To evaluate patterns of rrHL after contemporary first-line treatment we studied 409 patients with first rrHL (HD13: n = 87, HD14: n = 118, HD15: n = 188, HDR3i: n = 51) at a median age of 37.4 years (18.4–76.8) from the GHSG database. Time to first relapse was ≤12 months in 49% and stage III/IV rrHL present in 52% of patients. In total, 291 patients received high-dose chemotherapy and autologous stem-cell transplantation (ASCT) and intended ASCT failed in 38 patients. ASCT was primarily not intended in 80 patients largely due to low risk disease or age/comorbidities. Overall, 10-year progression-free (PFS) and overall survival (OS) rates after first relapse were 48.2% (95% CI 41.9–54.2%) and 59.4% (95% CI 53.0–65.2%), respectively, with significant differences between subgroups. Inferior survival was observed with no ASCT due to advanced age/comorbidities (five-year PFS 36.2%, 95% CI 17.7–55.0%) or failure of salvage therapy (five-year PFS 36.3%, 95% CI 19.7–53.2%). Similarly, presence of primary refractory disease or stage IV at rrHL conferred inferior survival. In patients with low-risk disease, however, survival appeared favorable even without ASCT (10 y PFS 72.6%, 95% CI 53.7–84.8%). We herein confirm the curative potential of current rrHL treatments providing a robust benchmark to evaluate novel therapeutic strategies in rrHL. Approximately 50% of rrHL patients experienced a consecutive relapse.

为了评估当代一线治疗后的 rrHL 模式，我们研究了 409 名首次 rrHL 患者（HD13： n = 87，HD14： n = 118，HD15： n = 188，HDR3i： n = 51），中位年龄为 37.4 岁(18.4–76.8) 来自 GHSG 数据库。 49% 的患者至首次复发的时间≤12 个月，52% 的患者出现 III/IV rrHL 期。总共有 291 名患者接受了大剂量化疗和自体干细胞移植 (ASCT)，其中 38 名患者的预期 ASCT 失败。主要由于低风险疾病或年龄/合并症，ASCT 最初并不打算用于 80 名患者。总体而言，首次复发后 10 年无进展 (PFS) 和总生存 (OS) 率分别为 48.2% (95% CI 41.9–54.2%) 和 59.4% (95% CI 53.0–65.2%)，亚组之间的差异。由于高龄/合并症（五年 PFS 36.2%，95% CI 17.7–55.0%）或挽救治疗失败（五年 PFS 36.3%，95% CI 19.7–53.2%），未进行 ASCT 时观察到生存率较差（五年 PFS 36.3%，95% CI 19.7–53.2%） 。同样，原发性难治性疾病或 rrHL IV 期的存在导致生存率较差。然而，在低风险疾病患者中，即使不进行 ASCT，生存率似乎也不错（10 年 PFS 72.6%，95% CI 53.7–84.8%）。我们在此确认了当前 rrHL 治疗的治疗潜力，为评估 rrHL 的新治疗策略提供了可靠的基准。大约 50% 的 rrHL 患者经历了连续复发。