Retrospective cohort study of hematopoietic cell transplantation for relapsed or refractory classical Hodgkin lymphoma, 2010-2022

Autologous hematopoietic cell transplantaion (auto-HCT) is the recommended treatment for chemosensitive relapsed Hodgkin lymphoma, while allogeneic hematopoietic cell transplantation (allo-HCT) is indicated for patients who had unsucessful auto-HCT. The introduction of novel therapeutic agents, alongside advances in donor selection, conditioning regimens, and graft-versus-host disease prophylaxis, might improve post-translation outcomes. A retrospective, registry-based cohort study from the EBMT Lymphoma Working Group evaluated changes in post-translation outcomes over the period 2010-2022. The study included 19 498 adult patients with relapsed or refractory classical Hodgkin lymphoma (R/R cHL) undergoing first auto-HCT (n=15 648) or allo-HCT (n=3850) at more than 600 transplantation centers across 53 countries. The primary endpoints were progression-free survival (PFS) and overall survival (OS). For auto-HCT, with a median follow-up of 2.4 years (IQR 2.3-2.5) after HCT, from 2010-2014 to 2019-2022 the 2-year PFS rate increased from 63% (95% CI 62-65) to 73% (71-74) and 2-year OS rate increased from 85% (84-86) to 93% (91-94). Partial response or stable/progressive disease at transplantation negatively affected PFS. For allo-HCT, from years 2010-2014 to 2019-2022, 2-year PFS rate increased from 44% (95% CI 41-46) to 62% (58-66) whereas 2-year OS rate increased from 66% (63-68) to 72% (68-75). Partial response or stable/progressive disease at transplantation negatively affected PFS. The authors conclude that in this largest study on HCT for R/R cHL in recent years, outcomes after auto-HCT and allo-HCT improved over time.