Brentuximab Vedotin (BV) treatment has improved the prognosis and survival of patients with Hodgkin’s lymphoma, relapsed after stem cell transplantation or having refractory disease. Aim: To analyze the prognostic factors, influencing the outcome after therapy with BV in relapsed or refractory patients with Hodgkin’s lymphoma.
We studied sixty-four (64) Hodgkin’s lymphoma patients treated with BV in six Hematology clinics in Bulgaria. The male / female ratio was 1 / 1, the mean age at the time of BV therapy was 40.66+/-13.1 years. The most common histological variant was nodular sclerosis 46 (71.9%). In the II clinical stage there were 26 patients (40.6%), in IIIrd - 17 (26.6%), in IVth - 21 (32.8%). All patients before treatment with BV received median of 4 (2-12) treatment lines, 30 ( 46.9%) received =/>3 lines. Autologous stem cell transplantation (autoSCT) was performed in 45 (70.3%) patients, two of which were second autologous SCTs, and in one auto/ allo SCT.
ORR was 60.9% (N = 39). Complete response was achieved in 39.1% (25) and partial response in 21.9% (14) patients. Stable disease was registered in 10.9% (7) and progression in 28.1% (18). PFS for the entire group was 14 months. The median survival (MS) was not reached by the end of the analysis. At least partial therapeutic response was significantly higher in patients with chemosensitive disease before autoSCT ( P = 0.006, R = +0.340), these who have undergone autoSCT ( P = 0.021, R= -0.335) and when BV was started as consolidation therapy by month 3 after autoSCT ( P = 0.02, R = +0.287). The only significant prognostic factor that determines a remarkably longer EFS is the type of therapeutic response itself: in the CR + PR group, the median PFS is not reached by the time of the analysis, while in patients with stable disease and progression EFS is 7 months (P < 0.001).
BV is most effective in patients with chemosensitive disease, and when used as consolidation therapy early, by 3-rd month after autoSCT. Our results confirm the international experience. BV improves the therapeutic response and prolongs progression-free survival in the patients with Hodgkin’s lymphoma who previously had really bad prognosis.
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