Nivolumab as a bridge to allogeneic hematopoietic stem cell transplantation is associated with improved survival

D. İskender, M.K. Çakar, M.S. Dal, N.A. Baysal, A. Merdin, M. Bakırtas, B.U. Ulu, S. Başcı, T.N. Yiğenoğlu, F. Altuntaş

Department of Hematology and Hematopoietic Stem Cell Transplantation unit, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey. diclekoca@yahoo.com

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• Hematology
• Oncology

OBJECTIVE: The aim of the present study was to compare the effects of nivolumab bridge to allogeneic hematopoietic stem cell transplantation (allo-SCT) on progression-free survival (PFS) and overall survival (OS) and toxicity profile.

PATIENTS AND METHODS: The study population consisted of relapsed/refractory cases of HL, who were treated with nivolumab for disease control and subsequently underwent allo-SCT at our institution. The control group consisted of HL patients who relapsed or refractory after multiple lines of therapy and underwent allo-SCT without nivolumab before transplantation as bridging therapy.

RESULTS: The incidence of acute and chronic graft vs. host disease (GVHD) was similar in both groups. The 100-day mortality occurred in 1 patient (10%) in the nivolumab group and 4 patients (16.7%) in the control group (p = 0.54). During 30-month follow-up, PFS was achieved in 60% of patients in the nivolumab group and 45.8% in the control group (p = 0.69). OS during 30-month follow-up was 80% in the nivolumab group and 41.7% in the control group, OS was superior in patients in the nivolumab group than in the control group (p = 0.04).

CONCLUSIONS: Allo-SCT after bridging therapy with nivolumab provides a survival advantage over patients who underwent allo-SCT without the bridging. Therapy with nivolumab in combination with post-transplant cyclophosphamide does not appear to increase GVHD.

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