{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T13:09:10Z","timestamp":1780924150998,"version":"3.54.1"},"reference-count":0,"publisher":"American Society of Hematology","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>The treatment landscape of relapsed\/refractory (R\/R) classic Hodgkin lymphoma (cHL) has evolved significantly over the past decade following the approval of brentuximab vedotin (BV) and the programmed death-1 (PD-1) inhibitors. We evaluated how outcomes and practice patterns have changed for R\/R cHL patients who underwent autologous hematopoietic cell transplantation (AHCT) at our institution from 2011-2020 (N=183) compared to 2001-2010 (N=159) and evaluated prognostic factors for progression-free survival (PFS) and overall survival (OS) in both eras. OS was superior in the modern era (4-year estimates 89.1% vs 79.0%, HR 0.53, 95% CI 0.33-0.85, p=0.011) with a trend towards lower non-relapse mortality beyond 2 years post-transplant. Among patients who progressed after AHCT, 4-year post-progression survival increased from 43.3% to 71.4% in the modern era, reflecting increasing use of BV and the PD-1 inhibitors. In multivariable analysis for patients transplanted in the modern era, age \u00b345 years, primary refractory disease, and lack of complete remission pre-AHCT were associated with inferior PFS, while receipt of a PD-1 inhibitor-based regimen pre-AHCT was associated with superior PFS (HR 0.21, 95% CI 0.05-0.80, p=0.030). Extranodal disease at relapse was associated with inferior OS (HR 3.12, 95% CI 1.25-7.77, p=0.014). Our study demonstrates improved survival for R\/R cHL after AHCT in the modern era attributed to more effective salvage regimens allowing for better disease control pre-AHCT and improved outcomes for patients who progressed after AHCT. Excellent outcomes were observed with PD-1 inhibitor-based salvage regimens pre-AHCT and support a randomized trial evaluating immunotherapy in the second line setting.<\/jats:p>","DOI":"10.1182\/blood.2022018827","type":"journal-article","created":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T20:57:51Z","timestamp":1677704271000},"update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":14,"title":["Improved outcomes for relapsed\/refractory Hodgkin lymphoma after autologous transplantation in the era of novel agents"],"prefix":"10.1182","author":[{"given":"Michael A","family":"Spinner","sequence":"first","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8877-4470","authenticated-orcid":false,"given":"R. Alejandro","family":"Sica","sequence":"additional","affiliation":[{"name":"University of California San Francisco, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9868-2366","authenticated-orcid":false,"given":"John S","family":"Tamaresis","sequence":"additional","affiliation":[{"name":"Stanford University, Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7698-8962","authenticated-orcid":false,"given":"Ying","family":"Lu","sequence":"additional","affiliation":[{"name":"Stanford University, Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Chang","sequence":"additional","affiliation":[{"name":"Stanford University Medical Center, Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Lowsky","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine, Stanford (CA), Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Frank","sequence":"additional","affiliation":[{"name":"Stanford University, Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura J","family":"Johnston","sequence":"additional","affiliation":[{"name":"Stanford University, Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0717-4305","authenticated-orcid":false,"given":"David B","family":"Miklos","sequence":"additional","affiliation":[{"name":"Stanford University Medical School, Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9887-6136","authenticated-orcid":false,"given":"Lori","family":"Muffly","sequence":"additional","affiliation":[{"name":"Stanford University, Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Negrin","sequence":"additional","affiliation":[{"name":"Stanford University Medical Center, Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R.","family":"Rezvani","sequence":"additional","affiliation":[{"name":"Stanford University, Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6721-0358","authenticated-orcid":false,"given":"Parveen","family":"Shiraz","sequence":"additional","affiliation":[{"name":"Stanford University, Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith A.","family":"Shizuru","sequence":"additional","affiliation":[{"name":"Stanford University Medical Center, Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Kai","family":"Weng","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine, Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2640-5255","authenticated-orcid":false,"given":"Michael S.","family":"Binkley","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine, Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0125-0194","authenticated-orcid":false,"given":"Richard T.","family":"Hoppe","sequence":"additional","affiliation":[{"name":"Stanford University Medical Center, Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjana H","family":"Advani","sequence":"additional","affiliation":[{"name":"Stanford University, Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1993-4172","authenticated-orcid":false,"given":"Sally","family":"Arai","sequence":"additional","affiliation":[{"name":"Stanford University, Stanford, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","published-online":{"date-parts":[[2023,3,1]]},"container-title":["Blood"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ashpublications.org\/blood\/article-pdf\/doi\/10.1182\/blood.2022018827\/2036580\/blood.2022018827.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/ashpublications.org\/blood\/article-pdf\/doi\/10.1182\/blood.2022018827\/2036580\/blood.2022018827.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T20:57:53Z","timestamp":1677704273000},"score":1,"resource":{"primary":{"URL":"https:\/\/ashpublications.org\/blood\/article\/doi\/10.1182\/blood.2022018827\/494750\/Improved-outcomes-for-relapsed-refractory-Hodgkin"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,1]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1182\/blood.2022018827","relation":{},"ISSN":["0006-4971","1528-0020"],"issn-type":[{"value":"0006-4971","type":"print"},{"value":"1528-0020","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,1]]},"article-number":"blood.2022018827"}}