Salvage regimen | Major toxicities | Clinical utility | Other |
ICE (ifosfamide, carboplatin, etoposide) | Hematologic (universal), infections, nephrotoxicity | Preferred initial salvage chemotherapy regimen | Administered every 14 to 21 days, as permitted by blood counts; can be given as inpatient or outpatient therapy |
GVD (gemcitabine, vinorelbine, pegylated liposomal doxorubicin) | Hematologic (universal), febrile neutropenia | Preferred second-line salvage chemotherapy regimen | Can be given as inpatient or outpatient therapy; doses should be adjusted if patient is post-HCT |
GDP (gemcitabine, dexamethasone, cisplatin) | Hematologic (universal), febrile neutropenia, nephrotoxicity | Alternative salvage chemotherapy | |
DHAP (dexamethasone, high dose cytarabine, cisplatin) | Hematologic (universal), infections, nephrotoxicity, neurotoxicity | Alternative salvage chemotherapy | |
BeGEV (bendamustine, gemcitabine, vinorelbine) | Hematologic (universal) | Alternative salvage chemotherapy | |
Brentuximab vedotin (BV) | Neurotoxicity, pancreatitis (rare), progressive multifocal leukoencephalopathy (rare) | For relapse after autologous HCT (if BV was not previously administered), relapse after two prior multi-agent chemotherapy regimens, consolidation after partial response to systemic chemotherapy | Targeted chemotherapy (monomethyl auristatin E linked to CD30 monoclonal antibody) |
Nivolumab or pembrolizumab | Pneumonitis, hepatitis, nephritis, gastrointestinal and metabolic abnormalities | For relapse after autologous HCT and post-HCT brentuximab vedotin | Immune checkpoint inhibitors; increased risk for severe graft-versus-host disease in patients previously treated with these agents |
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