Immunotherapy Plus Transplantation Improves Outcomes in Relapsed Lymphoma

Nina Wagner-Johnston, MD, recently published a retrospective study with coauthors that showed enhanced survival results with an immune checkpoint inhibitor followed by allogeneic transplantation. Before those results, however, she stated there was a belief that graft-vs-host disease would have been more common in patients who received immunotherapy before transplantation. Their results did not reflect that conclusion.

Additionally, the fields of non-Hodgkin and Hodgkin lymphoma are in a very exciting time. As she said, recent novel approaches have completely “changed the course of illness” for patients. Specifically, she highlighted chimeric antigen receptor (CAR) T-cell therapy and bispecific antibodies as newer forms of treatment that have had large impacts on the fields.

Wagner-Johnston is a professor of oncology and the director of lymphoma drug development at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, director of hematologic malignancies in the National Capital Region, and codirector of clinical research for hematologic malignancies.

Transcript:

This study was conducted to evaluate the safety of [immune checkpoint inhibitors plus allogeneic transplantation] because prior to our publication, there were concerns that there would be more toxicity in patients who had received prior immunotherapy treatment—particularly a complication from transplant called graft-vs-host disease. In our series, we evaluated that and found this did not [occur] and that the combination approach was safe, which is very important because these immunotherapy approaches have become the mainstay in treating patients with Hodgkin lymphoma who have relapsed. Recognizing that we could follow immunotherapy with a bone marrow transplant safely was quite important.

[Non-Hodgkin lymphoma and Hodgkin lymphoma] have been incredibly exciting fields over the last decade; some of the novel approaches have changed the course of illness for our patients. Previously, in patients whose disease had relapsed, we were discussing hospice, and now we have these options for patients that are potentially offering a chance for a cure—specifically, those that include things like CAR T cells, which is a cellular therapy where we’re reharnessing the patient’s immune system to fight cancer. CAR T cells have been a huge game changer. Additionally, drugs like bispecifics, which are off-the-shelf treatment options for patients, [are] improving outcomes for patients with lymphoma.

Reference

Tabbara N, Zahurak M, Sterling CH, et al. Improved overall survival with checkpoint inhibition and allogeneic transplantation in relapsed Hodgkin lymphoma. Blood Adv. 2025;9(5):1202-1209. doi:10.1182/bloodadvances.2024015048