Hodgkin Lymphoma as a Secondary Neoplasm During Therapy for Chronic Myeloid Leukaemia: Case Report and Review of the Literature

Abstract

Introduction Incidences of chronic myeloid leukaemia (CML) after treatment of Hodgkin lymphoma (HL) are well described. Here, we report a case of secondary HL in a patient with CML treated with dasatinib as a third-line treatment. Patient Information A 64-year-old male was diagnosed with CML and initially treated with imatinib and then with nilotinib due to resistance. Finally, the patient experienced cardiovascular complications, and dasatinib was introduced. After 19 months of treatment, the patient experienced enlargement of lymph nodes that formed packs on the neck. Interventions Based on histopathological examination of the lymph nodes, a diagnosis of classical Hodgkin lymphoma – mixed cellularity was established. The patient was successfully treated with 4 cycles of AVD (adriamycin, vinblastine, dacarbazine) chemotherapy. Outcomes Complete metabolic remission of Hodgkin lymphoma is currently sustained, and the molecular response to dasatinib at a reduced dose of 50 mg daily corresponds with a deep molecular response. Conclusion In this report, we demonstrate the efficacy and safety of the combination of dasatinib and AVD regimens in coexisting CML and HL. This case report emphasizes the importance of insightful evaluation and differential diagnosis in cases of lymphadenopathy during CML treatment.

A case report of primary cutaneous diffuse large B-cell lymphoma in chronic myeloid leukemia after treatment with dasatinib

“…Table I summarizes the detailed clinical course of lymphomas reported in the literature to date that occurred during or after TKI treatment in patients with CML 5 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ; All cases are B-cell lineage lymphoma, and imatinib was the most commonly administered drug. Miranda et al also found an increased standardized incidence ratio of non-Hodgkin lymphomas after imatinib treatment in a long-term observational study of patients with CML.…”

Atypical presentation of patients with chronic myeloid leukemia in chronic phase—Case report

“…In addition, the secondary neoplasia of a T-cell non-Hodgkin’s lymphoma (T-NHL) obscured the diagnosis, leading to the assumption of initial treatment failure. Although concurrent neoplasias are described in CML patients ( 22 – 25 ), they are still a diagnostic as well as therapeutic challenge. In our case, the atypical phenotype led to the assumption of CML infiltration of the skin, whereas autopsy revealed the diagnosis of a CD2-negative T-NHL.…”