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Background Classical Hodgkin Lymphoma (cHL) is a highly curable disease; however, 10% of patients (pts) with limited stage and 20%-30% with advanced stage disease still fail first line-treatment. Autologous hemopoietic cell transplantation (auto-HCT) is the standard of care in pts who fail to achieve remission with first-line therapy, or who relapse after induction chemotherapy. However, approximately 50% of cHL pts will ultimately relapse post auto-HCT. These pts historically have had poor outcomes, with median survival in the 1.5 year range. In recent years, highly active new therapies such as brentuximab vedotin (BV), checkpoints inhibitors (i.e. nivolumab and pembrolizumab), and increased accessibility to allogeneic HCT (including utilization of haploidentical donors) have become more widely available. We hypothesized that, in recent years, survival has improved in cHL patients who relapse after auto-HCT since the introduction of these novel therapies into more widespread clinical practice. Methods We conducted a multi-center retrospective study from 3 academic institutions in the U.S. (Medical College of Wisconsin, Ohio State University, and Washington University in St. Louis) to evaluate survival of cHL pts after the failure of an auto-HCT. We reviewed 341 pts who received auto-HCT from 2006-2015. Among them, 126 (37%) pts relapsed post auto-HCT and were evaluated in more detail. For the purpose of analysis, pts were divided into 2 cohorts based on timing of auto-HCT; 2006-2010 (Cohort 1, n=57) and 2011-2015 (Cohort 2, n=69) to compare outcomes. Results The median age at auto-HCT, time from diagnosis to transplant, time from transplant to relapse were similar in Cohort 1 & 2 (see Table 1). The proportion of pts who achieved complete remission (CR) at the time of auto-HCT were 22.8% in Cohort 1 and 40.6% in Cohort 2. Whereas, 68.4% of pts in Cohort 1 and 52.2% of pts in Cohort 2 had partial remission (PR) at the time of auto-HCT. The median number of lines of therapy after relapse from auto-HCT were 2 each in Cohort 1 (range, 0-13) and Cohort 2 (range, 0-7), respectively (p= 0.74). Twenty-five (45%) pts in Cohort 1 and 49 (73%) pts in Cohort 2 received BV as a salvage therapy post auto-HCT (p= 0.002). Similarly, 3 (5.5%) pts in Cohort 1 versus (vs.) 21 (32%) pts in Cohort 2 received check point inhibitors as salvage therapy post auto-HCT relapse (p= Conclusion Our analysis supports that survival of cHL pts post auto-HCT failure has significantly improved in recent years (2011-2015), most likely due to incorporation of novel therapies including BV, checkpoint inhibitors, and more widespread use of allogeneic HCT. Disclosures Shah: Miltenyi: Other: Travel funding, Research Funding; Juno Pharmaceuticals: Honoraria; Exelexis: Equity Ownership; Oncosec: Equity Ownership; Geron: Equity Ownership; Lentigen Technology: Research Funding. Hamadani:Celgene Corporation: Consultancy; Janssen: Consultancy; MedImmune: Consultancy, Research Funding; ADC Therapeutics: Research Funding; Takeda: Research Funding; Cellerant: Consultancy; Ostuka: Research Funding; Sanofi Genzyme: Research Funding, Speakers Bureau; Merck: Research Funding.

Background: The best results for allogeneic hematopoietic cell transplants (HCT) remain with HLA-matched sibling donors. Unfortunately, these donors are only available to about 30% of patients. Alternative donors have been used to fill this gap. Since the introduction of graft-versus-host disease (GVHD) prophylaxis with post-transplant cyclophosphamide (PTCy),haploidentical (haplo) donors have emerged as a resource with near universal availability. This type of transplant hasthe potential for greater graft-versus-leukemia effect, but increased bi-directionalalloreactivity. Identification of modifiable variables inhaplo-HCT that will optimize overall survival and predict relapse is importantin improving patient outcomes after transplant. Objectives: To characterize the impact of graft lymphocyte content in haploidentical hematopoietic cell transplants (haplo-HCT) from peripheral-blood stem cell (PBSC) source using PTCy. Methods: We retrospectively identified all patients undergoing haplo-HCT at our institution between June 2009 and October 2016. We assessed the impact of CD3 content, CD4 content, CD8 content, CD4:CD8 ratio, and CD56 content of the graft on post transplant outcomes. Statistical evaluation was done based on grouping of separate quartiles for each variable; this was compiled into 3 groupings based on the quartiles: quartile 1, quartile 2 & 3, and quartile 4. Acute and chronic GVHD were graded based on established criteria. Overall survival (OS) was calculated using log-rank test of equality. Overall survival (OS), relapse, acute GVHD, chronic GVHD, disease-free survival (DFS), and non-relapse mortality (NRM) were defined as time from transplantation to the event. Results: We identified 127 patients undergoing haplo-HCT between June 2009 and October 2016. CD4 content, CD8 content, CD4:CD8 ratio, CD3 content and CD56 content of the graft was assessed using clinical flow cytometry. The values defining each group for analysis are shown in table 1. For CD4:CD8 ratio, no significant difference was seen in log-rank test of equality between the 3 groupings in regards to overall survival (chi-square 2.0761, 2 degrees of freedom, P=0.3541). No significant difference was seen for cumulative incidence of relapse, acute GVHD, DFS, and NRM. For CD4:CD8 ratio, chronic GVHD did approach significance (p=0.1117), but the number of patients that fit this criteria was quite low (n=37). For all other cell content assessments (CD4, CD8, CD3, CD56) of the graft, there was no significant findings in regards to OS, relapse, NRM, DFS, acute GVHD, and chronic GVHD. Conclusions: Graft lymphocyte content inhaplo-HCT does not significantly impact survival, relapse, or GVHD. CD4/CD8 ratio content does approach significance with chronic GVHD, but this will need further evaluation. Other variables must be sought to optimize and improvehaploidentical transplants, as they are nearly universally available donor resources. Disclosures Schroeder: Incyte Corporation: Honoraria, Research Funding.