Ali Bazarbachi, Ariane Boumendil, Hervé Finel, Irma Khvedelidze, Joanna Romejko-Jarosinska, Alina Tanase, Saad Akhtar, Tarek Ben Othman, Mohammad Ma’koseh, Boris Afanasyev, Jean Cheikh, Javier Briones, Zafer Gülbas, Rose-Marie Hamladji, Tugrul Elverdi, Didier Blaise, Carmen Martínez, Eleonora Alma, Kazimierz Halaburda, Aida Botelho Sousa, Bertram Glass, Steven Robinson, Silvia Montoto, and Anna Sureda
Hodgkin lymphoma (HL) patients who relapse after autologous-stem-cell- transplantation (auto-SCT) have traditionally had a poor prognosis. We analyzed 1781 adult HL patients who relapsed between 2006 and 2017 after a first auto-SCT. The 4-year overall survival (OS) after relapse continuously increased from 32% for patients relapsing in 2006-2008, to 63% for patients relapsing in 2015-2017 (p = 0.001). The improvement over time was predominantly noted in patients who had an early relapse (within 12 months) after auto-SCT (p = 0.01). On multivariate analysis, patients who relapsed in more recent years and those with a longer interval from transplant to relapse had a better OS, whereas increasing age, poor performance status, bulky disease, extranodal disease and presence of B symptoms at relapse were associated with a worse OS. Brentuximab vedotin (BV), checkpoint inhibitors (CPI) and second transplant (SCT2; 86% allogeneic) were used in 233, 91 and 330 patients respectively. The 4-year OS from BV, CPI, and SCT2 use was 55%, 48% and 55% respectively. In conclusion, the outcome after post-transplant relapse has improved significantly in recent years, particularly in the case of early relapse. These large-scale real-world data can serve as benchmark for future studies in this setting.