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Posted by on Mar 29, 2019 in Hodgkin's lymphoma | 0 comments

In a nutshell

This study aimed to compare outcomes for patients with Hodgkin’s lymphoma who received brentuximab vedotin (Adcetris) compared to chemotherapy before a stem cell transplant. This study concluded that patients who received brentuximab vedotin had a better survival.

Some background

Allogeneic hematopoietic stem cell transplant (allo-HSCT) is a potentially curative therapy for patients with relapsed/unresponsive Hodgkin’s lymphoma (HL). Allo-HSCT is a procedure where the patient receives blood-forming stem cells from a non-identical donor such as a sister or brother. Reduced-intensity conditioning (RIC) uses a reduced dose of chemotherapy before an allo-HSCT. It aims to prevent graft-versus-host disease (GvHD). GvHD occurs when the stem cells view the body as foreign and begin to attack it.

Brentuximab vedotin (BV) is an antibody-drug conjugate that can be used to treat HL. It specifically targets lymphoma cells. It is not known if patients who receive BV would benefit more before allo-HSCT when compared to receiving RIC.

Methods & findings

This study involved 72 patients with classical HL who received allo-HSCT. 21 patients were pre-treated with BV and 51 patients received RIC. Patients were followed up for an average of 60 months.

The use of BV had no significant effect on engraftment (cells received during transplant start to grow and make healthy blood cells) or the occurrence and severity of acute GvHD. At 3 years, 43% of the BV group developed chronic GvHD compared to 47% in the no BV group.

The 3-year survival rate without cancer getting worse was 53% for the BV group compared to 33% in the no BV group. The 3-year overall survival rate was 62% for the BV group compared to 44% for the no BV group.

At the time of transplant, in patients who did not respond to chemotherapy, survival without cancer getting worse was significantly higher for the BV group (51%) compared to the no BV group (10%). Overall survival at 3 years for these patients was 59% in the BV group compared to 20% in the no BV group.

The bottom line

This study concluded that patients with HL who do not respond to chemotherapy have better survival with BV treatment.

The fine print

This study had a small number of patients and unequal groups. Larger studies are needed for stronger evidence.

Published By :

Annals of Hematology

Date :

Mar 14, 2019

Original Title :

Brentuximab vedotin prior to allogeneic stem cell transplantation increases survival in chemorefractory Hodgkin’s lymphoma patients.

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