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The outcome of patients with Hodgkin lymphoma and early relapse after autologous stem cell transplant has improved in recent years

Leukemia volume 36, pages 1646–1653 (2022)Cite this article

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A Correction to this article was published on 15 July 2022

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Abstract

Hodgkin lymphoma (HL) patients who relapse after autologous-stem-cell- transplantation (auto-SCT) have traditionally had a poor prognosis. We analyzed 1781 adult HL patients who relapsed between 2006 and 2017 after a first auto-SCT. The 4-year overall survival (OS) after relapse continuously increased from 32% for patients relapsing in 2006–2008, to 63% for patients relapsing in 2015–2017 (p = 0.001). The improvement over time was predominantly noted in patients who had an early relapse (within 12 months) after auto-SCT (p = 0.01). On multivariate analysis, patients who relapsed in more recent years and those with a longer interval from transplant to relapse had a better OS, whereas increasing age, poor performance status, bulky disease, extranodal disease and presence of B symptoms at relapse were associated with a worse OS. Brentuximab vedotin (BV), checkpoint inhibitors (CPI) and second transplant (SCT2; 86% allogeneic) were used in 233, 91 and 330 patients respectively. The 4-year OS from BV, CPI, and SCT2 use was 55%, 48% and 55% respectively. In conclusion, the outcome after post-transplant relapse has improved significantly in recent years, particularly in the case of early relapse. These large-scale real-world data can serve as benchmark for future studies in this setting.

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Fig. 1: Overall survival from relapse over time according to the year of relapse for 1781 adult patients who relapsed between 2006 and 2017 after auto-SCT for relapsed/refractory classical HL following first-line therapy.
Fig. 2: Improved overall survival after relapse over time.
Fig. 3: Treatment for relapse after auto-SCT.

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Author information

Author notes

  1. Deceased: Boris Afanasyev.

Authors and Affiliations

  1. Department of Internal Medicine, American University of Beirut medical center, Beirut, Lebanon

    Ali Bazarbachi & Jean Cheikh

  2. Clinical Hematology and Cellular Therapy Department, Hospital Saint- Antoine, 84 Rue du Faubourg Saint-Antoine, 75012, Paris, France

    Ariane Boumendil

  3. European Society for Blood and Marrow Transplantation, Paris, France

    Hervé Finel

  4. EBMT LWP Paris Office Hopital Saint-Antoine, Paris, France

    Irma Khvedelidze

  5. Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland

    Joanna Romejko-Jarosinska

  6. Fundeni Clinical Institute, Bucharest, Romania

    Alina Tanase

  7. King Faisal Specialist Hospital and Research Center, Oncology Center, Riyadh, Kingdom of Saudi Arabia

    Saad Akhtar

  8. Centre National De Greffe De La Moelle Osseuse, Tunis, Tunisia

    Tarek Ben Othman

  9. Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan

    Mohammad Ma’koseh

  10. First State Pavlov Medical University of St. Petersburg, Raisa Gorbacheva Memorial Research Institute for Paediatric Oncology, Hematology, and Transplantation, St, Petersburg, Russia

    Boris Afanasyev

  11. Hematology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    Javier Briones

  12. Anadolu Medical Center, Gebze, Turkey

    Zafer Gülbas

  13. Centre Pierre et Marie Curie, Alger, Algeria

    Rose-Marie Hamladji

  14. Istanbul University – Cerrahpasa, Cerrahpasa School of Medicine, Department of Internal Medicine, Division of Haematology, Bone Marrow Transplantation Unit, Istanbul, Turkey

    Tugrul Elverdi

  15. Department of Haematology, Institut Paoli Calmettes, Marseille, France

    Didier Blaise

  16. Hematopoietic Stem Cell Transplantation Unit, Hematology Department, Institute of Hematology and Oncology, Hospital Clínic of Barcelona, Barcelona, Spain

    Carmen Martínez

  17. Institute of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy

    Eleonora Alma

  18. Department of Hematopoietic Stem Cell Transplantation, Institute of Hematology and Transfusion Medicine, Warsaw, Poland

    Kazimierz Halaburda

  19. Hospital dos Capuchos, Lisboa, Portugal

    Aida Botelho Sousa

  20. Department of Haematology and Stem Cell Transplantation, Helios Clinic, Berlin-Buch, Germany

    Bertram Glass

  21. Bristol Oncology Centre, Bristol, UK

    Steven Robinson

  22. Department of Haemato-Oncology, St Bartholomew’s Hospital, Barts Health NHS Trust, London, UK

    Silvia Montoto

  23. Hematology Department, Institut Català d’Oncologia Hospitalet, IDIBELL, Universitat de Barcelona, Barcelona, Spain

    Anna Sureda

Authors
  1. Ali Bazarbachi
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Contributions

ABa and AS proposed the study, interpreted the data, and wrote the manuscript. SM and SR participated in study design, interpreted the data, and edited the manuscript. ABou. helped with the design and was responsible for statistical analysis. HF was the study coordinator. All other authors reported updated patient data and read and commented on the manuscript. All authors proofread the manuscript and agreed on the data presented.

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Correspondence to Ali Bazarbachi.

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Bazarbachi, A., Boumendil, A., Finel, H. et al. The outcome of patients with Hodgkin lymphoma and early relapse after autologous stem cell transplant has improved in recent years. Leukemia 36, 1646–1653 (2022). https://doi.org/10.1038/s41375-022-01563-8

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