IACH 2021 | Advances in the management of R/R Hodgkin lymphoma

Ali Bazarbachi, MD, of the American University of Beirut, Beirut, Lebanon, gives an overview of the latest developments in the treatment of relapsed/refractory (R/R) Hodgkin Lymphoma. The current standard of care for R/R Hodgkin lymphoma is salvage therapy followed by autologous stem cell transplant (ASCT). Dr Bazarbachi explains that novel agents such as brentuximab vedotin and immune checkpoint inhibitors (ICIs) can be used as part of the salvage therapy before ASCT, as a maintenance treatment post-ASCT, as salvage therapy after ASCT, and as salvage therapy for relapse after allogeneic hematopoietic stem cell transplantation (alloHSCT). Numerous studies have shown that salvage therapy before ASCT with chemotherapy plus brentuximab vedotin monotherapy, ICI monotherapy, or brentuximab vedotin and ICI combination therapy, can significantly improve complete remission rates. For patients at a high risk of relapse after ASCT, maintenance therapy with brentuximab vedotin, ICIs, or brentuximab vedotin plus ICIs has demonstrated improvements in progression-free survival (PFS). In addition, alloHSCT has significantly improved the outcomes of patients who relapse after ASCT. Whilst brentuximab vedotin can be used as a bridge to alloHSCT, ICIs have been reported to cause higher rates of steroid-refractory acute GvHD. For this reason, Dr Bazarbachi reports that it is important to wait for six weeks in between the last ICI dose and allotransplantation. Finally, Dr Bazarbachi reports that brentuximab vedotin has been shown to achieve response rates of above 70% for patients who still relapse after alloHSCT. This interview took place at the 4th Annual Meeting of the International Academy for Clinical Hematology (IACH), which took place virtually in 2021.