Further strategies after immune checkpoint inhibitors in relapsed/refractory Hodgkin lymphoma: salvage treatments and consolidation with transplantation, experience in daily clinical practice

• DOI: 10.1007/s00277-025-06255-8
• Publication Date: 2025-03-01T04:19:32Z
• Authors: Cinzia Pellegrini; Beatrice Casadei; Alessandro Broccoli; Martina Cantelli; Gabriele Gugliotta; Marianna Gentilini; Matteo Carella; Vittorio Stefoni; Nicole Fabbri; Giulia Gabrielli; Lisa Argnani; Camilla Mazzoni; Pierluca Maglio; Gianmarco Bagnato; Pier Luigi Zinzani
• Keywords: Salvage therapy; Refractory (planetary science); Hematology

Abstract Immune checkpoint inhibitors (CPIs) emerged as an effective and safe therapeutic option for patients with relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL). However, many lose their response to CPIs. To improve outcomes in this setting, two strategies can be considered: salvage chemotherapy (CHT) those unsatisfactory response, autologous stem-cell transplantation (auto-SCT) a consolidation at least partial (PR). We analyzed retrospectively the effectiveness terms of rate survivals these approaches cohort 1 (salvage CHT) 2 (auto-SCT consolidation). Adverse events were also assessed. A total 45 heavily pre-treated (median 4 prior therapies; 93.3% refractory last therapy). Thirty received further CHT median 32 days (range 1-1213) after CPI Fifteen underwent auto-SCT, 8 complete (CR) 7 PR. In final overall (ORR) 50.0% progression-free survival 24.6 months. 2, ORR was (all CR) not reached. No unexpected or cumulative toxicities observed. Our findings suggest that auto-SCT is strategy cHL who achieve PR therapy, despite multiple lines treatment. Additionally, CPIs treatment appears sensitize chemorefractory subsequent chemotherapy, potentially facilitating successful transplant improving chances cure.