Combined immunochemotherapy in patients with refractory/relapsed classical Hodgkin's lymphoma as a 2 nd  line treatment before autologous hematopoietic stem cell transplantation (preliminary results)

A. A. Mamedova; N. E. Mochkin; V. O. Sarzhevskiy; E. A. Demina; V. S. Bogatyrev; A. A. Spornik; A. A. Samoylova; A. A. Rukavitsin; E. G. Smirnova; A. E. Bannikova; V. Ya. Melnichenko; N. B. Mikhaylova; E. S. Borzenkova; L. V. Stelmakh; Yu. R. Zalyalov; A. A. Semenova; G. S. Tumyan; M. A. Danilova; O. A. Konova; N. A. Falaleeva; A. Yu. Terekhova; M. A. Vernyuk; A. M. Chervontseva; L. S. Khayrullina; A. A. Maslov; I. B. Lysenko; Yu. A. Alekseeva; E. S. Pavlyuchenko; A. A. Mirsaitov; A. A. Zverkova; I. V. Ishmatova; S. A. Volchenkov; M. S. Motalkina; I. S. Zyuzgin

doi:10.17650/1818-8346-2022-17-3-40-47

Combined immunochemotherapy in patients with refractory/relapsed classical Hodgkin's lymphoma as a 2^nd line treatment before autologous hematopoietic stem cell transplantation (preliminary results)

A. A. Mamedova, N. E. Mochkin, V. O. Sarzhevskiy, E. A. Demina, V. S. Bogatyrev, A. A. Spornik, A. A. Samoylova, A. A. Rukavitsin, E. G. Smirnova, A. E. Bannikova, V. Ya. Melnichenko, N. B. Mikhaylova, E. S. Borzenkova, L. V. Stelmakh, Yu. R. Zalyalov, A. A. Semenova, G. S. Tumyan, M. A. Danilova, O. A. Konova, N. A. Falaleeva, A. Yu. Terekhova, M. A. Vernyuk, A. M. Chervontseva, L. S. Khayrullina, A. A. Maslov, I. B. Lysenko, Yu. A. Alekseeva, E. S. Pavlyuchenko, A. A. Mirsaitov, A. A. Zverkova, I. V. Ishmatova, S. A. Volchenkov, M. S. Motalkina, I. S. Zyuzgin

https://doi.org/10.17650/1818-8346-2022-17-3-40-47

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Abstract

Aim. To study the efficacy and safety of combined immunochemotherapy according to the DHAp protocol + nivolumab in patients with refractory/relapsed classical Hodgkin's lymphoma before autologous hematopoietic stem cell transplantation.

Materials and methods. The study consisted of 2 phases: 1^st - immunotherapy with nivolumab (2 injections as monotherapy at a dose of 240 mg/day with 14 days interval); 2^nd - combined immunochemotherapy according to the DHAp protocol + nivolumab (14 days after the 2^nd administration of nivolumab): nivolumab 480 mg/day on day 1 in combination with chemotherapy according to the DHAp protocol, 4 cycles in total. The effectiveness of therapy was evaluated after 2 injections of nivolumab, after 2 and 4 cycles of combination therapy. from March 2020 to November 2021, 32 patients were included in the study. The median age was 34 (18-55) years.

Results. As of November 2021, the result was evaluated in 32 patients after the 1^st stage of treatment (nivolumab monotherapy). A complete response was obtained in 4 (12.5 %) patients, a partial response in 20 (62.5 %) patients, disease stabilization was noted in 5 (16 %) patients, an indeterminate response in 3 (9 %) patients. At the 2^nd phase, the efficacy after the 2^nd cycle of DHAp + nivolumab was evaluated in 31 patients (complete response was obtained in 19 (61 %), partial response in 11 (36 %)); the final efficacy evaluation (after the 4th cycle of DHAp + nivolumab) was performed in 30 patients, and all patients achieved response to therapy (complete response in 25 (83 %), partial response in 5 (17 %)). 2 patients were excluded from the study.

Conclusion. preliminary results of combined immuno- and chemotherapy according to the DHAp protocol showed high efficacy and relatively low toxicity in patients with refractory/relapsed classical Hodgkin's lymphoma before autologous hematopoietic stem cell transplantation.