The Impact of Prior Salvage Treatment With Immune Checkpoint Inhibitors on Hodgkin Lymphoma Patients Undergoing Autologous Hematopoietic Stem Cell Transplantation: A Single-Center Experience |
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| Affiliation: | 1. Rutgers University Ernest Mario School of Pharmacy, Piscataway, NJ;2. Rutgers Cancer Institute of New Jersey, New Brunswick, NJ;1. Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital Olomouc;2. Faculty of Medicine and Dentistry, Palacký University Olomouc;3. Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital Olomouc;4. Department of Microbiology, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital Olomouc;5. Department of Mathematical Analysis and Application of Mathematics, Faculty of Science, Palacký University Olomouc, Olomouc, Czech Republic;1. Department of Leukemia, MD Anderson Cancer Center, Houston, TX, USA;2. Leukemia Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;3. Gehr Family Center for Leukemia Research City of Hope, Duarte, CA, USA;4. Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA;5. Leukemia Service, Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA;6. Department of Clinical Hematology, The Alfred Hospital and Monash University, Melbourne, Australia;1. Department of Hematology, Huadong Hospital Affiliated with Fudan University, Shanghai, China;2. Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital Affiliated with Fudan University, Shanghai, China;3. Senior Department of Hematology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China;4. Department of Hematology, Taizhou Municipal Hospital, Taizhou, Zhejiang, China;5. Nanyang Central Hospital, Nanyang, Henan Province, China;6. Wuhu Second People''s Hospital, Wuhu, Anhui Province, China |
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| Abstract: | IntroductionThe objective of the study was to assess the impact of the previous use of immune-checkpoint inhibitors (ICIs) on the clinical course of Hodgkin Lymphoma (HL) patients undergoing autologous hematopoietic stem cell transplantation (ASCT).MethodsA single-center, retrospective chart review of adult HL patients who received ASCT from January 1, 2014, to December 31, 2019, was conducted. Primary endpoints included the length of stay (LOS) and the composite outcome of late-onset noninfectious fever (LONIF) or late-onset hypotension (LOH) requiring intravenous fluid (IVF) resuscitation. Secondary endpoints included number of days until neutrophil engraftment, documented infections, and corticosteroid use.ResultsA total of 52 HL patients were included. Nine (17%) received ICI before ASCT, and 43 (83%) patients underwent standard salvage chemotherapy. The composite outcome of LONIF or LOH requiring IVF resuscitation was significantly higher in patients previously treated with ICIs compared with those who received standard non-ICI salvage chemotherapy (78% vs. 33%; P = .022). The differences between the median LOS and time to neutrophil engraftment were not statistically significant (P = .94 and P = .083, respectively). All LONIF patients received systemic corticosteroids with symptom resolution.ConclusionThe composite outcome of LONIF or LOH requiring IVF resuscitation was significantly higher in patients who received prior ICI salvage therapy. LOS and time to neutrophil engraftment were not affected by prior ICI therapy. Early institution of steroids may prevent the evolution of additional sequelae associated with engraftment or engraftment-like syndrome that can complicate ASCT. |
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