Addition of Low Dose Nivolumab to Salvage Chemotherapy in Patients with Relapsed/Refractory Hodgkin Lymphoma.

[INTRODUCTION] Several studies have explored different doses of checkpoint inhibitors in various malignancies, but the optimal dose remains undefined. Here, we present our data on the use of low-dose Nivolumab (LD-Nivo) in combination with conventional chemotherapy for patients with Relapsed/Refractory Hodgkin lymphoma (RRHL).

[METHODS] All patients with RRHL who received LD-Nivo with conventional chemotherapy between 2020 and 2024 were included in the study. All patients received a fixed dose of 40 mg of Nivolumab per cycle.

[RESULTS] Twenty-one patients were included in the study with a median age of 26 years. The majority of patients had refractory disease (n = 16; 76.2%). Median Nivolumab dose per cycle was 0.66 mg/kg and median number of cycles of therapy was 3. The overall response rate was 100% with 19 patients achieving a complete response (90.5%). Eleven patients (52.4%) underwent an Autologous hematopoietic cell transplant post salvage therapy. The median follow-up was 23 months during which 2 patients relapsed. There were no deaths during follow-up. Median progression-free and overall survival were not reached.

[CONCLUSION] The addition of a fixed 40 mg dose of Nivolumab to conventional salvage therapy has demonstrated high response rates and favourable outcomes. This may serve as a viable option in Low/Middle Income Countries.