Treatment of Relapsed and Refractory Hodgkin Lymphoma – Recommendations of the Czech Hodgkin Lymphoma Study Group
Authors:
H. Mociková 1; J. Marková 1; Ľ. Gahérová 1; Z. Král 2; A. Sýkorová 3; D. Belada 3; V. Procházka 4; L. Martinková 5; T. Papajík 4; T. Kozák 1
Authors‘ workplace:
Interní hematologická klinika 3. LF UK a FN Královské Vinohrady, Praha
1; Interní hematologická a onkologická klinika LF MU a FN Brno
2; IV. interní hematologická klinika LF UK a FN Hradec Králové
3; Hematoonkologická klinika LF UP a FN Olomouc
4; Klinika hematoonkologie LF OU a FN Ostrava
5
Published in:
Klin Onkol 2016; 29(5): 342-346
Category:
Reviews
doi:
https://doi.org/http://dx.doi.org/10.14735/amko2016342
Overview
High-dose chemotherapy with autologous stem cell transplantation remains the current standard of treatment for young patients with Hodgkin lymphoma in first relapse or in those who are refractory to first-line treatment. The most important prognostic factors in relapses are clinical stage IV, poor performance status, bulky mass, and less than partial remission after salvage chemotherapy. Standard salvage chemotherapy in relapse before autologous transplantation has not been defined; however, DHAP and ICE are most frequently used in this setting. A standard conditioning regimen before autologous transplantation is BEAM. Tandem autologous transplantation has been investigated in high-risk patients. Brentuximab vedotin is recommended as a consolidation treatment in patients with a high risk of relapse after autologous transplantation. Brentuximab vedotin is the standard of treatment for relapse after autologous transplantation, and subsequent allogeneic stem cell transplantation should be considered in young patients. Bretuximab vedotin in combination with bendamustine, nivolumab, and pembrolizumab, and combinations thereof with other drugs, were investigated in clinical trials in relapsed or refractory patients with Hodgkin lymphoma.
Key words:
Hodgkin lymphoma – autologous stem cell transplantation – brentuximab vedotin – nivolumab
This work was supported by grant awarded by AZV 16-29857, Ministry of Health in Czech Republic, Research project P 27/2012 awarded by Charles University in Prague, 3rd Faculty of Medicine, Prague.
The authors declare they have no potential confl icts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.
Submitted:
7. 6. 2016
Accepted:
24. 8. 2016
Sources
1. Rancea M, von Tresckow B, Monsef I et al. High-dose chemotherapy followed by autologous stem cell transplantation for patients with relapsed or refractory Hodgkin lymphoma: a systematic review with meta-analysis. Crit Rev Oncol Hematol 2014; 92 (1): 1–10. doi: 10.1016/j.critrevonc.2014.04.003.
2. Linch DC, Winfield D, Goldstone A et al. Dose intensification with autologous bone-marrow transplantation in relapsed and resistant Hodgkin‘s disease, results of a BNLI randomised trial. Lancet 1993; 341 (8852): 1051–1054.
3. Schmitz N, Pfistner B, Sextro M et al. Aggressive conventional chemotherapy compared with high-dose chemotherapy with autologous haemopoietic stem-cell transplantation for relapsed chemosensitive Hodgkin’s disease: a randomised trial. Lancet 2002; 359 (9323): 2065–2071.
4. Mociková H, Pytlík R, Raida L et al. Léčba pacientů s relabovaným/refraktérním Hodgkinovým lymfomem. Klin Onkol 2011; 24 (2): 121–125.
5. Móciková H, Sýkorová A, Štěpánková P et al. Léčba a prognóza pacientů s relabovaným nebo refrakterním Hodgkinovým lymfomem nevhodných k transplantaci kmenových buněk. Klin Onkol 2014; 27 (6): 424–428. doi. 10.14735/amko2014424.
6. Bröckelmann PJ, Müller H, Casasnovas O et al. Risk factors and a prognostic score for progression free survival after treatment with autologous stem cell transplantation (ASCT) in patients with relapsed or refractory Hodgkin lymphoma (rrHL). Proc ASH 2015; abstr. 1978.
7. Moskowitz CH, Matasar MJ, Zelenetz AD et al. Normalization of pre-ASCT, FDG-PET imaging with second-line, non-cross-resistant, chemotherapy programs improves event-free survival in patients with Hodgkin lymphoma. Blood 2012; 119 (7): 1665–1670. doi: 10.1182/blood-2011-10-388058.
8. Josting A, Franklin J, May M et al. New prognostic score based on treatment outcome of patients with relapsed Hodgkin‘s lymphoma registered in the database of the German Hodgkin‘s Lymphoma Study Group. J Clin Oncol 2002; 20 (1): 221–230.
9. Santoro A, Magagnoli M, Spina M et al. Ifosfamide, gemcitabine, and vinorelbine: a new induction regimen for refractory and relapsed Hodgkin’s lymphoma. Haematologica 2007; 92 (1): 35–41.
10. Josting A, Müller H, Borchmann P et al. Dose intensity of chemotherapy in patients with relapsed Hodgkin‘s lymphoma. J Clin Oncol 2010; 28 (34): 5074–5080. doi: 10.1200/JCO.2010.30.5771.
11. Chen RW, Palmer J, Martin P et al. Results of a phase II trial of brentuximab vedotin as first line salvage therapy in relapsed/refractory HL prior to AHCT. Proc ASH 2014; abstr. 501.
12. Moskowitz AJ, Schöder H, Yahalom J et al. PET-adapted sequential salvage therapy with brentuximab vedotin followed by augmented ifosamide, carboplatin, and etoposide for patients with relapsed and refractory Hodgkin‘s lymphoma: a non-randomised, open-label, single-centre, phase 2 study. Lancet Oncol 2015; 16 (3): 284–292. doi: 10.1016/S1470-2045 (15) 70013-6.
13. LaCasce A, Bociek RG, Matous J et al. Brentuximab vedotin in combination with bendamustine for patients with Hodgkin lymphoma who are relapsed or refractory after frontline therapy. Proc ASH 2014; abstr. 293.
14. William BM, Loberiza FR Jr, Whalen V et al. Impact of conditioning regimen on outcome of 2-year disease-free survivors of autologous stem cell transplantation for Hodgkin lymphoma. Clin Lymphoma Myeloma Leuk 2013; 13 (4): 417–423. doi: 10.1016/j.clml.2013.03.009.
15. Morschhauser F, Brice P, Ferme C et al. Risk-adapted salvage treatment with single or tandem autologous stem-cell transplantation for first relapse/refractory Hodgkin’s lymphoma: results of the prospective multicenter H96 trial by the GELA/SFGM study group. J Clin Oncol 2008; 26 (36): 5980–5987. doi: 10.1200/JCO.2007.15.5887.
16. Moskowitz CH, Nademanee A, Masszi T et al. Brentuximab vedotin as consolidation therapy after autologous stem-cell transplantation in patients with Hodgkin‘s lymphoma at risk of relapse or progression (AETHERA): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2015; 385 (9980): 1853–1862. doi: 10.1016/S0140-6736 (15) 60165-9.
17. Younes A, Bartlett NL, Leonard JP et al. Brentuximab vedotin (SGN-35) for relapsed CD30-positive lymphomas. N Engl J Med 2010; 363 (19): 1812–1821. doi: 10.1056/NEJMoa1002965.
18. Younes A, Gopal AK, Smith SE et al. Results of a pivotal phase II study of brentuximab vedotin for patients with relapsed or refractory Hodgkin’s lymphoma. J Clin Oncol 2012; 30 (18): 2183–2189. doi: 10.1200/JCO.2011.38.0410.
19. Bartlett NL, Chen R, Fanale MA et al. Retreatment with brentuximab vedotin in patients with CD30-positive hematologic malignancies. J Hematol Oncol 2014; 7: 24. doi: 10.1186/1756-8722-7-24.
20. Ansell SM, Lesokhin AM, Borrello I et al. PD-1 blockade with nivolumab in relapsed or refractory Hodgkin‘s lymphoma. N Engl J Med 2015; 372 (4): 311–319. doi: 10.1056/NEJMoa1411087.
21. Armand P, Shipp MA, Ribrag V et al. PD-1 blockade with pembrolizumab in patients with classical Hodgkin lymphoma after brentuximab vedotin failure: safety, efficacy, and biomarker assessment. Proc ASH 2015; abstr. 584.
22. Chen R, Palmer JM, Thomas SH et al. Brentuximab vedotin enables successful reduced-intensity allogeneic hematopoietic cell transplantation in patients with relapsed or refractory Hodgkin lymphoma. Blood 2012; 119 (26): 6379–6381. doi: 10.1182/blood-2012-03-418673.
23. Rashidi A, Ebadi M, Cashen AF. Allogeneic hematopoietic stem cell transplantation in Hodgkin lymphoma: a systematic review and meta-analysis. Bone Marrow Transplant 2016; 51 (4): 521–528. doi: 10.1038/bmt.2015.332.
Labels
Paediatric clinical oncology Surgery Clinical oncologyArticle was published in
Clinical Oncology
2016 Issue 5
Most read in this issue
- The Impact of High Protein Nutritional Support on Clinical Outcomes and Treatment Costs of Patients with Colorectal Cancer
- Treatment of Relapsed and Refractory Hodgkin Lymphoma – Recommendations of the Czech Hodgkin Lymphoma Study Group
- Malignant Mesothelioma of the Tunica Vaginalis Testis. A Clinicopathologic Analysis of Two Cases with a Review of the Literature
- Multimodal Therapy of Recurrent Malignant Schwannoma