Evaluating the clinical outcomes in patients with relapsed or refractory classical Hodgkin lymphoma after first-line treatment.

This study evaluated the characteristics, treatment patterns, and outcomes of patients with relapsed or refractory (r/r) classical Hodgkin lymphoma (HL) after treatment with first-line therapy. 

HL is a cancer of white blood cells. Most patients with HL respond to first-line chemotherapy regimens. However, up to 25% of patients experience relapse (worsening of the disease) or refractory (not responsive to the treatment) disease. These patients must be given more aggressive treatment. This usually involves salvage therapies. Salvage therapies usually involve high-dose chemotherapy. If patients respond well, an autologous stem cell transplant (ASCT) can also be given. ASCT involves transplanting healthy stem cells from the same patient.

Dexamethasone (Decadron), cisplatin (Platinol), and cytarabine (Cytosar), or DHAP, is one of the most commonly used salvage chemotherapy combinations. Brentuximab vedotin (Adcetris), is a drug that is also used to treat patients with r/r HL. It is important to evaluate the characteristics, treatment patterns, and outcomes of patients with r/r HL after treatment with first-line treatment.

This study involved 409 patients with r/r HL. Patients were divided into 3 groups. Group 1 included 291 patients who received high-dose chemotherapy and autologous stem-cell transplantation (ASCT). Group 2 included 38 patients in which ASCT failed due to insufficient response from salvage therapy. Group 3 included 80 patients who did not receive ASCT due to age or presence of another medical condition that put the patient at risk. The average follow-up time was 70.6 months.

After 10 years, the overall survival rate was 59.4%. After 10 years, the survival rate without cancer worsening was 48.2%.

Overall, 82% of the patients responded to the treatment. The complete response rate (complete disappearance of cancer cells) was 56%. The partial response rate (partial disappearance of cancer cells) was 26%.

After 5 years, the overall survival rate was 73.3% in group 1, 40.5% in group 2, and 43.8% in group 3. After 5 years, the survival rate without cancer worsening was 61.1% in group 1, 36.3% in group 2, and 36.2% in group 3.

In patients with a low risk of disease, the survival rate without cancer worsening was favorable (72.6%) even without ASCT. Patients with more advanced disease and who relapse within 3 months of first-line therapies tended to have poorer outcomes. 

This study reported the treatment patterns and long-term outcomes of patients with r/r HL after treatment with first-line therapy.

This study looked back in time at medical records. Some information like treatment-related side effects were missing. This study only included German patients.