E. Lucchini, R. Sciarra, V. Tomarchio, S. Pelliccia, M. Marangon, E. Maiolo, M. Novo, L. Schiattone, M. Farina, G. Scapinello, F. M. Quaglia, J. Olivieri, L. Pagliaro, P. Angelillo, L. Mannelli, C. Ghiggi, F. Zaja
{"title":"干细胞移植在接受检查点抑制剂治疗的r / r经典霍奇金淋巴瘤患者中的作用：意大利多中心经验","authors":"E. Lucchini, R. Sciarra, V. Tomarchio, S. Pelliccia, M. Marangon, E. Maiolo, M. Novo, L. Schiattone, M. Farina, G. Scapinello, F. M. Quaglia, J. Olivieri, L. Pagliaro, P. Angelillo, L. Mannelli, C. Ghiggi, F. Zaja","doi":"10.1002/hon.70094_364","DOIUrl":null,"url":null,"abstract":"<p>There is no agreement on the role and positioning of stem cell transplantation (SCT) in patients (pts) with relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL) who undertake treatment with checkpoint inhibitors (CPI). The aim of this study is to evaluate the real-world outcomes of R/R cHL pts treated with CPI, particularly the use of consolidation with autologous (autoSCT) and allogeneic SCT (alloSCT). Observational, retrospective, multicenter study which enrolled consecutive pts with R/R cHL aged 18–70 years, treated with CPI monotherapy in Italy from January 2016 to June 2023. Primary objective was the proportion of pts who received consolidation with alloSCT.</p><p>We enrolled 126 pts from 15 Italian centers. Median age at CPI start was 36 years (18–70), 54% males, 95% received first-line ABVD, 51% previously received autoSCT and 98% brentuximab vedotin. Eighty-six pts (68%) were treated with pembrolizumab, 40 (32%) with nivolumab. Overall response rate to CPI was 81%, with 49% complete responses (CRs). 107 pts (85%) were considered fit for alloSCT, of those 62 (58%) were planned to receive alloSCT. Ultimately, 41 pts (32%) received alloSCT, 36 (29%) autoSCT and 49 (39%) received no consolidation. Reasons for not performing alloSCT in candidates were progressive disease (PD) (<i>n</i> = 9), donor unavailability (<i>n</i> = 4), patient’s refusal or comorbidities (<i>n</i> = 4), others (<i>n</i> = 4). Twenty-nine out of 41 allo-transplanted pts (70%) had already received an autoSCT before CPI. Reasons for not administering a consolidation after CPI were age/comorbidity (<i>n</i> = 19), center’s choice (<i>n</i> = 9), alloSCT refusal or donor unavailability (<i>n</i> = 9), PD (<i>n</i> = 7), other (<i>n</i> = 5).</p><p>In pts who consolidated with alloSCT or autoSCT, median PFS and OS were not reached at a median follow-up of 27 (range 7–90) and 47.5 months (range 4–99) from CPI treatment, respectively. 48-months PFS probability were 80.6% and 81% for alloSCT and autoSCT recipients. Transplant-related mortality after alloSCT was 14.6%. In non-consolidated pts, at a median follow-up of 21 months, median PFS was 27 months. Seventeen pts (35%) were still receiving CPI at last follow-up; the main reason for interruption was PD, in 18/32 pts (56%). In pts who received SCT consolidation there was no difference in terms of PFS according to the obtainment of a CR with CPI (<i>p</i> = 0.93 for alloSCT and <i>p</i> = 0.6 for autoSCT). Instead, pts who didn’t consolidate had a significantly poorer outcome if they didn’t obtain a CR with CPI (median PFS not reached versus 11 months; <i>p</i> < 0.001)—Figure 1.</p><p>Outcomes after autoSCT and alloSCT consolidation are excellent, regardless of the response achieved with CPI; alloSCT was burdened by higher toxicity. Pts who achieved a CR with CPI showed good outcomes even without consolidation, however autoSCT should be considered if not performed before. Pts who do not achieve/loss the CR and have already performed autoSCT can be considered for alloSCT. Those who don’t achieve a CR and don’t consolidate have the worst outcome.</p><p><b>Encore Abstract:</b> EHA 2025</p><p><b>Keywords:</b> stem cell transplant; Hodgkin lymphoma; immunotherapy</p><p>No potential sources of conflict of interest.</p>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 S3","pages":""},"PeriodicalIF":3.9000,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70094_364","citationCount":"0","resultStr":"{\"title\":\"THE ROLE OF STEM CELL TRANSPLANTATION IN PATIENTS WITH R/R CLASSICAL HODGKIN LYMPHOMA TREATED WITH CHECKPOINT INHIBITORS: ITALIAN MULTICENTER EXPERIENCE\",\"authors\":\"E. Lucchini, R. Sciarra, V. Tomarchio, S. Pelliccia, M. Marangon, E. Maiolo, M. Novo, L. Schiattone, M. Farina, G. Scapinello, F. M. Quaglia, J. Olivieri, L. Pagliaro, P. Angelillo, L. Mannelli, C. Ghiggi, F. Zaja\",\"doi\":\"10.1002/hon.70094_364\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>There is no agreement on the role and positioning of stem cell transplantation (SCT) in patients (pts) with relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL) who undertake treatment with checkpoint inhibitors (CPI). The aim of this study is to evaluate the real-world outcomes of R/R cHL pts treated with CPI, particularly the use of consolidation with autologous (autoSCT) and allogeneic SCT (alloSCT). Observational, retrospective, multicenter study which enrolled consecutive pts with R/R cHL aged 18–70 years, treated with CPI monotherapy in Italy from January 2016 to June 2023. Primary objective was the proportion of pts who received consolidation with alloSCT.</p><p>We enrolled 126 pts from 15 Italian centers. Median age at CPI start was 36 years (18–70), 54% males, 95% received first-line ABVD, 51% previously received autoSCT and 98% brentuximab vedotin. Eighty-six pts (68%) were treated with pembrolizumab, 40 (32%) with nivolumab. Overall response rate to CPI was 81%, with 49% complete responses (CRs). 107 pts (85%) were considered fit for alloSCT, of those 62 (58%) were planned to receive alloSCT. Ultimately, 41 pts (32%) received alloSCT, 36 (29%) autoSCT and 49 (39%) received no consolidation. Reasons for not performing alloSCT in candidates were progressive disease (PD) (<i>n</i> = 9), donor unavailability (<i>n</i> = 4), patient’s refusal or comorbidities (<i>n</i> = 4), others (<i>n</i> = 4). Twenty-nine out of 41 allo-transplanted pts (70%) had already received an autoSCT before CPI. Reasons for not administering a consolidation after CPI were age/comorbidity (<i>n</i> = 19), center’s choice (<i>n</i> = 9), alloSCT refusal or donor unavailability (<i>n</i> = 9), PD (<i>n</i> = 7), other (<i>n</i> = 5).</p><p>In pts who consolidated with alloSCT or autoSCT, median PFS and OS were not reached at a median follow-up of 27 (range 7–90) and 47.5 months (range 4–99) from CPI treatment, respectively. 48-months PFS probability were 80.6% and 81% for alloSCT and autoSCT recipients. Transplant-related mortality after alloSCT was 14.6%. In non-consolidated pts, at a median follow-up of 21 months, median PFS was 27 months. Seventeen pts (35%) were still receiving CPI at last follow-up; the main reason for interruption was PD, in 18/32 pts (56%). In pts who received SCT consolidation there was no difference in terms of PFS according to the obtainment of a CR with CPI (<i>p</i> = 0.93 for alloSCT and <i>p</i> = 0.6 for autoSCT). Instead, pts who didn’t consolidate had a significantly poorer outcome if they didn’t obtain a CR with CPI (median PFS not reached versus 11 months; <i>p</i> < 0.001)—Figure 1.</p><p>Outcomes after autoSCT and alloSCT consolidation are excellent, regardless of the response achieved with CPI; alloSCT was burdened by higher toxicity. Pts who achieved a CR with CPI showed good outcomes even without consolidation, however autoSCT should be considered if not performed before. Pts who do not achieve/loss the CR and have already performed autoSCT can be considered for alloSCT. Those who don’t achieve a CR and don’t consolidate have the worst outcome.</p><p><b>Encore Abstract:</b> EHA 2025</p><p><b>Keywords:</b> stem cell transplant; Hodgkin lymphoma; immunotherapy</p><p>No potential sources of conflict of interest.</p>\",\"PeriodicalId\":12882,\"journal\":{\"name\":\"Hematological Oncology\",\"volume\":\"43 S3\",\"pages\":\"\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2025-06-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70094_364\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hematological Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/hon.70094_364\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hematological Oncology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/hon.70094_364","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
THE ROLE OF STEM CELL TRANSPLANTATION IN PATIENTS WITH R/R CLASSICAL HODGKIN LYMPHOMA TREATED WITH CHECKPOINT INHIBITORS: ITALIAN MULTICENTER EXPERIENCE
There is no agreement on the role and positioning of stem cell transplantation (SCT) in patients (pts) with relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL) who undertake treatment with checkpoint inhibitors (CPI). The aim of this study is to evaluate the real-world outcomes of R/R cHL pts treated with CPI, particularly the use of consolidation with autologous (autoSCT) and allogeneic SCT (alloSCT). Observational, retrospective, multicenter study which enrolled consecutive pts with R/R cHL aged 18–70 years, treated with CPI monotherapy in Italy from January 2016 to June 2023. Primary objective was the proportion of pts who received consolidation with alloSCT.
We enrolled 126 pts from 15 Italian centers. Median age at CPI start was 36 years (18–70), 54% males, 95% received first-line ABVD, 51% previously received autoSCT and 98% brentuximab vedotin. Eighty-six pts (68%) were treated with pembrolizumab, 40 (32%) with nivolumab. Overall response rate to CPI was 81%, with 49% complete responses (CRs). 107 pts (85%) were considered fit for alloSCT, of those 62 (58%) were planned to receive alloSCT. Ultimately, 41 pts (32%) received alloSCT, 36 (29%) autoSCT and 49 (39%) received no consolidation. Reasons for not performing alloSCT in candidates were progressive disease (PD) (n = 9), donor unavailability (n = 4), patient’s refusal or comorbidities (n = 4), others (n = 4). Twenty-nine out of 41 allo-transplanted pts (70%) had already received an autoSCT before CPI. Reasons for not administering a consolidation after CPI were age/comorbidity (n = 19), center’s choice (n = 9), alloSCT refusal or donor unavailability (n = 9), PD (n = 7), other (n = 5).
In pts who consolidated with alloSCT or autoSCT, median PFS and OS were not reached at a median follow-up of 27 (range 7–90) and 47.5 months (range 4–99) from CPI treatment, respectively. 48-months PFS probability were 80.6% and 81% for alloSCT and autoSCT recipients. Transplant-related mortality after alloSCT was 14.6%. In non-consolidated pts, at a median follow-up of 21 months, median PFS was 27 months. Seventeen pts (35%) were still receiving CPI at last follow-up; the main reason for interruption was PD, in 18/32 pts (56%). In pts who received SCT consolidation there was no difference in terms of PFS according to the obtainment of a CR with CPI (p = 0.93 for alloSCT and p = 0.6 for autoSCT). Instead, pts who didn’t consolidate had a significantly poorer outcome if they didn’t obtain a CR with CPI (median PFS not reached versus 11 months; p < 0.001)—Figure 1.
Outcomes after autoSCT and alloSCT consolidation are excellent, regardless of the response achieved with CPI; alloSCT was burdened by higher toxicity. Pts who achieved a CR with CPI showed good outcomes even without consolidation, however autoSCT should be considered if not performed before. Pts who do not achieve/loss the CR and have already performed autoSCT can be considered for alloSCT. Those who don’t achieve a CR and don’t consolidate have the worst outcome.
期刊介绍：
Hematological Oncology considers for publication articles dealing with experimental and clinical aspects of neoplastic diseases of the hemopoietic and lymphoid systems and relevant related matters. Translational studies applying basic science to clinical issues are particularly welcomed. Manuscripts dealing with the following areas are encouraged:
-Clinical practice and management of hematological neoplasia, including: acute and chronic leukemias, malignant lymphomas, myeloproliferative disorders
-Diagnostic investigations, including imaging and laboratory assays
-Epidemiology, pathology and pathobiology of hematological neoplasia of hematological diseases
-Therapeutic issues including Phase 1, 2 or 3 trials as well as allogeneic and autologous stem cell transplantation studies
-Aspects of the cell biology, molecular biology, molecular genetics and cytogenetics of normal or diseased hematopoeisis and lymphopoiesis, including stem cells and cytokines and other regulatory systems.
Concise, topical review material is welcomed, especially if it makes new concepts and ideas accessible to a wider community. Proposals for review material may be discussed with the Editor-in-Chief. Collections of case material and case reports will be considered only if they have broader scientific or clinical relevance.
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