Safety and efficacy of anti-programmed cell death-1 monoclonal antibodies before and after allogeneic hematopoietic cell transplantation for relapsed or refractory Hodgkin lymphoma: a multicenter retrospective study
Safety and efficacy of anti-programmed cell death-1 monoclonal antibodies before and after allogeneic hematopoietic cell transplantation for relapsed or refractory Hodgkin lymphoma: a multicenter retrospective study
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DOI：
10.1007/s12185-020-02960-4
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发表时间：
2020-08-03
影响因子：
2.1
通讯作者：
Fukuda, Takahiro
中科院分区：
文献类型：
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作者：
Ito, Ayumu;Kim, Sung-Won;Fukuda, Takahiro
我们进行了一项多中心研究，在异基因造血细胞移植（allo-HCT）治疗霍奇金淋巴瘤之前/之后，使用抗程序性细胞死亡-1单克隆抗体（抗PD-1 mAb）。在allo-HCT之前向25名患者施用抗PD-1 mAb，在allo-HCT之后向20名患者施用抗PD-1 mAb。在allo-HCT前环境中，从末次给药至allo-HCT的中位间隔为59天。allo-HCT后，12例患者发生非感染性发热综合征，需要大剂量皮质类固醇。II-IV级急性移植物抗宿主病（aGvHD）的累积发生率为47.1%。8例接受移植后环磷酰胺（PTCy）预防GvHD的患者发生aGvHD的频率较低（II-IV级，14.6% vs 58.8%;P = 0.086）。1年总生存率（OS）、复发/进展率和非复发死亡率分别为81.3%、27.9%和8.4%。在allo-HCT后设置中，从allo-HCT到首次给药的中位间隔为589天。总有效率和完全有效率分别为75%和40%。抗PD-1治疗后100天，II-IV级aGvHD、中重度慢性GvHD和3-4级免疫相关毒性的累积发生率分别为15.0%、30.0%和30.0%。1年复发/进展率为47.4%，1年OS概率为89.7%。总之，尽管GvHD预防或抗PD-1 mAb给药进行了调整，但免疫相关并发症仍很常见。在抗PD-1-mAb预治疗的患者中，基于PTCy的GvHD预防可能有效。
We conducted a multicenter study on anti-programmed cell death-1 monoclonal antibodies (anti-PD-1 mAbs) before/after allogeneic hematopoietic cell transplantation (allo-HCT) for Hodgkin lymphoma. Anti-PD-1 mAbs were administered to 25 patients before allo-HCT and to 20 after allo-HCT. In pre-allo-HCT setting, the median interval from the last administration to allo-HCT was 59 days. After allo-HCT, 12 patients developed non-infectious febrile syndrome requiring high-dose corticosteroid. The cumulative incidences of grade II-IV acute graft-versus-host disease (aGvHD) were 47.1%. Eight patients who had GvHD prophylaxis with post-transplant cyclophosphamide (PTCy) had less frequent aGvHD (grade II-IV, 14.6% versus 58.8%;P = 0.086). The 1 year overall survival (OS), relapse/progression, and non-relapse mortality rates were 81.3%, 27.9%, and 8.4%. In post-allo-HCT setting, the median interval from allo-HCT to the first administration was 589 days. The overall and complete response rates were 75% and 40%. At 100 days after anti-PD-1 therapy, the cumulative incidences of grade II-IV aGvHD, moderate-to-severe chronic GvHD, and grade 3-4 immune-related toxicity were 15.0%, 30.0%, and 30.0%. While the 1 year relapse/progression rate was 47.4%, the 1 year OS probability was 89.7%. In conclusion, immune-related complications were frequent despite modifications of GvHD prophylaxis or anti-PD-1 mAb dosing. In anti-PD-1-mAb-pretreated patients, PTCy-based GvHD prophylaxis may be effective.