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

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).

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.

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.

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.