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Journal Articles Leukemia Year : 2021

Allogeneic transplantation after PD-1 blockade for classic Hodgkin lymphoma

David Bond
Samantha Jaglowski
Sally Arai
  • Function : Author
Jean Marc Schiano de Colella
Didier Blaise
Alex Herrera
  • Function : Author
Geoffrey Shouse
Stephen Ansell
Yago Nieto
  • Function : Author
Talha Badar
  • Function : Author
Mehdi Hamadani
Tatyana Feldman
  • Function : Author
Lori Dahncke
  • Function : Author
Anurag Singh
Joseph Mcguirk
Taiga Nishihori
Julio Chavez
  • Function : Author
Anthony Serritella
  • Function : Author
Justin Kline
  • Function : Author
Mohamad Mohty
Kamal Bouabdallah
  • Function : Author
Dipenkumar Modi
Radhakrishnan Ramchandren
  • Function : Author
Lazaros Lekakis
  • Function : Author
Amer Beitinjaneh
  • Function : Author
Matthew Frigault
  • Function : Author
Yi-Bin Chen
Ryan Lynch
  • Function : Author
Stephen Smith
Uttam Rao
  • Function : Author
Michael Byrne
  • Function : Author
Jason Romancik
  • Function : Author
Jonathon Cohen
  • Function : Author
Sunita Nathan
Tycel Phillips
  • Function : Author
Robin Joyce
  • Function : Author
Maryam Rahimian
  • Function : Author
Asad Bashey
  • Function : Author
Hatcher Ballard
  • Function : Author
Jakub Svoboda
  • Function : Author
Valter Torri
  • Function : Author
Martina Sollini
  • Function : Author
Chiara de Philippis
  • Function : Author
Massimo Magagnoli
  • Function : Author
Armando Santoro
  • Function : Author
Philippe Armand

Abstract

Anti-PD-1 monoclonal antibodies yield high response rates in patients with relapsed/refractory classic Hodgkin lymphoma (cHL), but most patients will eventually progress. Allogeneic hematopoietic cell transplantation (alloHCT) after PD-1 blockade may be associated with increased toxicity, raising challenging questions about the role, timing, and optimal method of transplantation in this setting. To address these questions, we assembled a retrospective cohort of 209 cHL patients who underwent alloHCT after PD-1 blockade. With a median follow-up among survivors of 24 months, the 2-year cumulative incidences (CIs) of non-relapse mortality and relapse were 14 and 18%, respectively; the 2-year graft-versus-host disease (GVHD) and relapse-free survival (GRFS), progression-free survival (PFS), and overall survival were 47%, 69%, and 82%, respectively. The 180-day CI of grade 3-4 acute GVHD was 15%, while the 2-year CI of chronic GVHD was 34%. In multivariable analyses, a longer interval from PD-1 to alloHCT was associated with less frequent severe acute GVHD, while additional treatment between PD-1 and alloHCT was associated with a higher risk of relapse. Notably, post-transplant cyclophosphamide (PTCy)-based GVHD prophylaxis was associated with significant improvements in PFS and GRFS. While awaiting prospective clinical trials, PTCy-based GVHD prophylaxis may be considered the optimal transplantation strategy for this patient population.
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Dates and versions

hal-03229516 , version 1 (19-05-2021)

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Reid Merryman, Luca Castagna, Laura Giordano, Vincent Ho, Paolo Corradini, et al.. Allogeneic transplantation after PD-1 blockade for classic Hodgkin lymphoma. Leukemia, 2021, 35 (9), pp.2672-2683. ⟨10.1038/s41375-021-01193-6⟩. ⟨hal-03229516⟩
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