Safety and efficacy of anti-programmed cell death-1 monoclonal antibodies before and after allogeneic hematopoietic cell
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ORIGINAL ARTICLE
Safety and efficacy of anti‑programmed cell death‑1 monoclonal antibodies before and after allogeneic hematopoietic cell transplantation for relapsed or refractory Hodgkin lymphoma: a multicenter retrospective study Ayumu Ito1 · Sung‑Won Kim1 · Ken‑ichi Matsuoka2 · Toshiro Kawakita3 · Takashi Tanaka1 · Yoshihiro Inamoto1 · Tomomi Toubai4 · Shin‑ichiro Fujiwara5 · Masafumi Fukaya6 · Tadakazu Kondo7 · Junichi Sugita8 · Miho Nara9 · Yuna Katsuoka10 · Yosuke Imai11 · Hideyuki Nakazawa12 · Ichiro Kawashima13 · Rika Sakai14 · Arata Ishii15 · Makoto Onizuka16 · Tomonari Takemura17 · Seitaro Terakura18 · Hiroatsu Iida19 · Mika Nakamae20 · Kohei Higuchi21 · Shinobu Tamura22 · Satoshi Yoshioka23 · Kazuto Togitani24 · Noriaki Kawano25 · Ritsuro Suzuki26 · Junji Suzumiya26 · Koji Izutsu27 · Takanori Teshima8 · Takahiro Fukuda1 Received: 28 May 2020 / Revised: 9 July 2020 / Accepted: 22 July 2020 © Japanese Society of Hematology 2020
Abstract We conducted a multicenter study on anti-programmed cell death-1 monoclonal antibodies (anti-PD-1 mAbs) before/after allogeneic hematopoietic cell transplantation (allo-HCT) for Hodgkin lymphoma. Anti-PD-1 mAbs were administered to 25 patients before allo-HCT and to 20 after allo-HCT. In pre-allo-HCT setting, the median interval from the last administration to allo-HCT was 59 days. After allo-HCT, 12 patients developed non-infectious febrile syndrome requiring high-dose corticosteroid. The cumulative incidences of grade II–IV acute graft-versus-host disease (aGvHD) were 47.1%. Eight patients who had GvHD prophylaxis with post-transplant cyclophosphamide (PTCy) had less frequent aGvHD (grade II–IV, 14.6% versus 58.8%; P = 0.086). The 1 year overall survival (OS), relapse/progression, and non-relapse mortality rates were 81.3%, 27.9%, and 8.4%. In post-allo-HCT setting, the median interval from allo-HCT to the first administration was 589 days. The overall and complete response rates were 75% and 40%. At 100 days after anti-PD-1 therapy, the cumulative incidences of grade II–IV aGvHD, moderate-to-severe chronic GvHD, and grade 3–4 immune-related toxicity were 15.0%, 30.0%, and 30.0%. While the 1 year relapse/progression rate was 47.4%, the 1 year OS probability was 89.7%. In conclusion, immunerelated complications were frequent despite modifications of GvHD prophylaxis or anti-PD-1 mAb dosing. In anti-PD1-mAb-pretreated patients, PTCy-based GvHD prophylaxis may be effective. Keywords Anti-PD-1 monoclonal antibody · Immune checkpoint inhibitor · Hodgkin lymphoma · Allogeneic hematopoietic cell transplantation
Introduction Hodgkin lymphoma (HL) is a highly chemosensitive malignancy. Approximately 85–95% of early stage and 70–80% of advanced-stage cases are cured after standard first-line Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12185-020-02960-4) contains supplementary material, which is available to authorized users. * Sung‑Won Kim [email protected] Extended author information available on the last page of the article
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