Among patients with relapsed or refractory Hodgkin lymphoma (HL) for whom autologous stem cell transplantation (ASCT) is planned, adding rituximab to a carmustine, etoposide, cytarabine, and melphalan (BEAM) conditioning regimen may reduce the risk of relapse, according to research published in Bone Marrow Transplantation.

The standard approach for treating pediatric and adult patients with relapsed or refractory HL is high-dose chemotherapy followed by ASCT. Although ASCT is known to be excellent for preventing nonrelapse mortality, which is less than 10% in this patient population, the risk of relapse remains high and remains the leading cause of mortality among these patients.

The high risk of relapse suggests the need for novel treatment strategies among patients with HL undergoing ASCT. Previous research has suggested that monoclonal antibodies targeting CD20 and CD30, which are often expressed on HL cell surfaces, may be promising in this setting.


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Rituximab is a CD20-targeting monoclonal antibody that has shown activity in CD20-positive HL. For this retrospective study, researchers evaluated the disease-free survival (DFS) outcomes after adding rituximab to a BEAM conditioning regimen for patients with relapsed or refractory HL undergoing ASCT.

Overall, data from 96 patients were included in this study, of whom 77 were adults and 16 were pediatric patients. The median age in the cohort was 28 years (range, 6-76), 52% of patients were male sex, 41% had stage II disease, 62% were positron emission tomography (PET)-negative prior to ASCT, and 61% were CD20-negative.

At 1 year, the DFS rate was 91.5% (95% CI: 86%-98%), while at 3 years, the DFS rate was 78% (95% CI, 68%-88%); the 1-year and 3-year nonrelapse mortality rates were 0% (95% CI, 0%-3%) and 3.5% (95% CI, 0%-8.5%), respectively. No relapses were noted among pediatric patients.

Neutropenia occurred in 25% of patients; 7% of patients needed hospitalization because of infection, and 1 patient died because of a neutropenic infection.

Disclosure: The study author(s) declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

Reference

Friend BD, Muhsen IN, Patel S, et al. Rituximab as adjunctive therapy to BEAM conditioning for autologous stem cell transplantation in Hodgkin lymphoma. Bone Marrow Transplant. Published online February 1, 2022. doi:10.1038/s41409-022-01599-5