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Durable Response to Brentuximab Vedotin-Based Chemotherapy in Refractory Hodgkin Lymphoma with Central Nervous System (CNS) Involvement

Unusual or unexpected effect of treatment, Rare disease

Heidi Mocikov√°, Hana Malikova, Michal Holesta, Abdulfattah Elturki, Vit Campr, Tomas Kozak

Department of Internal Medicine and Hematology, Faculty Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University in Prague, Prague, Czech Republic

Am J Case Rep 2020; 21:e921657

DOI: 10.12659/AJCR.921657

Available online: 2020-01-29

Published: 2020-03-14

BACKGROUND: CNS involvement in Hodgkin lymphoma is rare. Despite various treatment options, median overall survival is only 13 months after diagnosis of CNS involvement in relapsed/refractory HL.
CASE REPORT: A 29-year-old woman with classical HL (mixed cellularity) in clinical stage IIB was treated with multilineage chemotherapy and radiotherapy without achieving a sustained complete remission. Systemic and CNS progression of HL occurred at the age of 32 years and the patient received 2 cycles of brentuximab vedotin with bendamustine alternating with 2 cycles of high-dose methotrexate-based treatment and achieved partial remission. She then underwent autologous stem cell transplantation followed by brentuximab vedotin consolidation. The disease progressed and the patient died 6 months after the last dose of brentuximab vedotin.
CONCLUSIONS: We demonstrated a durable response to brentuximab vedotin-based chemotherapy in a patient with refractory Hodgkin lymphoma with CNS involvement. Prognosis of these patients is poor and new treatment options are needed.

Keywords: Antineoplastic Agents, Central Nervous System, Hodgkin Disease