Improved outcomes of high-risk relapsed Hodgkin lymphoma patients after high-dose chemotherapy: a 15-year analysis.

High-dose chemotherapy and autologous stem-cell transplant (HDC/ASCT) is standard treatment of chemosensitive relapsed classical Hodgkin lymphoma (cHL), although outcomes of high-risk relapse (HRR) patients remain suboptimal. We retrospectively analyzed all HRR cHL patients treated with HDC/ASCT at our institution between 01/01/2005-12/31/2019. HRR criteria included primary refractory disease/relapse within 1 year, extranodal extension, B symptoms, requiring > 1 salvage line, or PET+ disease at ASCT. All patients met the same ASCT eligibility criteria. We treated 501 patients with BEAM (N=146), BuMel (N=38), GemBuMel (N=189) and vorinostat/GemBuMel (N=128). The GemBuMel and vorinostat/GemBuMel cohorts had more HRR criteria and more patients with PET+ disease at ASCT. Pre-ASCT BV, anti-PD1, PET-negative disease at ASCT, and maintenance BV increased over time. BEAM and BuMel predominated in earlier years (2005-2007), GemBuMel and BEAM in middle years (2008-2015), and vorinostat/GemBuMel and BEAM in later years (2016-2019). Median follow-up is 50 months (6-186). Outcomes improved over time, with 2-year PFS/OS rates of 58%/82% (2005-2007), 59%/83% (2008-2011), 71%/94% (2012-2015) and 86%/99% (2016-2019) (P.

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Authors: Yago Nieto, Stephen Gruschkus, Benigno C Valdez, Roy B Jones, Paolo Anderlini, Chitra Hosing, Uday Popat, Muzaffar Qazilbash, Partow Kebriaei, Amin Alousi, Neeraj Saini, Samer Srour, Katayoun Rezvani, Jeremy Ramdial, Melissa Barnett, Alison Gulbis, Terri Lynn Shigle, Sairah Ahmed, Swaminathan Iyer, Hun Lee, Ranjit Nair, Simrit Parmar, Raphael Steiner, Bouthaina Dabaja, Chelsea Pinnix, Jillian Gunther, Branko Cuglievan, Kris Mahadeo, Sajad Khazal, Hubert Chuang, Richard Champlin, Elizabeth J Shpall, Borje S Andersson