GVHD
Published on February 13, 2025
Comparison of outcomes with ICI and chemotherapy before alloBMT for cHL
by Blood Advances
Tabbara N, Zahurak ML, Sterling C, et al. Improved Overall Survival With Checkpoint Inhibition and Allogeneic Transplantation in Relapsed Hodgkin Lymphoma. Blood Advances. 2014; (doi: 10.1182/bloodadvances.2024015048).
Comparison of outcomes with ICI and chemotherapy before alloBMT for cHL
Tabbara N, Zahurak ML, Sterling C, et al. Improved Overall Survival With Checkpoint Inhibition and Allogeneic Transplantation in Relapsed Hodgkin Lymphoma. Blood Advances. 2014; (doi: 10.1182/bloodadvances.2024015048).
While both are accepted rescue therapies for classic Hodgkin lymphoma (cHL) relapse, research suggests immune checkpoint inhibitors (ICIs) offer an advantage over chemotherapy. Investigators retrospectively analyzed 147 patients with relapsed/refractory disease who responded to one intervention or the other and then underwent consolidation with allogeneic blood or marrow transplantation (alloBMT). All participants received graft-versus-host disease (GVHD) prevention with post-transplantation cyclophosphamide. The 5-year data favored ICIs, which achieved estimated overall survival (OS) of 91% vs. 66% for chemotherapy and estimated progression-free survival of 84% vs. 53% with chemotherapy. Grade 3-4 GVHD developed in 20% of the ICI cohort, possibly due to a shorter period of immunosuppression, while the incidence rate reached only 7% in the chemotherapy arm. By ramping up immunosuppression and choosing ICIs over chemotherapy before alloBMT, the study authors believe patients with relapsed/refractory cHL can reduce their risk for GVHD while benefiting from improved OS.
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