This study aimed to compare use of original brand-name lenalidomide (Revlimid®) vs. generic equivalent (Rivelime®) in terms of efficacy, safety and survival outcome in patients with relapsed/refractory multiple myeloma (RRMM) PATIENTS AND METHODS: A total of 184 patients RRMM (median age: 62 years, 60.9% were males) who received singlet, doublet or triplet lenalidomide-containing regimens including either Revlimid® (n=74) or Rivelime® (n=110) were included in this study. Treatment response was based on evaluation of objective response to treatment (ORR) including the sum of patients who achieved partial response (PR), very good partial responses (VGPR) or complete response (CR) to therapy. Progression-free survival (PFS), overall survival (OS) and safety data were also recorded. Revlimid® and Rivelime® groups were similar in terms of ORR (54.1 vs. 60.0%), CR (22.5 vs. 28.8%), VGPR (55.0 vs. 50.0%) and PR (22.5 vs. 21.2%) rates. Median (SE) PFS time were similar between Rivelime® vs. Revlimid® treated patients who were in the 2^nd line (30.3(3.8) vs. 22.7(7.0) months, p=0.827) or 3^rd line of therapy (38.1(12.1) vs. 20.1(0.9) months, p=0.147) at lenalidomide initiation. Two groups also had similar OS rate (83.8 vs. 73.6%) and OS time (mean 122.3 vs. 123.5 months). Side effects were manageable in both groups. In conclusion, replacing Revlimid® with its generic version Rivelime® in singlet, doublet or triplet lenalidomide containing RRMM regimens seems not to compromise the efficacy of treatment, and to yield a similarly improved response rates and survival outcome and no additional toxic effects, enabling a long-term therapy.

Central nervous system (CNS) involvement in chronic lymphocytic leukemia (CLL) is unfamiliar. The diagnosis is delayed commonly, because of underdiagnosis or subclinical symptoms. We describe a 80-year-old woman with a previous diagnosis of CLL who presented to the emergency service with tonic clonic seizure. The new therapies, eg, ibrutinib and venetoclax, can be effective treatment strategies for CLL with CNS involvement. In our case, treatment with ibrutinib led to a resolution of the cerebralspinal fluid (CSF) neoplastic infiltration, but the patient died afterwards.

AlloHCT remains a curative option for R/R Hodgkin lymphoma despite advances with BV and CPIs. This study evaluates its role and outcomes in this challenging patient population. This retrospective oligocentric analysis involved 70 patients with R/R classical HL who underwent alloHCT. Patients were split into two treatment cohorts: era1 (2004-2010), 16 patients, and era2 (2011-2021), 54 patients. Among the cohort, sixty-three patients had previously received an autologous stem cell transplant. Forty patients were administered only (n=29) BV or BV preceding CPI (n=11) before alloHCT. A median follow-up of 64 months (40.7-87.3) revealed a 100-day non-relapse mortality (NRM) rate of 26%, with the 3-year overall survival (OS) and progression-free survival (PFS) reported as 39% and 28%, respectively. AlloHCT using haplotype-matched donors was linked to better OS and PFS. Post-transplant cyclophosphamide (post-tx CY) as a prophylactic approach for graft versus host disease (GVHD) significantly improved OS and PFS. A complete response (CR) during the post-transplant phase significantly improved OS and PFS. Indeed, better OS, PFS, and a reduced rate of NRM were observed in the pre/post-alloHCT BV and CPI group, although we could not demonstrate statistical significance. The survival (OS, PFS) curves and NRM rates were similar for both eras. AlloHCT is a potentially practical therapeutic approach in responding to R/R HL patients.