Successful restoration of checkpoint inhibitors efficacy after allogeneic hematopoietic cell transplant for classic Hodgkin lymphoma patients

Background

Classic Hodgkin lymphoma (cHL) is a highly-curable disease. However, relapses after bone marrow transplant are challenging especially relapses after allogeneic transplant.

Methods

A retrospective chart review of the institution transplant database to summarize the safety and efficacy of checkpoint inhibitors (CPIs) use for cHL relapses postallo-HCT in patients who already failed to derive sustained benefit from CPIs received prior to allo-HCT.

Results

Six cases were identified and reviewed. All patients received and failed to derive sustained benefit from CPIs and brentuximab vedotin preallo-HCT. The median age at the time of allo-HCT was 28.6 years (IQR 23.6–34.2), the median number of lines received prior to allo-HCT was 6.5 (range 5–9). The median duration of CPI therapy prior to allo-HCT was 8.1 months (IQR 6.7–12.9). The median time between the discontinuation of CPI and allo-HCT was 5.78 months (IQR 3.15–15.8). The median time to progression postallo-HCT was 5.75 months (IQR 2.6–11.7). The median time between allo-HCT and re-challenge with a CPI was 7.6 months (IQR 3.2–28.6). The median time of follow up after starting postallo-HCT CPIs was 16 months (IQR 7.25–25.75). Five out six patients responded and two patients developed GvHD.

Conclusion

Our report shows preserved efficacy without any new safety signals by using CPIs postallo-HCT despite using and having failed to derive sustained benefit from CPIs preallo-HCT.