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Standard salvage therapies include ICE (ifosfamide, carboplatin, etoposide), DHAP (dexamethasone, high-dose cytarabine, cisplatin) and Dexa-BEAM (dexam- ethasone, carmustine, etoposide, cytarabine, melphalan) fol- lowed by autologous stem cell transplant (ASCT) (Kuruvilla et al, 2011). Patients with primary refractory disease have poor prognosis with a 5-year overall survival (OS) of only 26%, compared to 46% in those with early relapse and 71% in those where relapse occurred >1 year (Pfreundschuh et al, 1994; Josting et al, 2000). Overall response rate (ORR) to ICE was 88% with 26% patients achieving complete remission (CR) (Moskowitz et al, 2001). Those patients achieving CR prior to proceeding to ASCT experienced improved OS. As such, CR prior to ASCT is considered an important determinant of outcome. Patients who undergo salvage treatment followed by ASCT had superior freedom from treatment failure (FFTF) com- pared to those treated with chemotherapy alone (Schmitz et al, 2002). Patients who experienced early relapse had infe- rior survival, with 3 year FFTF and OS of 41% and 43% respectively, compared to 75% and 93% in patients with late relapse. Early favourable outcomes of patients undergoing allo- geneic stem cell transplant (allo-SCT) are marred by mature data that consistently demonstrates lack of long-term disease control (Burroughs et al, 2008). Novel salvage options capable of producing high CR rates are needed for patients with primary refractory disease, partic- ularly regimens that can achieve CR prior to ASCT. While PD1 (also termed PCDC1) inhibitors produce impressive ORR, CR rates in HL patients remain modest (Ansell et al, 2015). Brentuximab vedotin (Bv) and bendamustine (B) both showed activity in relapsed HL patients as monotherapy (Younes et al, 2012). Their combination in heavily pretreated (median number of prior therapies: 5) patients with multiply relapsed or refractory HL and ALCL resulted in an ORR and CR rate of 67% and 19%, respectively (n = 42) (Sawas et al, 2015). In a second study in which Bv+B was used in HL patients with primary refractory disease or at first relapse reported ORR and CR rate of 93% and 73%, respectively (n = 55) (LaCasce et al, 2015). Based on these results, we have studied Bv+B in primary refractory HL patients parallel to an ongoing Phase 1–2 study, but who were not eligible for the trial. As our experi- ence of all recently and consecutively treated primary refrac- tory patients is strongly suggestive that Bv+B may represent Correspondence ª 2016 John Wiley & Sons Ltd 757 British Journal of Haematology, 2018, 180, 735–760