Transplant strategies in relapsed/refractory Hodgkin lymphoma Journal Article

Authors: Shah, G. L.; Moskowitz, C. H.
Article Title: Transplant strategies in relapsed/refractory Hodgkin lymphoma
Abstract: The majority of patients with Hodgkin lymphoma (HL) are cured with initial therapy. However, high-dose therapy with autologous hematopoietic cell transplant (AHCT) allows for the cure of an additional portion of patients with relapsed or primary refractory disease. Positron emission tomography–negative complete remission before AHCT is critical for long-term disease control. Several salvage options are available with comparable response rates, and the choice can be dependent of comorbidities and logistics. Radiation therapy can also improve the remission rate and is an important therapeutic option for selected patients. Brentuximab vedotin (BV) maintenance after AHCT is beneficial in patients at high risk for relapse, especially those with more than 1 risk factor, but can have the possibility of significant side effects, primarily neuropathy. Newer agents with novel mechanisms of action are under investigation to improve response rates for patients with subsequent relapse, although are not curative alone. BV and the checkpoint inhibitors nivolumab and pembrolizumab are very effective with limited side effects and can bridge patients to curative allogeneic transplants (allo-HCT). Consideration for immune-mediated toxicities, timing of allogeneic hematopoietic cell transplant based on response, and the potential for increased graft-versus-host disease remain important. Overall, prospective investigations continue to improve outcomes and minimize toxicity for relapsed or primary refractory HL patients. © 2018 by The American Society of Hematology.
Journal Title: Blood
Volume: 131
Issue: 15
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2018-04-12
Start Page: 1689
End Page: 1697
Language: English
DOI: 10.1182/blood-2017-09-772673
PROVIDER: scopus
PMCID: PMC5897866
PUBMED: 29500170
Notes: Review -- Export Date: 2 July 2018 -- Source: Scopus
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MSK Authors
  1. Craig Moskowitz
    375 Moskowitz
  2. Gunjan Lalitchandra Shah
    81 Shah