title: Efficacy and tolerability of nivolumab after allogeneic transplantation for relapsed Hodgkin lymphoma.
abstract: Allogeneic hematopoietic cell transplantation (allo-HCT) is indicated for patients with relapsed or refractory Hodgkin lymphoma (HL). Although long-term disease control can be achieved, relapse is still frequent. The programmed cell death protein 1 (PD-1) pathway-blocking antibody nivolumab has shown substantial therapeutic activity and an acceptable safety profile in patients with relapsed or refractory HL who did not receive allo-HCT. However, PD-1 blocking strategy can increase the risk of graft-versus-host disease (GVHD) in murine models. We retrospectively assessed the efficacy and toxicity of nivolumab as a single agent in 20 HL patients relapsing after allo-HCT. GVHD occurred in 6 patients (30%) after nivolumab initiation. All 6 patients had prior history of acute GVHD. The patients with nivolumab-induced GVHD were managed by standard treatment for acute GVHD. Two patients died as a result of GVHD, 1 of progressive disease and 1 of complications related to a second allo-HCT. Overall response rate was 95%. At a median follow-up of 370 days, the 1-year progression-free survival rate was 58.2% (95% CI, 33.1%-76.7%) and the overall survival rate was 78.7% (95% CI, 52.4%-91.5%). Among 13 patients still in response, 6 received a single dose of nivolumab and 7 remain on nivolumab. Compared with standard options for this indication, our results show that nivolumab is effective with an acceptable safety profile.
authors.affiliation: Centre Hospitalier Universitaire (CHU) Lille, Service des Maladies du Sang, Lille, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Herbaux
authors.affiliation: Centre Hospitalier Universitaire (CHU) Lille, Service des Maladies du Sang, Lille, France.
authors.forename: Jordan
authors.initials: J
authors.lastname: Gauthier
authors.affiliation: Service d'Onco-hématologie, CHU Paris Saint-Louis, Lariboisière, Paris, France.
authors.forename: Pauline
authors.initials: P
authors.lastname: Brice
authors.affiliation: Université Lille Nord de France, Equipe Biostatistique, Lille, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Drumez
authors.affiliation: Département d'Hématologie Oncopole, Toulouse, France.
authors.forename: Loic
authors.initials: L
authors.lastname: Ysebaert
authors.affiliation: Service d'Onco-hématologie, CHU de Tours, Tours, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Doyen
authors.affiliation: Service d'Onco-hématologie, CHU de Strasbourg, Strasbourg, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Fornecker
authors.affiliation: Service des Maladies du Sang, Hôpital Haut-Lévèque, Pessac, France.
authors.forename: Krimo
authors.initials: K
authors.lastname: Bouabdallah
authors.affiliation: Department of Hematology, CHU Rennes, Rennes, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Manson
authors.affiliation: Service d'Onco-hématologie, Unicancer, Lyon, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Ghesquières
authors.affiliation: Service d'Onco-hématologie, CHU de Bordeaux, Bordeaux, France.
authors.forename: Reza
authors.initials: R
authors.lastname: Tabrizi
authors.affiliation: Service d'Onco-hématologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Hermet
authors.affiliation: Service des Maladies du Sang, Institut Gustave Roussy, Villejuif, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Lazarovici
authors.affiliation: Service des Maladies du Sang, CHU de Grenoble, Grenoble, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Thiebaut-Bertrand
authors.affiliation: Service d'Onco-hématologie, CHU de Besançon, Besançon, France.
authors.forename: Adrien
authors.initials: A
authors.lastname: Chauchet
authors.affiliation: Centre Hospitalier Universitaire (CHU) Lille, Service des Maladies du Sang, Lille, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Demarquette
authors.affiliation: Centre Hospitalier Universitaire (CHU) Lille, Service des Maladies du Sang, Lille, France.
authors.forename: Eileen
authors.initials: E
authors.lastname: Boyle
authors.affiliation: Department of Hematology, CHU Rennes, Rennes, France.
authors.forename: Roch
authors.initials: R
authors.lastname: Houot
authors.affiliation: Centre Hospitalier Universitaire (CHU) Lille, Service des Maladies du Sang, Lille, France.|Lille Inflammation Research International Center INSERM U995, Lille, France; and.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yakoub-Agha
authors.affiliation: Centre Hospitalier Universitaire (CHU) Lille, Service des Maladies du Sang, Lille, France.|Université de Lille, Groupe de Recherche sur les Formes Injectables et les Technologies Associées, Lille, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Morschhauser
mesh_terms: D000328:Adult; D064591:Allografts; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077594:Nivolumab; D015996:Survival Rate
chemical_list: D000911:Antibodies, Monoclonal; D000077594:Nivolumab