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Checkpoint inhibition before haploidentical transplantation with posttransplant cyclophosphamide in Hodgkin lymphoma

2020; Elsevier BV; Volume: 4; Issue: 7 Linguagem: Inglês

10.1182/bloodadvances.2019001336

2473-9537

Chiara De Philippis, Faezeh Legrand-Izadifar, Stéfania Bramanti, Laura Giordano, Catalina Montes De, Rémy Duléry, Réda Bouabdallah, Angéla Granata, Raynier Devillier, Jacopo Mariotti, Barbara Sarina, Samia Harbi, Valério Maisano, Sabine Fürst, Thomas Pagliardini, Pierre‐Jean Weiller, Claude Lemarié, Boris Calmels, Christian Chabannon, Armando Santoro, Mohamad Mohty, Didier Blaise, Luca Castagna,

Hematopoietic Stem Cell Transplantation

Abstract We report on 59 Hodgkin lymphoma patients undergoing haploidentical stem cell transplantation (SCT; haplo-SCT) with posttransplant cyclophosphamide (PTCy) as graft-versus-host disease (GVHD) prophylaxis, comparing outcomes based on pretransplant exposure to checkpoint inhibitors (CPIs). Considering pretransplant characteristics, the 2 cohorts (CPI = 29 patients vs no-CPI = 30 patients) were similar, except for the number of prior lines of therapy (6 vs 4; P < .001). With a median follow-up of 26 months (range, 7.5-55 months), by univariate analysis, the 100-day cumulative incidence of grade 2-4 acute GVHD was 41% in the CPI group vs 33% in the no-CPI group (P = .456), whereas the 1-year cumulative incidence of moderate to severe chronic GVHD was 7% vs 8%, respectively (P = .673). In the CPI cohort, the 2-year cumulative incidence of relapse appeared lower compared with the no-CPI cohort (0 vs 20%; P = .054). No differences were observed in terms of overall survival (OS), progression-free survival (PFS), and nonrelapse mortality (NRM) (at 2 years, 77% vs 71% [P = .599], 78% vs 53% [P = .066], and 15% vs 21% [P = .578], respectively). By multivariable analysis, CPI before SCT was an independent protective factor for PFS (hazard ratio [HR], 0.32; P = .037). Stable disease (SD)/progressive disease (PD) was an independent negative prognostic factor for both OS and PFS (HR, 14.3; P < .001 and HR, 14.1; P < .001, respectively) . In conclusion, CPI as a bridge to haplo-SCT seems to improve PFS, with no impact on toxicity profile.