Successful treatment with brentuximab vedotine for a patient with very late relapse of limited stage classic Hodgkin lymphoma

Nukui, Jun; Takahashi, Hiroyuki; Tokunaga, Mayumi; Suzuki, Taisei; Suzuki, Masaki; Yokose, Tomoyuki; Nakamura, Naoya; Sakai, Rika; Nakajima, Hitoshi

doi:10.1007/s13691-021-00510-1

Cited by 2 publications

(1 citation statement)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinical trials of immune-mediated therapy for Hodgkin's lymphoma have shown high efficacy, mostly in relapse/refractory settings [15]. Anti-CD30 (Brentuximab) and immune checkpoint inhibitors (Pembrolizumab, PD-1 inhibitor) showed effective responses before and after autologous stem cell transplantation (ASCT), respectively [15,16]. The recent use of brentuximab, which causes lymphopenia and compromises the CD4 T-cell-mediated immune system, resulted in severe disease, including pneumonia and acute respiratory syndrome related to the COVID-19 infection.…”

Section: Introductionmentioning

confidence: 99%

Recurrent COVID-19 Infection in a Refractory/Classical Hodgkin's Lymphoma Patient Undergoing Autologous Stem Cell Transplantation: A Case Report

Hamed,

Alamoudi

2023

Cureus

View full text Add to dashboard Cite

Patients with challenging hematological malignancies like classic Hodgkin lymphoma (cHL) can be further complicated when affected by a concurrent coronavirus disease-2019 (COVID-19) infection and often face unique and complex management and outcomes. In this case report, we describe a refractory or relapsed classic Hodgkin lymphoma patient with a recurrent infection of COVID-19 three times preceding chemotherapy. A 52-year-old female presented to our hospital with a second incidence of COVID-19 and a complaint of fever, anorexia, night sweats, and abdominal lymphadenopathy, for which she was diagnosed with mixed cellularity classic Hodgkin lymphoma. Three weeks later, in consideration of her manifestation of lung disease, which was due to her past medical history of airway hypersensitivity and abnormal pulmonary function test along with testing positive for COVID-19, she was started with the first-line chemotherapy of the brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine chemotherapy regimen, commonly referred to as Bv-AVD, without bleomycin. After six cycles of chemotherapy, at the end of treatment, positron emission tomography/computed tomography (PET/CT) revealed the progression of nodes in the abdomen and the development of new lymphadenopathy in the chest and right supraclavicular region. Hence, it was considered refractory Hodgkin's lymphoma, and the patient was referred for salvage therapy. She was started on salvage chemotherapy with brentuximab/bendamustine (BvB). Follow-up evaluations after two cycles of BvB continued to show newer lesions in the right sub-diaphragmatic area, internal mammary, and supraclavicular lymph nodes. Therefore, the patient was switched to pembrolizumab immunotherapy, a PD-1 inhibitor. After four cycles of pembrolizumab monotherapy, PET/CT showed significant improvement with a complete molecular response (CMR). Then, she was admitted for high-dose therapy/autologous stem cell transplantation (HDT/ASCT) after collecting stem cells. PET/CT: three months post-ASCT, she continued to be in a CMR with a Deauville score of 1. The patient was continued on pembrolizumab maintenance for six months afterward. Currently, the patient is healthy and doing well. COVID-19 patients with hematological malignancies may experience compromised viral elimination and a prolonged period of viral infection, which may also worsen the symptoms and outcomes and entitle them to comprehensive and extended care.

show abstract

Section: Introductionmentioning

confidence: 99%