PD-1–based combinations before autologous transplant are associated with improved outcomes in classical Hodgkin lymphoma
Combination therapy incorporating programmed cell death protein 1 (PD-1) blockade results in unprecedented response rates in both frontline and relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL). Previous retrospective studies have suggested benefit for PD-1 blockade before autologous stem cell transplant (ASCT) but included few patients receiving PD-1 blockade with cytotoxic chemotherapy. To explore the impact of anti-PD-1 based salvage on outcomes for patients with R/R cHL, we retrospectively reviewed 1280 patients with R/R cHL who underwent ASCT from 2010 to 2022 at 6 transplant centers, none of whom received PD-1 blockade as part of frontline therapy. Overall, 25% received a PD-1 inhibitor at any point before ASCT (10% in conjunction with chemotherapy), 28% received salvage brentuximab vedotin (BV) without PD-1 blockade, and the rest received salvage chemotherapy alone. Patients who received PD-1 inhibitors at any point before ASCT had a significantly higher 2-year progression-free survival than those who received BV without PD-1 inhibitors or patients receiving chemotherapy alone (88.2%, 70.2%, and 67.4%, respectively; P< .0001). When restricted to patients in complete response before ASCT, the benefit of PD-1 blockade remained significant. PD-1 blockade before ASCT is independently associated with superior post-ASCT outcomes and patients proceeding to ASCT should be treated with PD-1-based salvage.
Authors
- Margaret Kelsey Baron (ORCID: https://orcid.org/0000-0001-8115-7322)
- Ayo Samuel Falade (ORCID: https://orcid.org/0000-0001-9201-6998)
- Gunjan L. Shah (ORCID: https://orcid.org/0000-0002-9977-0456)
- Sanjal H. Desai (ORCID: https://orcid.org/0000-0002-7892-2625)
- Nuttavut Sumransub (ORCID: https://orcid.org/0000-0001-7456-0623)
- Urshila Durani (ORCID: https://orcid.org/0000-0003-1860-2424)
- Tiffany Chang (ORCID: https://orcid.org/0009-0008-7751-8429)
- Alex Francisco Herrera (ORCID: https://orcid.org/0000-0002-9665-7415)
- Tamer Adel Othman (ORCID: https://orcid.org/0000-0001-6376-4495)
- Lay She Ng
- Shin Yeu Ong (ORCID: https://orcid.org/0000-0003-0192-6975)
- Ivana N. Micallef (ORCID: https://orcid.org/0000-0002-4675-4903)
- Levi Pederson (ORCID: https://orcid.org/0000-0001-5902-8882)
- Philippe A. Armand (ORCID: https://orcid.org/0000-0001-6098-1603)
- Stephen M. Ansell (ORCID: https://orcid.org/0000-0003-1244-6758)
- Alison J. Moskowitz (ORCID: https://orcid.org/0000-0002-3408-050X)
- Matthew Mei (ORCID: https://orcid.org/0000-0002-1109-6955)
- Kevin Yoon
- Reid W. Merryman (ORCID: https://orcid.org/0000-0002-6360-3234)
- Siddharth Iyengar (ORCID: https://orcid.org/0000-0002-9545-4691)
- Harsh R. Shah (ORCID: https://orcid.org/0000-0003-2304-2927)
- Robert N. Stuver (ORCID: https://orcid.org/0000-0003-0991-5170)
- Nivetha Ganesan (ORCID: https://orcid.org/0009-0005-3491-8033)
- Susan Geyer
Institutions
- University of Southern California (US)
- City Of Hope National Medical Center (US)
- University of Minnesota (US)
- Mayo Clinic (US)
- Memorial Sloan Kettering Cancer Center (US)
- Harvard University (US)
- University of Evansville (US)
- University of California, San Francisco (US)
- University of Utah (US)
- Singapore General Hospital (SG)
- University of Minnesota System (US)
- California Southern University (US)
- Huntsman Cancer Institute (US)
- WinnMed (US)
- Deaconess Clinic (US)
- City of Hope (US)
- HOPE Clinic (US)
- St. Mary's Medical Center (US)
- Dana-Farber Cancer Institute (US)
Publication Details
- Journal
- Blood
- Published
- 2025-12-17
- DOI
- https://doi.org/10.1182/blood.2025030151
- Citations
- 1
- Primary Topic
- Lymphoma Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 1.47