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Tandem haematopoietic stem cell transplantation for High Risk relapsed/refractory Hodgkin Lymphoma: a LYSA study

Tandem stem cell transplantation (SCT) is an option for high‐risk relapsed/refractory Hodgkin Lymphoma (HL) patients. We evaluated the tolerance/efficacy of double autologous or autologous SCT (ASCT) followed by allogenic SCT (alloSCT) in 120 HL patients prospectively registered on a French nationwide database. Median age was 26 (14–56) years. Complete remission rate was 60%, including 33% after a single line, and another 27% after two or more salvage regimens. Partial response rate was 32%, and 8% suffered treatment failure. Overall, 115 (96%) patients underwent a first ASCT, and 73 (61%) had a tandem SCT, including alloSCT in 44 (60%) and ASCT in 29 (40%). The median follow‐up was 43 months (4.8–73.7 months). The two‐year progression‐free survival rate for the whole population and for patients receiving tandem transplant was 56% (95% confidence interval [CI]: 46–65%) and 71% (95% CI: 49–84%), respectively. Among tandem transplants, we observed 20 deaths (17%), 10 of which were transplant‐related (6 alloSCT and 4 ASCT). We suggest that tandem SCT is efficient in high‐risk relapsed/refractory HL patients, although transplant‐related mortality remains high. The benefit of tandem SCT should be balanced with the efficacy of Brentuximab vedotin‐based post‐transplant consolidative strategies in high‐risk relapsed/refractory HL patients.