BEGEV as salvage regimen in first setting for relapsed/refractory classical Hodgkin lymphoma

Introduction: One of the most critical issues in the management of Hodgkin lymphoma (HL) patients who resulted as primary relapsed or refractory is to obtain a minimal disease status before autologous stem cell transplantation (ASCT) with a salvage regimen able to induce this status without severe toxicity. Methods: A single-center retrospective study was conducted to assess effectiveness and safety of BEGEV (bendamustine, gemcitabine, and vinorelbine) regimen as first salvage setting. Patients with HL who were refractory to or had relapsed after one previous chemotherapy line were eligible. The primary end point was complete response (CR) rate after four cycles of therapy. Secondary end points were: overall response rate, stem-cell mobilization activity, and toxicity. Progression-free and overall survival were also evaluated on an intention to treat analysis taking into account ASCT outcomes too. Results: Fifty-seven patients were eligible for this retrospective analysis. Median age at BEGEV therapy was 36.2 years (range 18–70), and the median time from frontline therapy to the first cycle of BEGEV was 5 months. At the end of BEGEV, 50 patients achieved a complete response (CR, 87.7%), with an overall response rate of 89.5%. Fifty-five patients harvested CD34+ cells and 50 ones underwent ASCT with 49 patients in CR at the end of the therapeutic pathway. With a median follow-up of 31.4 months, 7 CR patients had disease relapse, yielding an estimated disease-free survival of 73.9% at 34 months. The estimated 2-year progression-free survival was 83.4% (median not reached). Six patients had an early BEGEV discontinuation due toxicity, but they were still able to perform ASCT with a CR. Conclusions: Real-life data on BEGEV regimen as first salvage setting showed a relevant rate of objective responses and a limited myelotoxicity with no impairment of a subsequent mobilization of peripheral blood stem cells. BEGEV regimen was well tolerated, and reversible adverse events were the most common ones. Keywords: Chemotherapy, Hodgkin lymphoma, Stem Cell Transplant No conflicts of interests pertinent to the abstract.