Outcomes of patients with Hodgkin lymphoma receiving Brentuximab Vedotin (BV) as maintenance therapy after ASCT according to previous exposure to BV. A retrospective analysis of the EBMT Lymphoma Working Party in collaboration with GELTAMO, FIL, LYSA, and Turkish Lymphoma Group.

Abstract

We evaluated brentuximab vedotin (BV) as maintenance therapy after autologous stem cell transplantation (ASCT) in 353 patients with relapsed/refractory Hodgkin lymphoma (HL). Of these, 52.6% received BV prior to ASCT. The five-year overall survival (OS) and progression-free survival (PFS) from the start of BV maintenance were 85.1% and 69.9%, respectively. Multivariable analysis revealed that age at ASCT (HR 1.17, P = 0.037), disease status (HR 3.61, P = 0.002), and BV treatment before ASCT (HR 0.40, P = 0.033) significantly impacted OS. Disease status at ASCT was the only factor significantly associated with PFS (HR 3.09, p < 0.001) and relapse risk (HR 3.33, p < 0.001). Although a trend toward improved PFS (HR 0.59, p = 0.053) and lower relapse risk (HR 0.57, p = 0.051) was observed in patients treated with BV before ASCT, the data were not statistically significant. Patients in complete remission (CR) at ASCT showed similar 2-year OS (94.6% vs. 99.2%, P = 0.3) and PFS (84.6% vs. 89%, P = 0.3) regardless of BV pre-transplant. In those not in CR, OS (83.1% vs. 93.6%, P = 0.076) and PFS (51.5% vs. 75.3%, P = 0.039) were higher in those previously treated with BV. This large study emphasizes BV maintenance post-ASCT, even in patients pre-treated with BV, ang highlights disease status as a key prognostic factor.