Clinical characteristics and outcomes of patients with Hodgkin lymphoma at first relapse in the real setting before the use of novel agents: importance of autologous stem cell transplantation

Objective: The standard of care in first relapsed/refractory Hodgkin lymphoma (R/R HL) is salvage therapy, including high-dose chemotherapy (HDT), followed by autologous stem cell transplantation (ASCT). To date, this treatment approach has been shown to improve event-free survival (EFS), progression-free survival (PFS), and freedom from treatment failure (FFTF) in controlled clinical trials. This study aims to determine the outcomes of patients with HL using this strategy at first relapse but in real-world practice in Colombia before the widespread use of novel agents such as antibody-drug conjugates (ADCs) and checkpoint inhibitors (ICIs). Methods: We present a retrospective case series of patients diagnosed with R/R HL treated at the Instituto Nacional de Cancerologia (INC) (Bogota, Colombia) between 2013 and 2017. Results: We found 31 patients with R/R HL fulfilling the inclusion criteria from a 171 patients database. The most widely used regimens were platinum-based, followed by gemcitabine-based regimens. Chemotherapy-sensitive dis-ease was demonstrated in 16 (51.6%) patients, where the majority achieved complete response (CR). In the entire cohort, overall survival (OS) and PFS were lower than the rates reported in other series. Patients who ultimately did undergo ASCT had the best PFS and OS compared to those who did not.Conclusion: Our retrospective case series showed that responses and survivals are lower than those reported in the literature. ASCT is essential for achieving a potential cure in R/R HL patients with chemotherapy-sensitive disease. Health systems must guarantee access to transplantation for all patients who are candidates for this therapy.