BEGEV salvage regimen in relapsed/refractory classical Hodgkin lymphoma: a real-life experience

J Cancer Res Clin Oncol. 2023 Mar;149(3):1043-1047. doi: 10.1007/s00432-022-03955-w. Epub 2022 Mar 3.

Abstract

Purpose: 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). Finding a salvage regimen able to induce this status without severe toxicity would represent a major achievement in this setting.

Methods: A single-center retrospective study was conducted to assess effectiveness and safety of BEGEV (bendamustine, gemcitabine, and vinorelbine) regimen as first salvage setting prior to ASCT in HL patients.

Results: Forty-three patients were treated in our institution between October 2017 and November 2020. Median age at BEGEV therapy was 35.0 years (range 17.2- 70.0), and the median time from frontline therapy to the first cycle of BEGEV was 79.5 days (range 4-2267). At the end of treatment, 31 patients achieved a complete response (CR), with an overall response rate of 76.7%. Forty-one patients harvested CD34+ cells and 35/43 (81.4%) patients underwent ASCT. With a median follow-up of 22 months, 4 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 66.7%. Response to first-line chemotherapy did not significantly influence prognosis.

Conclusions: BEGEV regimen was well tolerated, and reversible haematological toxic effects were the most common adverse events. 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.

Keywords: Autologous stem cell transplantation; BEGEV; Hodgkin lymphoma; Real life; Salvage regimen.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Hematopoietic Stem Cell Transplantation* / methods
  • Hodgkin Disease* / drug therapy
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy
  • Recurrence
  • Retrospective Studies
  • Salvage Therapy / methods
  • Transplantation, Autologous
  • Young Adult