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Combining brentuximab vedotin with dexamethasone, high-dose cytarabine and cisplatin as salvage treatment in relapsed or refractory Hodgkin lymphoma: the phase II HOVON/LLPC Transplant BRaVE study

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  1. Increments in DNA-thioguanine level during thiopurine enhanced maintenance therapy of acute lymphoblastic leukemia

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  2. Structural aberrations are associated with poor survival in patients with clonal cytopenia of undetermined significance

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  3. The ASXL1-G643W variant accelerates the development of CEBPA mutant acute myeloid leukemia

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  4. Induction of erythroferrone in healthy humans by micro-dose recombinant erythropoietin or high-altitude exposure

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  1. Parenthood Rates and Use of Assisted Reproductive Techniques in Younger Hodgkin Lymphoma Survivors: A Danish Population-Based Study

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  2. Reference values for the EORTC QLQ-C30 in patients with advanced stage Hodgkin Lymphoma and in Hodgkin Lymphoma survivors

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  3. Detailed Long-Term Follow-Up of Patients Who Relapsed After the Nordic Mantle Cell Lymphoma Trials: MCL2 and MCL3

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  4. Immune-related protein signature in serum stratify relapsed mantle cell lymphoma patients based on risk

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  • Marie José Kersten
  • Julia Driessen
  • Josée M Zijlstra
  • Wouter J Plattel
  • Franck Morschhauser
  • Pieternella J Lugtenburg
  • Pauline Brice
  • Martin Hutchings
  • Thomas Gastinne
  • Roberto Liu
  • Coreline N Burggraaff
  • Marcel Nijland
  • Sanne H Tonino
  • Anne IJ Arens
  • Roelf Valkema
  • Harm van Tinteren
  • Marta Lopez-Yurda
  • Arjan Diepstra
  • Daphne De Jong
  • Anton Hagenbeek
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Achieving a metabolic complete response (mCR) before high-dose chemotherapy (HDC) and autologous peripheral blood stem-cell transplant (auto-PBSCT) predicts progression free survival (PFS) in relapsed/refractory classical Hodgkin lymphoma (R/R cHL). We added brentuximab vedotin (BV) to DHAP to improve the mCR rate. In a Phase I dose-escalation part in 12 patients, we showed that BV-DHAP is feasible. This Phase II study included 55 R/R cHL patients (23 primary refractory). Treatment consisted of three 21-day cycles of BV 1.8 mg/kg on day 1, and DHAP (dexamethasone 40mg days 1-4, cisplatin 100mg/m2; day 1 and cytarabine 2x2g/m2; day 2). Patients with a metabolic partial response (mPR) or mCR proceeded to HDC/auto-PBSCT. Based on independent central FDG-PET-CT review, 42 of 52 evaluable patients (81% [95% CI: 67-90]) achieved an mCR before HDC/auto-PBSCT, five had an mPR and five had progressive disease (three were not evaluable). After HDC/auto-PBSCT, four patients with an mPR converted to an mCR. The 2-year PFS was 74% [95% CI: 63-86], and the overall survival 95% [95% CI: 90-100]. Toxicity was manageable and mainly consisted of grade 3/4 hematological toxicity, fever, nephrotoxicity, ototoxicity (grade 1/2) and transiently elevated liver enzymes during BV-DHAP. Eighteen patients developed new onset peripheral neuropathy (maximum grade 1/2) and all recovered. In conclusion, BV-DHAP is a very effective salvage regimen in R/R cHL patients, but patients should be monitored closely for toxicity. ClinicalTrials.gov identifier: NCT02280993.

Original languageEnglish
JournalHaematologica
Volume106
Issue number4
Pages (from-to)1129-1137
Number of pages9
ISSN0390-6078
DOIs
Publication statusPublished - 1 Apr 2021

ID: 62112358