Publication Only: Hodgkin lymphoma - Clinical
Hodgkin disease (HL) is curable disease in up to 80% of patients, but for the remaining relapse/refractory patients no standard salvage therapy exists. Brentuximab vedotin comprises an anti CD30 antibody conjugated by a protease-cleavable linker to a microtubule-disrupting agent.
The aim of the study is to evaluate the outcome of patients with relapse/refractory form of HL, who received Brentuximab vedotin.
In our Institute 21 patients with HL were treated, from 2015 till 2018 years. 17 (81%) patients had a primary-resistant form, four (19%) patients had relapse of the disease.
The average age was 34.5 years (from 20 to 69 years), the average number of courses of therapy is 5.38 (from 3 to 8 courses). The mean follow-up period was 17.9 months (from 4.1 to 38.1 months).
We have analyzed the survival of patients who received treatment. 21 patients who entered the study at the time of collection of information, 15 (71.4%) patients were alive. Median survival was 33.2 months. The standard error (SE) is 3.3 months, with 95% CI (26.8 - 39.6).
Among patients with a primary resistant form, 13 (76.5%) patients were alive, with a median survival of 28.1 months, a SE of 2.3 months of 95% CI (23.6-32.6). Among patients with a non-primary resistant form, two (50%) patients were alive, while the median survival was 9.1 months, SE 2.4 months 95% CI (4.5-13.7). Eleven patients had a partial response to treatment (52, 4%), ten of them (90.9%) were alive, while the median survival was 27.9 months, SE 2.3 months 95% CI (23.5 - 32.4).
In three (14.3%) patients, a complete response to treatment was noted, of which three (100%) patients were alive. Cancer progression was noted in seven (33.3%) patients, two of them (28.6%) were alive, while the median survival was 27.9 months, SE 2.3 months 95% CI (23.5 - 32.4).
In analyzing six (28.6%) patients had AutoSCT, and 15 (71.4%) patients did not, due to low stem cell growth. Among patients, which didn't have AutoSCT 11 (73.3%) patients were alive, with a median survival of 30.4 months, a SE of 2.7 months of 95% CI (25.1 - 35.7). When analyzing the causes of mortality, all patients indicated the cause of death from the progression of cancer.
The analysis of the results using Brentuximab Vedotin showed good results in treatment of relapse and refractory forms of HL. In patients who failed to perform autologous stem cell transplantation, showed median survival of 30.4 months. This indicates the possibility of using the drug as an alternative to this procedure for the primary resistant form of the disease or further therapy options.