Nivolumab as a bridge to allogeneic hematopoietic stem cell transplantation is associated with improved survival

Objective: The aim of the present study was to compare the effects of nivolumab bridge to allogeneic hematopoietic stem cell transplantation (allo-SCT) on progression-free survival (PFS) and overall survival (OS) and toxicity profile. Patients and Methods: The study population consisted of relapsed/refractory cases of HL, who were treated with nivolumab for disease control and subsequently underwent allo- SCT at our institution. The control group consisted of HL patients who relapsed or refractory after multiple lines of therapy and underwent allo-SCT without nivolumab before transplantation as bridging therapy. Results: The incidence of acute and chronic graft vs. host disease (GVHD) was similar in both groups. The 100-day mortality occurred in 1 patient (10%) in the nivolumab group and 4 patients (16.7%) in the control group (p = 0.54). During 30-month follow-up, PFS was achieved in 60% of patients in the nivolumab group and 45.8% in the control group (p = 0.69). OS during 30-month follow-up was 80% in the nivolumab group and 41.7% in the control group, OS was superior in patients in the nivolumab group than in the control group (p = 0.04). Conclusions: Allo-SCT after bridging therapy with nivolumab provides a survival advantage over patients who underwent allo-SCT without the bridging. Therapy with nivolumab in combination with post-transplant cyclophosphamide does not appear to increase GVHD

Pregnancy outcomes in female cancer survivors after hematopoietic stem cell transplantation

Objective: This study was conducted to retrospectively investigate the pregnancy outcomes of patients who underwent stem cell transplantation (SCT). We also aimed at determining the reasons for avoiding pregnancy despite prolonged remission. Patients and Methods: The study population consisted of patients who became pregnant after autologous or allogeneic SCT at Dr. Abdurrahman Yurtarslan Oncology Hospital between 2009 and 2020 for hematologic diseases. Data from 83 patients who had undergone allogeneic or autologous SCT were available for analysis. A total of 18 pregnancies occurred in 14 of these patients. To compare pregnancy outcomes, pregnant patients who received care at Etlik Zübeyde Hanim Maternity Hospital were selected as the control group. Results: No pregnancy occurred in 69 of the patients whose data were analyzed. Of these 69 patients, 48 (69.6%) did not want to become pregnant. The most common reason for not wanting a pregnancy was due to the fact that the patient was not married [21 patients (30.4%)]. The pregnancy rate was higher in the HL group than in other hematologic malignancies [8 patients (57.1%)]. Twelve (85.7%) of the patients who became pregnant did so after autologous SCT and 2 (14.3%) after allogeneic SCT. The cumulative incidence of obstetric complications was higher in pregnancies after SCT than in the control group, and the prevalence of low birth weight was observed more frequently. Conclusions: Patients who became pregnant after SCT have a higher rate of pregnancy complications. However, these patients achieve similar live birth rates as the healthy population. Many patients have concerns about pregnancy and should be counseled appropriately