Combination Brentuximab Vedotin and Bendamustine for Pediatric Patients with Relapsed/Refractory Hodgkin Lymphoma.

In patients with relapsed/refractory (R/R) Hodgkin lymphoma (HL), achieving a complete metabolic response (CMR) following salvage therapy is associated with superior outcomes, and optimal treatments need to be identified. The combination of brentuximab vedotin and bendamustine (BVB), while highly active in adult patients, has not been extensively evaluated in pediatric patients with R/R HL. We performed a multi-institution retrospective review of pediatric patients <21 years of age with R/R HL treated with BVB from January 2016 to July 2019. Response was assessed by local radiologists according to Lugano classification criteria. Twenty-nine patients (17 relapsed, 12 refractory) with a median age of 15 years (range 10-20) were treated with BVB and received a median of three cycles of therapy (range 2-7). Patients received an infusion of 1.8mg/kg of brentuximab vedotin on day 1 with bendamustine 90mg/m2 on Days 1 and 2 of 3-week cycles. Nineteen patients (66%) achieved a CMR (CI: 46 to 82%). An objective response was observed in 23 patients (ORR 79%) (CI: 60 to 92%). The most common grade 3/4 toxicities were hematologic and 3 patients (10%) experienced grade 3 infusion reactions. Seventeen of 18 patients underwent successful mobilization and collection of stem cells. Sixteen patients (13 autologous, 3 allogeneic) received a consolidative transplant following BVB. The 3-year post-BVB event-free and overall survival was 65% (95%CI: 46 to 85%) and 89% (95%CI: 74 to 100), respectively. For pediatric patients with R/R HL, BVB was well tolerated and compares favorably with currently accepted salvage regimens.