Reduced incidence of relapse after checkpoint inhibitors relative to brentuximab vedotin as salvage therapy before allogeneic stem cell transplantation for refractory/relapsed Hodgkin lymphoma: A retrospective analysis

Eighty-two patients were eligible for allogeneic transplantation (Allo-SCT) at our Institution between April 2014 and August 2022. Of these, 72 actually received Allo-SCT, n = 44 after checkpoint inhibitor (CPI) containing salvage therapy (CPI cohort) and n = 28 with brentuximab-vedotin (BV) containing therapy without CPI (BV cohort). With a median follow-up of 63 months, the CPI cohort had improved cumulative incidence of relapse (5% vs. 37%, p = 0.002) and progression-free survival (PFS) (79% and 56%, p = 0.049) relative to the BV group. By multivariable analysis, pretransplant CPI resulted in the only independent predictor of relapse (hazard ratio [HR]: 0.124, 95% confidence interval 0.270-0.570, p = 0.007) and a strong predictor for PFS (HR 0.43, 95% CI 0.18-1.02, p = 0.057). Our findings support the use of CPI over BV as the first-line salvage therapy for R/R HL patients relapsing after autologous stem cell transplantation when consolidation with Allo-SCT is planned.