Brentuximab vedotin in transplant-naïve relapsed/refractory hodgkin lymphoma: experience in 30 patients

Background. Hodgkin lymphoma (HL) is characterized by the presence of CD30-positive Hodgkin Reed-Sternberg cells. Approximately30%- 40%ofpatientswithadvanceddisease arerefractory to frontline therapy or will relapse after first-line treatment. The standard management of these patients is salvage chemotherapy followed by high-dose chemotherapy and autologous stem cell transplant(ASCT).Thebestprognostic factor isthestatusofdisease before ASCT; in particular, the normalization of positron emission tomography (PET) scan. Brentuximab vedotin (BV) has shown a high overall response rate in refractory/relapsed HL after ASCT, whereas few data are available regarding its role before ASCT. Patients and Methods. A multicenter, retrospective, observational study was conducted.The primary endpoint of the study was the effectiveness of BV as single agent in patients with relapsed/refractory, ASCT-naïve HL, determined by the conversion of PET status from positive to negative; secondary endpoints were safety, capacity to proceed to ASCT, survival, and progression-free status. Results. Thirty patients with relapsed/refractory HL- and PETpositive disease after conventional chemotherapy salvage treatments were treated with a median of 4 cycles of BV. Normalization of PET findings (Deauville score#2) occurred in 9 of 30 patients (30%).Those nine patients proceeded to ASCT. Conclusion. These data suggest that BV can normalize PETstatus in a subset of HL patients refractory to conventional chemotherapy salvage treatments, such as ifosfamide-containing regimens, cytarabine- and platinum-containing regimens, prior to ASCT