自体干细胞移植后进展的淋巴組織瘤患者的总体生存率：新型治疗药物时代的结果。
Overall survival of cHL patients who progress after autologous stem cell transplant: results in novel agent era.
发表日期：2023 Sep 20
作者：
Sanjal H Desai, Michael A Spinner, Andrew M Evens, Alice Sýkorová, Veronika Bachanova, Gaurav Goyal, Brad S Kahl, Kathleen A Dorritie, Jacques Azzi, Vaishalee P Kenkre, Cheryl Chang, Jozef Michalka, Stephen M Ansell, Brendon Fusco, Nuttavut Sumransub, Haris Hatic, Raya Saba, Uroosa Ibrahim, Elyse I Harris, Harsh R Shah, Nina D Wagner-Johnston, Sally Arai, Grzegorz S Nowakowski, Heidi Mocikova, Deepa Jagadeesh, Kristie Blum, Catherine Diefenbach, Siddharth Iyengar, Katherine Cynthia Rappazzo, Firas Baidoun, Yun Choi, Vit Prochazka, Ranjana H Advani, Ivana N Micallef
来源：
Cell Death & Disease
摘要：
在无新药物治疗时代，经ASCT后进展的古典霍奇金淋巴瘤（cHL）患者的中位进展后总生存期（PPS）为2-3年。最近，免疫检查点抑制剂（CPI）和布伦替单抗（BV）改善了该人群的反应深度和持续时间。我们在这里报告ASCT后复发cHL患者的PPS估计，以CPI和BV时代为基准。这是一项多中心回顾性研究，共有15个参与机构，纳入了ASCT后复发cHL的成年患者。研究目标是进展后总生存期（PPS），定义为从移植后进展到死亡或最后随访的时间。在1158名接受ASCT的患者中，367名患者病情进展。中位年龄为34岁（范围：27-46岁），其中192名为男性。中位PPS为114.57（CI95：91-NA）个月，即9.5年。在多变量分析中，年龄增长、6个月内进展和术前阳性PET与PPS较差有关。在调整了这些特征后，与未接受CPI/未接受BV的患者组相比，作为ASCT后进展的首次治疗接受CPI的患者PPS显著更高（HR：3.5，CI95：1.6-7.8，p=0.001）。接受异基因骨髓移植（alloSCT）并不能改善PPS。在新药物时代，ASCT后进展的cHL患者具有较长的生存期，与之前的报告相比有利。首次接受CPI治疗进展的患者PPS较高。与此人群相关的AlloSCT接受与PPS无关。Copyright © 2023 American Society of Hematology.
In pre-novel agent era, median post progression overall survival (PPS) of classic Hodgkin lymphoma (cHL) patients (pts) who progress after ASCT have been 2-3 years. Recently, Checkpoint inhibitors (CPI) and brentuximab vedotin (BV) have improved depth and durability of response in this population. Here we report estimate of PPS in pts with relapsed cHL after ASCT in the era of CPI and BV. In this multicenter retrospective study of 15 participating institutions, adult pts with relapsed cHL after ASCT were included. Study objective was post progression overall survival (PPS), defined at time from post-transplant progression to death or last follow up. Of 1158 pts who underwent ASCT, 367 had progressive disease. Median age was 34 years (range: 27-46), 192 were male. Median PPS was 114.57 (CI95: 91-NA) months, 9.5 years. In multivariable analysis, increasing age, progression within 6 months and pre-ASCT positive PET were associated with inferior PPS. When adjusted for these features, patients who received CPI, but not BV, as first treatment for post-ASCT progression had significantly higher PPS compared to no CPI/no BV group (HR: 3.5, CI95: 1.6-7.8, p=0.001). Receipt of alloSCT did not improve PPS. In the era of novel agents, progressive cHL after ASCT had long survival that compares favorably to prior reports. Patients who receive CPI as first treatment for progression had higher PPS. Receipt to AlloSCT was not associated with PPS in this population.Copyright © 2023 American Society of Hematology.