HL-041 The Efficacy and Safety of BV-ICE Salvage Therapy for Relapsed/Refractory Hodgkin Lymphoma: A Single-Center

Abstract

Context: ASCT is the standard of care in R/R HL. Brentuximab-vedotin (BV) has been studied as maintenance post-ASCT, as single-agent after failure chemotherapy or in combination with different protocols. Objective: This study is to evaluate the CMR post salvage BV-ICE in patients with R/R HL prior to ASCT. The secondary endpoints: PFS, OS, RR, safety profile, and the delay to platelets and neutrophils engraftment post ASCT. Methods: Retrospective study of patients with R/R HL treated and followed at AUBMC between 2018 and 2021 Results: We identified 14 R/R HL patients, median age 30 yrs. 13 were nodular sclerosis (NS) subtype. 1 patient had mixed cellularity. All received ABVD initially. Median duration from diagnosis to relapse was 9.6 months. Patients were divided into 3 categories, 43% primary refractory, 21% relapsed within 3 to 12 months, 36% relapsed after 12 months from initial therapy. 57% were stage II on relapse and 36% stage IV. 14% received E-BEACOPP and 7% received DHAP as 1st salvage therapy. 21% received BV-ICE as 2nd salvage and 79% received BV-ICE as 1st salvage. Median duration from 1st relapse to BV-ICE was 1 month. BV was given on day 1 at 1.8mg/kg IV, etoposide 100 mg/m2 IV on days 1-3 and ifosfamide 5mg/m2 plus mesna 5g/m2 IV over 24 h on day 2, carboplatin IV AUC5 on day 2 for 2 cycles every 21-day cycle. All received GCSF 24hrs after treatment. Disease evaluation after 2nd cycle of BV-ICE using PET-FDG showed 93% CR and 7% PR. All did one attempt for SCC after cycle 2 without plerixafor. 93% were in CR and 7% in PR prior to transplant. The median PBSC collection was 14.7×106 CD34+cells/Kg, median of 10.96×106 CD34+ cells/Kg were infused. All received 3rd BV-ICE cycle and went into ASCT using BEAM conditioning. Median days to ANC engraftment was 9 and to platelet engraftment was 16.5. At day 100, 79% had CR, 14% PR, 7% had progression. After a median follow-up [E2] of 12.3 months the OS was 100% and PFS of 77%. Most common adverse event was hematological toxicity: 50% grade 3 anemia, 72% grade 3 thrombocytopenia, 72% FN. 7% developed grade 4 PN with reversible symptoms. Conclusions: BV-ICE as 1st salvage in R/R HL showed high ORR of 100% to be translated into improvement in DFS with acceptable toxicity profile. © 2022 Elsevier Inc.