Evaluating anti-CD25 radioimmunotherapy with BEAM autologous stem cell transplantation in patients with high-risk relapsed or refractory classical Hodgkin lymphoma

The authors compared the safety and effectiveness of 90Y-antiCD25 (yttrium 90 basiliximab; aTac) radioimmunotherapy (RAI), followed by BEAM (carmustine, etoposide, cytarabine, melphalan) and autologous stem cell transplantation (ASCT) for the treatment of patients with high-risk relapsed or refractory (r/r) classical Hodgkin lymphoma (cHL).

The study found that aTac-BEAM-ASCT was safe and well tolerated in these patients. 

The BEAM regimen has long been the standard chemotherapy combination for cHL. However, a high number of patients with cHL experience relapse (worsening of the disease) or refractory (not responsive) disease to standard treatments. After high-dose chemotherapy, patients often receive an ASCT. This involves transplanting healthy cells taken from the same patient back to restore healthy blood cells.

Immunotherapy is a type of cancer treatment that boosts the body’s natural defenses to fight cancer. RAI attaches a radioactive molecule to an immune protein to target and kill cancer cells. HL expresses a protein called CD25 on cancer cells. It remains unclear if attaching a radioactive molecule to immune cells that attack CD25 (aTac) followed by BEAM and ASCT improves the outcomes of patients with r/r cHL.

This study included 22 patients with high-risk r/r cHL. All patients received aTac followed by BEAM and ASCT. The average follow-up period was 59.2 months.

95% of patients responded to treatment and 91% had a complete response (complete disappearance of cancer). 32% of patients relapsed at an average of 3.7 months after ASCT. 

68% of patients were estimated to survive without cancer worsening for 5 years. 95% of patients were estimated to be alive after 5 years. 

The most common side effects were an inflamed or sore mouth (95%), digestive problems (27%), and liver problems (23%).

This study concluded that aTac RAS followed by BEAM and AHCT was a safe and tolerated treatment in patients with high-risk r/r cHL.

This study reported on a small number of patients who were treated at various dose levels of radiation. These results require confirmation with a larger number of patients with high-risk r/r HL.