Refractory Hodgkin Lymphoma

Abstracts noticed an increase in the use of PET-CT: 65% of patients had a PET-CT at diagnosis (p: 0.0001). 66% of patients had a PET-CT at the end of treatment by 2010. The usage of CT at diagnosis has dropped significantly from 92.9% prior to 2009 to 54.4% after 2010 (p¼0.0001). We also observed in patients with advanced HL a decrease in the usage of 8 cycles of ABVD protocol from 9.5% in 1990-1999 to 5.9% in 2000-2009 to 4.5% in 2010-2015 (p¼0.5). Conclusion: Functional imaging techniques are gaining popularity over anatomical imaging. The usage of PET-CT has emerged as a highly valuable staging and follow up method in the treatment of HL 8 years after the introduction of PET in Lebanon, it was used at first to improve the staging, then to evaluate response to treatment and recently for tailoring therapy according to response.

the salvage group. After a median follow up of 9 months, only 2 patients (22%) in the maintenance group progressed and all patients are still alive. Conversely, in the salvage group, 4 patients (67%) progressed and 1 patient developed secondary AML and died. Conclusion: BV therapy showed an efficacy only as maintenance treatment after auto-SCT but was less successful when used as post-transplant salvage in R/R HL. Four cycles of maintenance may suffice. Prospective trials with larger samples are warranted to support these findings. Table 1 Patients Characteristics Characteristics

N (%)

Age at BV initiation Median (range)

HL-160 Post Transplant Brentuximab Maintenance Appears more Effective than Post Transplant Salvage Brentuximab for Relapsed /Refractory Hodgkin Lymphoma

Male

9 (60)

Female

6 (40)

HL subtype Nodular Sclerosis Unknown Prior transplant

Amanda Chidiac , Radwan Massoud, Mohamad Haidar, Ali Bazarbachi, Jean El Cheikh

14 (93)

Allogeneic

1 (7)

Frontline ABVD

-

Clinical Lymphoma, Myeloma & Leukemia September 2016

3 (20) 15 (100)

Autologous

Median (Range)

Medical Center, Beirut, Lebanon, Beirut, Lebanon

S68

12 (80)

Lines of treatment before BV

Bone Marrow Transplantation Program, American University of Beirut

Context: Brentuximab Vedotin (BV) is a chimeric anti CD30 IgG1 antibody, conjugated to synthetic antitubulin momomethyl auristatin. BV is approved for the treatment of classical HL in relapse either after autologous stem cell transplantation (ASCT) or after two lines of combination chemotherapy in transplant ineligible patients. The AETHERA trial revealed increased PFS when BV is used as maintenance therapy after ASCT. Objective: Compare the effectiveness of BV as maintenance or salvage therapy after ASCT for relapsed/refractory (R/R) HL. Design: A retrospective analysis conducted on patients with R/R HL treated with BV after ASCT either as maintenance or salvage therapy. Analysis after a median follow up of 12 months is reported. Setting: The study was conducted in a single institution; American University of Beirut Medical Center (AUBMC) after IRB approval. Patients: The study included 15 adult patients with R/R HL treated with BV with the following indications: Maintenance therapy after ASCT in high risk patients Salvage therapy for relapse after ASCT or allo-SCT Intervention: BV at 1.8mg/kg IV every 4 weeks for the above indications. Main Outcome Measures: response rate (RR), overall survival (OS) and progression free survival (PFS). Results: Nine high-risk patients (60%) received 4 cycles of BV as maintenance therapy post ASCT. Six additional patients (40%) in relapse after ASCT (n¼5) or after allo-SCT (n¼1) received BV as salvage therapy for an average of 4 cycles (range 3-21). Patients characteristics are listed on Table 1. RR was 33% in 6 patients who received BV as salvage post SCT. Two patients proceeded with allo-SCT in

29 (20-61)

Gender

Primary Refractory Responded Unknown

3 (2-6) 15 (100) 2 (13) 10 (67) 3 (20)

BV initiation As maintenance post auto-SCT

9 (60)

Salvage for post transplant relapse

6 (40)

HL-182 Differences in Outcome of Patients with Syncytial Variant Hodgkin Lymphoma (HL) Compared with Typical Nodular Sclerosis HL Tarsheen Sethi ,1 Van Nguyen,2 Shaoying Li,3 David Morgan,1 John Greer,1 Nishitha Reddy1 1

Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States; 2

Department of Medicine, Vanderbilt University Medical Center,

Nashville, TN, United States; 3Department of Hematopathology, MD Anderson Cancer Center, Houston, TX, United States

Introduction: Syncytial variant of nodular sclerosis HL (SV) is a well described pathologic entity characterized by prominent aggregates of Hodgkin/Reed Sternberg cells in nodules separated by