Evaluating BEGEV chemotherapy before a stem cell transplant for hard-to-treat Hodgkin lymphoma

This study evaluated the effectiveness of BEGEV chemotherapy for patients with relapsed or unresponsive Hodgkin lymphoma (HL) before a stem cell transplant. The authors concluded that this regimen was safe and effective for these patients.

Chemotherapy, followed by a stem cell transplant (SCT), remains the standard of care for patients with HL that comes back (relapse) or stops responding to treatment (becomes refractory). High-dose chemotherapy is given before the transplant to get rid of the remaining cancer cells. This is called an induction regimen.

How well a patient responds to induction chemotherapy greatly impacts SCT outcomes. Which regimen is the most effective for patients with recurrent or refractory HL is unclear. Previous studies suggest that the BEGEV (bendamustine, gemcitabine, vinorelbine) regimen is effective. However, the long-term outcomes of patients treated with BEGEV before SCT are still under investigation.

This study had 59 patients with HL that came back or stopped responding to treatment. All patients received BEGEV chemotherapy. 43 patients then had SCT. Patients were followed for an average of 5 years.

Overall, 83% of patients responded to BEGEV. 75% had no signs of cancer, and 8% had tumor shrinkage after BEGEV chemotherapy. Among all patients, 78% were still alive 5 years later. 59% of patients were still alive 5 years later without tumor growth or spread.

After chemotherapy, 73% of all patients went on to have SCT. After SCT, 56% of patients had no signs of cancer. Among these patients who had the transplant, 91% were still alive 5 years later. 77% were still alive 5 years later without tumor growth or spread.

At follow-up, 56% of patients who had SCT (33 patients) remained in remission. 7 patients had the cancer come back. 16 patients did not receive SCT. 43% of these patients were still alive 5 years later.

This study concluded that BEGEV chemotherapy was effective for patients with HL before SCT. 

This study had a very small number of patients. Larger studies are needed to confirm these results. This study received partial funding support from Mundipharma Pharmaceuticals, the manufacturer of bendamustine.