Improving outcomes after autologous transplantation in relapsed/refractory Hodgkin lymphoma: a European expert perspective

• Published in: BMC cancer Vol. 20; no. 1; pp. 1088 - 14
• Main Authors: Sureda, Anna, André, Marc, Borchmann, Peter, da Silva, Maria G, Gisselbrecht, Christian, Vassilakopoulos, Theodoros P, Zinzani, Pier Luigi, Walewski, Jan
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 10.11.2020; BioMed Central; BMC
• Subjects: Antineoplastic Agents - therapeutic use; Autografts; Cancer research; Care and treatment; Chemotherapy; Consolidation; Development and progression; Disease; Drug dosages; Drug Resistance, Neoplasm; Hematopoietic Stem Cell Transplantation - mortality; Hodgkin Disease - drug therapy; Hodgkin Disease - mortality; Hodgkin Disease - pathology; Hodgkin's disease; Hodgkin's lymphoma; Humans; Lymphoma; Methods; Monoclonal antibodies; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Oncology; Patient outcomes; Patients; Precision medicine; Prognosis; Regulatory approval; Review; Salvage; Salvage Therapy; Stem cell transplantation; Stem cells; Survival Rate; Targeted cancer therapy; Transplantation, Autologous; Transplants & implants; Spain; Stem cell transplantation; Consolidation; Salvage; HL
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-020-07561-2

Autologous stem cell transplantation (ASCT) is a well-established approach to treatment of patients with relapsed/refractory (R/R) Hodgkin lymphoma (HL) recommended by both the European Society for Medical Oncology and the National Comprehensive Cancer Network based on the results from randomized controlled studies. However, a considerable number of patients who receive ASCT will progress/relapse and display suboptimal post-transplant outcomes. Over recent years, a number of different strategies have been assessed to improve post-ASCT outcomes and augment HL cure rates. These include use of pre- and post-ASCT salvage therapies and post-ASCT consolidative therapy, with the greatest benefits demonstrated by targeted therapies, such as brentuximab vedotin. However, adoption of these new approaches has been inconsistent across different centers and regions. In this article, we provide a European perspective on the available treatment options and likely future developments in the salvage and consolidation settings, with the aim to improve management of patients with HL who have a high risk of post-ASCT failure. CONCLUSIONS: We conclude that early intervention with post-ASCT consolidation improves outcomes in patients with R/R HL who require ASCT. Future approvals of targeted agents are expected to further improve outcomes and provide additional treatment options in the coming age of personalized medicine.