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2918 Real Life Analysis of Brentuximab Vedotin (BV) Use As Consolidation Therapy in Patients with Hodgkin’s Lymphoma (HL) with High Risk of Relapse after Autologous Stem Cell Transplantation (ASCT). a Retrospective Analysis of the EBMT Lymphoma Working Party

Program: Oral and Poster Abstracts
Session: 624. Hodgkin Lymphomas and T/NK cell Lymphomas: Clinical and Epidemiological: Poster II
Hematology Disease Topics & Pathways:
Research, Hodgkin lymphoma, Clinical Practice (Health Services and Quality), Lymphomas, Clinical Research, Diseases, real-world evidence, Lymphoid Malignancies
Sunday, December 11, 2022, 6:00 PM-8:00 PM

Maria Carmen Martinez Munoz, PhD1*, Mariana Bastos-Oreiro, MD, PhD2*, Ariane Boumendil3*, Hervé Finel4*, Ali Bazarbachi, MD, PhD5, Mohsen Alzahrani, MD6*, Arpad Illes, MD7*, Didier Blaise, MD, PhD8, Ioanna Sakellar9*, Carlos Solano, MD, PhD10*, Alessandro Pulsoni11*, Tsila Zuckerman, MD12, Nadira Durakovic13*, Luca Castagna14*, Simona Sica15*, Stéphanie Guidez, MD16*, Jean-Henri Bourhis, MD17*, Ramon Garcia-Sanz18, Muhlis Cemm Ar19*, Aspasia Stamatoulas Bastard, MD20*, Javier Briones, MD, PhD21*, Saad Aktar22*, Ron Ram, MD23*, Inmaculada Heras, MD, PhD24*, Marie Thérèse Rubio, MD, PhD25,26*, Mario Petrini27, Mario Ojeda-Uribe28*, Bertram Glass, MD29* and Anna Sureda30

1Hematopoietic Transplantation Unit and Hematology Department, Clinical Institute of Hematology and Oncology (ICMHO), IDIBAPS, Hospital Clínic de Barcelona, Barcelona, Spain
2Servicio de Hematología y Hemoterapia, Hospital Gral. Univ. Gregorio Marañón, Madrid, Madrid, Spain
3Lymphoma Working Party Office, EBMT, Paris, France
4EBMT Lymphoma Working Party Paris Office, Paris, France
5American University of Beirut Dept. of Medicine, Beirut, Lebanon
6King-Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
7Faculty of Medicine, Department of Hematology, University of Debrecen, Debrecen, Hungary
8Hematology Department, Institut Paoli-Calmettes, Marseille, France
9George Papanicolaou General Hospital, Thessaloniki, Greece
10Hospital Clinico Universitario, University of Valencia, Valencia, Spain
11Sapienza University of Rome, Rome, Italy
12Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel
13University Hospital Center Zagreb, Zagreb, Croatia
14U.O.D Trapianti di midollo osseo, Palermo, Italy
15Universita Cattolica S. Cuore, Rome, Italy
16Hopital La Miletrie, Poitiers, France
17BMT Service, Department of Hematology, Institut Gustave Roussy, Villejuif, France
18Hospital Clínico Universitario, Salamanca, Spain
19Istanbul University-Cerrahpasa, Cerrahpasa, Turkey
20Henri Becquerel Center, Rouen, France
21Hematology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain
22Department of Medical Oncology, King Faisal Specialist Hospital and Research Cen, Riyadh, SAU
23BMT Unit, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
24Hematology Department, Hospital Universitario Morales Meseguer, Murcia, Spain
25IMoPa, University of Lorraine, Vandoeuvre, France
26Service Hématologie, CHRU Brabois, Nancy, France
27Azienda Ospedaliero Universitaria Pisana, Department of Clinical and Experimental Medicine, Hematology, Pisa, Italy
28Department of Hematology and Cellular Therapy, GHRMSA, Mulhouse, France
29Asklepios Hospital St Georg, Hamburg, Germany
30Institut Català d'Oncologia, Hospital Duran i Reynals. Institut d’Investigació Biomèdica de Bellvitge (IDIBELL). Universitat de Barcelona, Barcelona, Spain

Introduction: The gold standard treatment for patients (pts) with classical HL who fail first-line treatment is ASCT. However, a significant number of pts with high-risk relapsed/refractory (RR) HL will relapse after transplant. Most patients who relapse do so within the first 1–3-years following ASCT, providing a rationale for post-transplant consolidation strategies to mitigate relapse risk. The AETHERA trial demonstrated that post-ASCT consolidation with brentuximab vedotin (BV) in high-risk HL pts improved progression-free survival (PFS) compared to placebo. Three previous studies have reported real-life results of BV consolidation with similar results. Here, we present the largest series so far.

Methods: Information of pts older than 18y with HL who received BV as consolidation after first ASCT between May 2016 and January 2021 was downloaded from the EBMT database. The decision to use BV consolidation was made by the attending physician on an individual basis. Patients who received BV for disease relapse after ASCT were excluded from the study. The primary endpoint was 2 year PFS from ASCT.

Results: 309 pts (female 48%/male 52%) with HL were identified meeting the inclusion criteria. Median age at ASCT was 31y (18-70). The median number of therapy lines before ASCT was 2 (1-6), and 43% pts required >1 salvage treatment to achieve disease response. At the time of ASCT, 200 (66%) pts were in complete remission (CR), 81 (27%) in partial remission (PR), and 21 (7%) had refractory disease. Most pts (73%) received BEAM as conditioning regimen. Median time from ASCT to BV initiation was 2.2 months (0.1-16.7). A total of 55 (19%) pts relapsed after a median time of 8 months after BV initiation, and 24 of them were treated with an allogeneic transplantation. After a median follow-up of 20 months, 2 and 5-year PFS were 73.2% (95% CI 67.3-79.6) and 70.3% (95% CI 63.9-77.4) (Figure 1), and overall survival 95.1% (95% CI 92.1-98.2) and 91.3% (95% CI 86.7-96.1), respectively. The prognostic was excellent and significantly better for pts in CR at transplant than for those in PR or with progression disease (2-y PFS 83.5% [95%CI 77.3-90.2] vs. 57.2% [95% CI 45.6-71.8] and 63.6% [95% CI 45.3-89.5], respectively, p=0.001). No differences in OS were observed according to the disease status at ASCT. In comparison to AETHERA trial, the proportion of pts requiring >1 salvage therapy lines before transplant was similar (43% in both studies); however, in contrast to that trial, pts treated with >1 salvage therapy line had similar PFS than those treated with only one line (69.6% [95%CI 60.4-80.2] vs. 75.8% [95%CI 68.5-84.0], respectively, p=0.2). In our study, the number of pts with chemosensitive disease at ASCT was higher than in the AETHERA (93% vs. 72% CR + PR, and 66% vs. 37% CR). This fact could justify that the PFS observed in this real-life series was higher than this of the AETHERA trial (70.3% vs. 59%) and more similar to that reported in other real-life series.

Conclusions: This EBMT-registry study confirms the improved PFS of RR HL pts who underwent ASCT followed by BV consolidation compared to historical cohorts. The proportion of patients receiving ASCT in CR is higher than published in the AETHERA trial, which would suggest that more effective pre-transplant salvage schemes, possibly including BV, have been used.

Disclosures: Bastos-Oreiro: JANSSEN: Speakers Bureau; INCYTE: Consultancy, Speakers Bureau; NOVARTIS: Speakers Bureau; KITE/GILEAD: Consultancy, Honoraria; Roche: Consultancy, Research Funding, Speakers Bureau. Zuckerman: Orgenesis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Gilead: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; BioSight Ltd: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Cellect Biotechnology: Honoraria, Speakers Bureau; Janssen: Honoraria, Speakers Bureau; Novartis: Honoraria, Speakers Bureau. Guidez: Incyte: Honoraria; AstraZeneca: Honoraria; Takeda: Honoraria; Gilead Kite: Honoraria. Briones: GSK: Consultancy; Novartis: Consultancy, Honoraria; BMS: Consultancy, Honoraria; Gilead: Consultancy; Takeda: Consultancy, Honoraria; Celgene/BMS: Research Funding; HOSPITAL SANTA CREU I SANT PAU: Current Employment. Ram: Gilead: Honoraria; BMS: Honoraria; Takeda: Honoraria; Novartis Pharmaceuticals: Honoraria. Glass: Gilead: Consultancy; Roche: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Bristol Myers Squibb: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Novartis: Consultancy, Honoraria. Sureda: NOVARTIS: Consultancy, Honoraria; GILEAD: Consultancy; ROCHE: Consultancy, Honoraria; BMS: Consultancy, Honoraria; TAKEDA: Consultancy, Honoraria, Speakers Bureau; MSD: Honoraria; JANSSEN: Consultancy, Honoraria; SANOFI: Consultancy, Honoraria.

*signifies non-member of ASH