Safety and efficacy of anti-programmed cell death-1 monoclonal antibodies before and after allogeneic hematopoietic cell transplantation for relapsed or refractory Hodgkin lymphoma: a multicenter retrospective study

Ayumu Ito, Sung Won Kim, Ken ichi Matsuoka, Toshiro Kawakita, Takashi Tanaka, Yoshihiro Inamoto, Tomomi Toubai, Shin ichiro Fujiwara, Masafumi Fukaya, Tadakazu Kondo, Junichi Sugita, Miho Nara, Yuna Katsuoka, Yosuke Imai, Hideyuki Nakazawa, Ichiro Kawashima, Rika Sakai, Arata Ishii, Makoto Onizuka, Tomonari TakemuraSeitaro Terakura, Hiroatsu Iida, Mika Nakamae, Kohei Higuchi, Shinobu Tamura, Satoshi Yoshioka, Kazuto Togitani, Noriaki Kawano, Ritsuro Suzuki, Junji Suzumiya, Koji Izutsu, Takanori Teshima, Takahiro Fukuda

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

We conducted a multicenter study on anti-programmed cell death-1 monoclonal antibodies (anti-PD-1 mAbs) before/after allogeneic hematopoietic cell transplantation (allo-HCT) for Hodgkin lymphoma. Anti-PD-1 mAbs were administered to 25 patients before allo-HCT and to 20 after allo-HCT. In pre-allo-HCT setting, the median interval from the last administration to allo-HCT was 59 days. After allo-HCT, 12 patients developed non-infectious febrile syndrome requiring high-dose corticosteroid. The cumulative incidences of grade II–IV acute graft-versus-host disease (aGvHD) were 47.1%. Eight patients who had GvHD prophylaxis with post-transplant cyclophosphamide (PTCy) had less frequent aGvHD (grade II–IV, 14.6% versus 58.8%; P = 0.086). The 1 year overall survival (OS), relapse/progression, and non-relapse mortality rates were 81.3%, 27.9%, and 8.4%. In post-allo-HCT setting, the median interval from allo-HCT to the first administration was 589 days. The overall and complete response rates were 75% and 40%. At 100 days after anti-PD-1 therapy, the cumulative incidences of grade II–IV aGvHD, moderate-to-severe chronic GvHD, and grade 3–4 immune-related toxicity were 15.0%, 30.0%, and 30.0%. While the 1 year relapse/progression rate was 47.4%, the 1 year OS probability was 89.7%. In conclusion, immune-related complications were frequent despite modifications of GvHD prophylaxis or anti-PD-1 mAb dosing. In anti-PD-1-mAb-pretreated patients, PTCy-based GvHD prophylaxis may be effective.

Original languageEnglish
Pages (from-to)674-689
Number of pages16
JournalInternational journal of hematology
Volume112
Issue number5
DOIs
Publication statusPublished - Nov 1 2020
Externally publishedYes

Keywords

  • Allogeneic hematopoietic cell transplantation
  • Anti-PD-1 monoclonal antibody
  • Hodgkin lymphoma
  • Immune checkpoint inhibitor

ASJC Scopus subject areas

  • Hematology

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