ St Petersburg, Raisa Gorbacheva Mem Res Inst Paediat Oncol Haema, St Petersburg, Russia
Diez-Martin, JL:
Univ Complutense Madrid, Hosp GU Gregorio Maranon, Inst Invest Sanitaria Gregorio Maranon, Dept Haematol,Fac Med, Madrid, Spain
Sierra, J:
Hosp Santa Creu & Sant Pau, Haematol Dept, Barcelona, Spain
Bloor, A:
Christie Hosp NHS Trust, Adult Leukaemia & Bone Marrow Transplant Unit, Manchester, Lancs, England
Martinez, C:
Hosp Clin Barcelona, Inst Haematol & Oncol, Dept Haematol, Barcelona, Spain
Robinson, S:
Univ Hosp Bristol, Bone Marrow Transplant Unit, Bristol, Avon, England
Malladi, R:
Queen Elizabeth Hosp, Ctr Clin Haematol, Birmingham, W Midlands, England
El-Cheikh, J:
Amer Univ Beirut, Dept Internal Med, Beirut, Lebanon
Corradini, P:
Univ Milan, IRCCS, Ist Nazl Tumori, Dept Haematol, Milan, Italy
Montoto, S:
St Bartholomews Hosp, Barts Hlth NHS Trust, Dept Haematooncol, London, England
Dreger, P:
Hop St Antoine, EBMT LWP Paris Off, Paris, France
Heidelberg Univ, Dept Med 5, Heidelberg, Germany
Sureda, A:
Hosp Duran & Reynals, Inst Catala Oncol, Dept Haematol, Barcelona, Spain
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