# Subgroup analysis of treatment pathways and clinical outcomes in Hodgkin lymphoma in Latin America from the retrospective B-HOLISTIC study

## TL;DR

This study analyzed Hodgkin lymphoma treatment and outcomes in Latin America, finding suboptimal survival compared to developed regions despite guideline-aligned care.

## Contribution

The study provides real-world data on HL treatment patterns and outcomes in Latin America, highlighting the need for improved therapies and stem cell transplantation rates.

## Key findings

- Most frontline HL treatment in Latin America used ABVD chemotherapy, consistent with guidelines.
- Stem cell transplantation improved survival outcomes in relapsed/refractory HL patients.
- Clinical outcomes in Latin America were suboptimal compared to developed regions.

## Abstract

Real-world data on Hodgkin lymphoma (HL) treatment and outcomes in Latin America are limited. The B-HOLISTIC study (2010–2013) retrospectively assessed treatment patterns and outcomes in patients with stage IIB–IV classical HL receiving frontline chemotherapy (frontline cHL) or relapsed/refractory HL (RRHL) in regions outside Europe and North America. This subgroup analysis presents findings from patients enrolled from treatment centers in Argentina, Colombia, and Mexico. The primary endpoint was progression-free survival (PFS) in patients with RRHL. Other endpoints included overall survival (OS), best clinical response, and treatment patterns. In Latin America (frontline cHL: 344; RRHL: 92), the most common frontline regimen was ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine). In patients with RRHL receiving salvage chemotherapy (92.4%), common regimens were ESHAP (etoposide, methylprednisolone, cytarabine, cisplatin) and ICE (ifosfamide, carboplatin, etoposide). Overall, 68.2% of eligible patients with RRHL underwent stem cell transplantation (SCT). Median PFS and OS in the RRHL group was 20.2 and 87 months, respectively; the 5-year PFS rate was 27.1%. Survival outcomes were improved in patients who underwent SCT than those without SCT. Median PFS and OS in the cHL group were not reached. These data demonstrated that while real-world HL treatment in Latin America was consistent with guidelines during the study period, clinical outcomes were suboptimal compared with developed regions. This emphasizes the need for novel therapies and improved progression to SCT in this patient population. These findings may offer valuable insights and serve as a reference for future studies in this region. ClinicalTrials.gov Identifier: NCT03327571, registered October 31, 2017.

The online version contains supplementary material available at 10.1038/s41598-025-07704-0.