Article Type
Article
Abstract
Background: Relapsed or refractory classical Hodgkin lymphoma (cHL) remains a therapeutic challenge, particularly in patients who progress after multiple lines of therapy or autologous stem cell transplantation (ASCT). Immune checkpoint inhibitors targeting the programmed death-1 (PD-1) pathway have demonstrated substantial activity in clinical trials; however, real-world outcomes in routine clinical practice across heterogeneous patient populations in the United States remain limited. This study evaluated the effectiveness and safety of PD-1 blockade in patients with relapsed or refractory cHL treated in a U.S. cohort. Methods: We conducted a retrospective multicenter cohort study including adult patients (≥ 18 years) with histologically confirmed relapsed or refractory classical Hodgkin lymphoma treated with nivolumab or pembrolizumab between January 2016 and December 2023. Clinical and treatment data were obtained from electronic medical records. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), overall response rate (ORR), duration of response (DOR), and treatment-related adverse events. Survival outcomes were estimated using the Kaplan–Meier method, and prognostic factors were evaluated using multivariable Cox proportional hazards regression analysis. Results: A total of 142 patients were included, with a median age of 34 years. Patients were heavily pretreated, with a median of three prior therapy lines; 68% had undergone prior ASCT and 73% had received brentuximab vedotin. The overall response rate was 71%, including a complete response rate of 34%. Median progression-free survival was 14.9 months, with 12- and 24-month PFS rates of 58% and 38%, respectively. Median overall survival was not reached; estimated 24-month OS was 72%. Primary refractory disease and ECOG performance status ≥ 2 were independently associated with inferior survival, whereas achievement of complete response and consolidation with transplantation were associated with improved outcomes. Treatment was generally well tolerated, with grade 3–4 immune-related adverse events occurring in 12% of patients and no treatment-related mortality. Conclusion: In this real-world U.S. cohort, PD-1 checkpoint inhibitors demonstrated substantial clinical activity and durable responses in heavily pretreated patients with relapsed or refractory classical Hodgkin lymphoma. Outcomes were comparable to clinical trial results, supporting the effectiveness of checkpoint inhibition in routine practice. These findings reinforce immune checkpoint blockade as a standard therapeutic strategy and support its integration into earlier treatment lines for Hodgkin lymphoma.
Keywords
Hodgkin lymphoma, Relapsed disease, Refractory disease, Immune checkpoint inhibitors, Nivolumab
Recommended Citation
Whitman, Daniel R.; Patterson, Emily K.; Reyes, Jonathan M.; and Chen, Laura B.
(2026)
"Immune Checkpoint Inhibition in Relapsed or Refractory Hodgkin Lymphoma: A U.S. Cohort Analysis,"
Muthanna Medical Journal: Vol. 13:
Iss.
1, Article 5.
Available at:
https://muthmj.mu.edu.iq/journal/vol13/iss1/5
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
