ASH Clinical News May 2017 NEW | Page 36

Written in Blood

( alloHCT ). The median number of prior therapies ( including alloHCT ) was two ( range = 1-5 therapies ), and no patient had responded to SMILE or SMILE-like regimens .

After a median of seven cycles ( range = 2-13 cycles ) and a median follow-up of six months ( range = 2-10 months ), five patients remained in complete response ( CR ) and two patients achieved a partial response ( PR ).

Three patients achieved clinical and radiologic CR , including two cases of molecular remission ( undetectable EBV DNA ) but with minimal EBV-encoded-RNApositive cells in lesions comprising predominantly

CD3 + CD4 + and CD3 + CD8 + T cells , “ which ultimately disappeared , suggesting pseudo-progression ,” the authors wrote .

“ Responses after pembrolizumab treatment require clinical , radiologic , pathologic , and molecular assessment ,” the authors wrote , and these responses were often “ discordant .”

The authors outlined two cases in which patients had advanced disease and responded to pembrolizumab treatment . One patient had biopsy-proven esophageal involvement and radiologic pulmonary infiltration , and

Dr . Kwong and co-authors reported that “ pembrolizumab treatment led to immediate improvement , and a positron emission tomography / computed tomography ( PET / CT ) scan after six cycles showed metabolic CR .” The patient then continued to receive six more cycles of pembrolizumab .

Another patient who presented with marrow involvement , cytopenia , and HPS relapsed following alloHCT . Following two cycles of pembrolizumab , laboratory monitoring found that EBV DNA levels fell to undetectable levels ; after three cycles , marrow