ISSN 1866-8836
Клеточная терапия и трансплантация

LY-02. Usage of Brentuximab vedotin with chemotherapy as a “salvage” regimen before autologous stem cell transplantation in classical Hodgkin’s lymphoma patients

Evgeniya S. Borzenkova, Natalia B. Mikhailova, Kirill V. Lepik, Andrey V. Kozlov, Yuri R. Zalyalov, Elena V. Kondakova, Anastasia V. Beynarovich, Elena E. Lepik, Ivan S. Moiseev, Boris V. Afanasyev

RM Gorbacheva Research Institute of Pediatric Oncology, Hematology and Transplantation, Pavlov University, St. Petersburg, Russia

Contact: Dr. Evgenia S. Borzenkova, e-mail:

doi 10.18620/ctt-1866-8836-2020-9-3-1-152



Hodgkin’s lymphoma (cHL) is a subtype of lymphoid malignancies characterized by expression of CD30 on Reed-Stenberg cells. Brentuximab vedotin (BV) is an antibody-drug conjugate specific for CD30 consisting of chimeric IgG1 antibody against CD30 covalently attached to the microtubule-disrupting agent monomethyl auristatin E. BV was approved for patients (pts) with relapsed or refractory classical Hodgkin’s lymphoma (r/r cHL) who are not candidates for, or progressed after, autologous stem cell transplantation (ASCT). Bendamustine is a fusion hybrid molecule containing the purine analogue fludarabine and alkylating agent (cyclophosphan). They shown high efficacy and safety as monotherapy [1, 2], also combination of them showed a high activity and is not more toxic than the single agent alone [3]. DHAP (cisplatin, cytarabine, and dexamethasone) is the standard of platinum-based salvage chemotherapy regimens followed by ASCT. The success of ASCT may be predicted by achievement of complete remission (CR) by positron emission tomography (PET) following salvage chemotherapy [4]. Unfortunately, about half of these pts are unable to achieve CR with first salvage. We decided to combine these effective drugs for achievement complete response (CR) before ASCT, confirmed by PET-CT. Our results of ASCT in cHL we compared with historical data [5].

Patients and methods

Twenty-five pts with cHL were included into real data analysis. Median age at the diagnosis time was 24 years (range, 13-50). The first-line chemotherapy was ABVD or BEACOPP (standard; escalated; 14 days) in 23 pts. Two pts <18 years old were subjected to GPON-HD-2002 protocol. At the time of BV treatment, all the pts were >18 years old. The primary resistant pts comprised 60% of the group (15 of 25 cases). 24% of the pts had early relapse of cHL (n=6), and 16% (n=4) exhibited late relapses. BV was used as a “salvage” regimen to ASCT: BV-DHAP, in 15 pts (60%); BV-bendamustine, in 6 pts (24%), and BV as monotherapy was applied in 4 pts (16%). Median number of courses was 3 (range, 2-11). The BV dosage was 1.8 mg/kg in day 1 for all pts; bendamustine was used at 90 mg/kg in day 1 and 2; cisplatin, cytarabine and dexamethasone were also used at standard doses, and DHAP was started on the next day after BV. Stem cells for ASCT were collected by apheresis after a median of 3 cycles (range 1-6) BV- therapy, or after preceding standard chemotherapy. ASCT was planned for 25 pts, but it was performed in 17 cases. All seventeen transplanted pts received BeEAM conditioning. Median number of CD34+ cells was 3.9 (range, 1.0-15) ×106/kg. Characteristics of patient group and complications are presented in Tables 1 and 2.

Table 1. The patient characteristics



At the time of analysis, the median follow-up after BV therapy was 30.4 (8.4-75.5) months. Overall response rate was 96% (24 pts), with complete remission (CR) in 84% (21 pts), and partial remission (PR) in 12% (3 cases). At the moment of analysis, all the patients are alive, progression/relapse was observed in 40% (10 of 25). The median of progression-free survival (PFS) was not reached, and 2-year PFS for all patients was 56.0%. Seventeen pts who received a combination of BV-based therapy + ASCT had the 2-year PFS of 70.6% versus 25% for 8 pts who were not consolidated by ASCT (p=0.013). The therapy was well tolerated at the stage of second-line therapy and ASCT (Table 2).

Table 2. Characteristics of complications in BV- treatment and ASCT



ASCT after high-dose chemotherapy is the standard of care in the second-line treatment of cHL. Addition of BV to these regimens is a promising and safe option that may increase the efficacy of second-line treatment. Multicenter validation studies are required to confirm our preliminary results.


Hodgkin lymphoma, autologous stem cell transplantation, brentuximab vedotin, bendamustine.


1. Younes A, Gopal AK, Smith SE, et al. Results of a pivotal phase II study of brentuximab vedotin for patients with relapsed or refractory Hodgkin’s lymphoma. J Clin Oncol 2012; 30; 2183-89.
2. Moskowitz AJ, Hamlin PA Jr, Perales MA, et al. Phase II study of bendamustine in relapsed and refractory Hodgkin lymphoma.J Clin Oncol 2013; 31: 456-60.
3. O’ConnorOA, Lue JK, et al. Brentuximab vedotin plus bendamustine in relapsed or refractory Hodgkin’s lymphoma: an international, multicentre, single-arm, phase 1-2 trial Lancet Oncol 2018; 19; 257-66.
4. Craig H, Moskowitz AJ et al. Normalization of pre-ASCT, FDG-PET imaging with second-line, non–cross-resistant, chemotherapy programs improves event-free survival in patients with Hodgkin lymphoma Blood 2012; 7; 1665-1670.
5. Schmitz N, Buske C, Gisselbrecht C. Autologous Stem Cell Transplantation in Lymphoma. Seminars in Hematology 2007 44; 234-245.

Volume 9, Number 3

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doi 10.18620/ctt-1866-8836-2020-9-3-1-152

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