In a nutshell
This study aimed to analyse the side effects associated with brentuximab vedotin (BV; Adcetris) treatment for patients with Hodgkin lymphoma (HL) who had undergone stem cell transplantation (SCT) that is now unresponsive to treatment. The main side effects identified included nerve damage, infections and low white blood cell count which were manageable.
Some background
Hodgkin's Lymphoma is a cancer of the bone marrow which can lead to abnormal white blood cells. SCT involves the transfer of stem cells to patients from healthy donors. Stem Cell Transplantation is a common treatment for patients with HL. In many cases SCT can cure HL. However, some patients may lose response to treatment over time (relapsing). Brentuximab vedotin (BV; Adcetris) is often used to treat relapsing HL. BV is a targeted treatment meaning that it kills only tumor cells. Patients participating in clinical trials may experience side effects. Common side effects in clinical trials for cancer treatments include peripheral neuropathy (PN; meaning weakness and pain, usually in the hands and feet due to nerve damage), infections and neutropenia (meaning low levels of a type of white blood cell called neutrophils). It is necessary to monitor the side effects in every clinical trial.
Methods & findings
The study included 229 patients. BV plus best supportive care (BSC; treatment for cancer symptoms) were administered to 165 and 164 received placebo (a treatment which has no effect) plus BSC. The time taken for the side effect to develop, the ability of the sid effect to be managed by changing the dose of the drug, and the side effect going away were recorded.
Sixty-seven percent of patients experienced PN, 60% had infections and 35% developed neutropenia. On average, PN developed after 13.7 weeks. PN was managed in 57% of patients by increasing the interval between BV doses and by dose lowering. Increasing the length of time between BV doses and treatment with a protein called GCSF caused neutrophils to develop. Less common side effects identified included problems in the lungs, the liver and the heart. These side effects were reversible.
The bottom line
The main side effects identified in this study were nerve damage, infections and neutropenia. However, these side effects could be managed and reversed.
The fine print
This study only included patients in North America. Therefore the results may not apply to patients elsewhere.
What’s next?
If you have questions about treatment for HL, please ask your doctor.
Published By :
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
Date :
May 30, 2018
