经过异基因造血干细胞移植治疗经典霍奇金淋巴瘤患者后，成功恢复检查点抑制剂的疗效。
Successful restoration of checkpoint inhibitors efficacy after allogeneic hematopoietic cell transplant for classic Hodgkin lymphoma patients.
发表日期：2023 May 26
作者：
Riad El Fakih, Abdulwahab A Albabtain, Saud Alhayli, Khawlah Farhan, Walid Rasheed, Alfadel Alshaibani, Naeem Chaudhri, Mahmoud Aljurf
来源：
Bone & Joint Journal
摘要：
经典霍奇金淋巴瘤（cHL）是一种治愈率很高的疾病。然而，在骨髓移植后复发尤其是寻找同种异基因移植后的复发是具有挑战性的。通过回顾机构移植数据库的图表资料总结了使用免疫检查点抑制剂（CPIs）治疗已经在同种异基因移植前未能持续受益的患者在同种异基因移植后的cHL复发的安全性和疗效。我们共鉴定和回顾了6例病例。所有患者都在同种异基因移植前接受并未能持续受益的CPIs和布伦特克司亚脱素治疗。同种异基因移植时的中位年龄为28.6岁（IQR 23.6-34.2），同种异基因移植前接受的治疗次数的中位数为6.5次（范围5-9）。同种异基因移植前CPI治疗的中位持续时间为8.1个月（IQR 6.7-12.9）。CPI停药至同种异基因移植的中位时间为5.78个月（IQR 3.15-15.8）。同种异基因移植后至进展的中位时间为5.75个月（IQR 2.6-11.7）。同种异基因移植后再次尝试CPI治疗的中位时间为7.6个月（IQR 3.2-28.6）。继续使用同种异基因移植后CPI治疗的中位随访时间为16个月（IQR 7.25-25.75）。其中5例患者有反应，2例患者出现移植物抗宿主病。我们的报告显示，尽管使用并未能持续受益于同种异基因移植前的CPIs，但在同种异基因移植后使用CPIs仍保持了疗效且没有出现新的安全信号。版权所有© 2023 Elsevier Inc. 保留所有权利。
Classic Hodgkin lymphoma (cHL) is a highly-curable disease. However, relapses after bone marrow transplant are challenging especially relapses after allogeneic transplant.A retrospective chart review of the institution transplant database to summarize the safety and efficacy of checkpoint inhibitors (CPIs) use for cHL relapses postallo-HCT in patients who already failed to derive sustained benefit from CPIs received prior to allo-HCT.Six cases were identified and reviewed. All patients received and failed to derive sustained benefit from CPIs and brentuximab vedotin preallo-HCT. The median age at the time of allo-HCT was 28.6 years (IQR 23.6-34.2), the median number of lines received prior to allo-HCT was 6.5 (range 5-9). The median duration of CPI therapy prior to allo-HCT was 8.1 months (IQR 6.7-12.9). The median time between the discontinuation of CPI and allo-HCT was 5.78 months (IQR 3.15-15.8). The median time to progression postallo-HCT was 5.75 months (IQR 2.6-11.7). The median time between allo-HCT and re-challenge with a CPI was 7.6 months (IQR 3.2-28.6). The median time of follow up after starting postallo-HCT CPIs was 16 months (IQR 7.25-25.75). Five out six patients responded and two patients developed GvHD.Our report shows preserved efficacy without any new safety signals by using CPIs postallo-HCT despite using and having failed to derive sustained benefit from CPIs preallo-HCT.Copyright © 2023 Elsevier Inc. All rights reserved.