Онкогематология (Jul 2022)

Combined immunochemotherapy in patients with refractory/relapsed classical Hodgkin's lymphoma as a 2<sup>nd</sup> 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
https://doi.org/10.17650/1818-8346-2022-17-3-40-47
Journal volume & issue
Vol. 17, no. 3
pp. 40 – 47

Abstract

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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: 1st - immunotherapy with nivolumab (2 injections as monotherapy at a dose of 240 mg/day with 14 days interval); 2nd - combined immunochemotherapy according to the DHAp protocol + nivolumab (14 days after the 2nd 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 1st 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 2nd phase, the efficacy after the 2nd 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.

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