Safety and efficacy of nivolumab applied at different dosage in the patients with relapsing hodgkin lymphoma after allogeneic hematopoietic stem cell transplantation

Abstract

Allogeneic hematopoietic cell transplantation (allo-HSCT) is a potentially curative treatment for patients with relapsed and refractory Hodgkin lymphoma (HL) followed by long-term survival. However, relapse and progression of disease in the post-transplant period may occur in a substantial number of patients. nivolumab, an antibody blocking the programmed cell death receptor 1 (PD-1) has shown high efficiency in patients with HL in pre-and post-allo-HSCT setting. We have retrospectively assessed efficacy and toxicity of nivolumab as a single agent in seven HL patients relapsing after allo-HSCT using the drug at different doses (0.5 to 3 mg/kg body mass) administered every 2 weeks. We did not observe any cases of graft-versus-host disease (GVHD) after nivolumab initiation. An objective clinical response to the therapy was noted in all patients (100%), at any dos-dos- ing regimen. Complete metabolic response, as detected by PET/CT, was observed in two patients (28.6%) treated at 0.5 and 1 mg/kg. Three patients of seven (42.9%) experienced grade 3-4 grade adverse events (AEs) from nivolumab, which included immune disorders. There was no correlation with nivolumab dosing regimen since severe AEs were documented in patients treated at 0.5, 1, or 3 mg/kg. All the patients are alive by the time of evaluation, 4/7 patients had the disease relapse at a median of 7 months (5 to 9) after initiation of the treatment. nivolumab may represent an efficient therapeutic tool in patients with HL relapse after allo-HSCT, however, followed by a considerable toxicity in some cases. ing.