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Use of brentuximab vedotin as salvage therapy pre‐allogeneic stem cell transplantation in relapsed/refractory CD30 positive lympho‐proliferative disorders: a single centre experience
Author(s) -
Mediwake Heshani,
Morris Kirk,
Curley Cameron,
Butler Jason,
Kennedy Glen
Publication year - 2017
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.13415
Subject(s) - brentuximab vedotin , medicine , transplantation , cd30 , refractory (planetary science) , surgery , salvage therapy , anaplastic large cell lymphoma , oncology , lymphoma , graft versus host disease , stem cell , gastroenterology , chemotherapy , physics , astrobiology , biology , genetics
Background The role of brentuximab peri‐allogeneic transplantation in patients with relapsed and/or refractory CD30 positive lymphomas remains poorly defined. Aim To assess the outcome of use of brentuximab as a bridge to allogeneic stem cell transplantation ( SCT ) in patient with relapsed/refractory CD30 + classic Hodgkin lymphoma cHL and anaplastic large cell lymphoma ( ALCL ). Methods Outcomes of consecutive patients with relapsed/refractory cHL / ALCL treated with brentuximab as a bridge to SCT were determined by retrospective review of individual medical records. Survival analysis was measured from start of brentuximab treatment. Results A total of 12 patients (10 cHL , 2 ALCL ) had received brentuximab as a planned bridge to allogeneic SCT . Median age was 27 years (range 20–54 years); median prior lines of therapy was 4 (range 3–6) and all except one patient had undergone prior autologous SCT (92%). Patients received at median of 3 brentuximab doses pre‐allogeneic SCT (range 1–4), with an overall response rate of 66.7%. At a median follow up of 30 months (range 6–52 months), 2 years progression free survival and overall survival post‐allogeneic SCT is 58 and 92% respectively. Incidence of non‐relapse mortality, grade 3–4 acute graft versus host disease and extensive stage chronic graft versus host disease is 8, 17 and 18% respectively. Of five patients who subsequently relapsed post‐ SCT , four remain alive with disease control post manipulation of immune‐suppression. Conclusion Our experience suggests that brentuximab use pre‐allogeneic SCT is not associated with any significant post‐transplant toxicity, and is associated with a rapid response in a majority of patients with relapsed/refractory CD30 positive lymphomas. Brentuximab may thus provide a non‐toxic bridge to allogeneic SCT for patients with relapsed/refractory CD30 positive cHL or ALCL .