Blood Res.  2021 Sep;56(3):134-140. 10.5045/br.2021.2021039.

Bendamustine in combination with ifosfamide, etoposide, and vinorelbine (VIBE) is an effective salvage regimen for heavily pre-treated patients with relapsed or refractory Hodgkin lymphoma: a single-center experience

• Prakash G
• Jain A
• Sahu K
• Bal A
• Singh C
• Basher R
• Singh H
• Mishra K
• Jandial A
• Lad D
• Khadwal A
• Srinivasan R
• Das A
• Varma N
• Varma S
• Malhotra P

• KMID: 2520582
• DOI: http://doi.org/10.5045/br.2021.2021039

Abstract

Background
This study evaluated the outcomes of patients with refractory/relapsed Hodgkin lymphoma (RRHL) treated with a bendamustine-based regimen in combination with ifosfamide, etoposide, and vinorelbine (VIBE).
Methods
Consecutive RRHL patients who were treated with the VIBE regimen were identified and studied for clinicopathologic characteristics, response to VIBE regimen, event-free survival (EFS), and feasibility of an autologous stem-cell transplant (autoSCT).
Results
In total, 24 patients received the VIBE regimen, and a median of 3 cycles were administered. In this cohort, 80% of the patients had received ≥2 prior lines of therapy. The overall and complete response rates with VIBE were 79% and 42%, respectively. After a median follow-up (following VIBE regimen) of 14 months (range, 3‒76), the 3-year EFS and OS were 46% and 74%, respectively. Of the eligible patients, 92% underwent successful AutoSCT. The mean CD34+ cell count in the autograft was 5.5×10⁶/kg (SD 2.07). Neutropenia was the commonest hematologic toxicity and it was observed in 42% of the patients. However, only 9% of the patients developed grade III/IV febrile neutropenia. Chemotherapy-induced nausea and vomiting were the second most common grade III/IV toxicities in our cohort of patients.
Conclusion
In this retrospective analysis, the combination regimen, VIBE, has shown good efficacy in heavily pre-treated patients with RRHL without compromising stem cell collection. These encouraging results provide a rationale for further development of this regimen.

Keyword

Relapsed refractory; Hodgkin Lymphoma; Salvage; Bendamustine; Autologous transplant

Figure

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  Fig. 1 Y-axis: CR/CRu rates (expressed in percentage); X-axis: various variables.

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  Fig. 2 Kaplan-Meier survival curve for event-free survival (A). Whole group. EFS according to response to VIBE therapy (B). EFS according to age group (C). EFS according to AutoHSCT status (D).

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