Own experience in the treatment of primary refractory Hodgkin's lymphoma. Case report

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Abstract

Despite significant progress made in recent decades in the treatment of classical Hodgkin's lymphoma, in 10–30% of patients develop a refractory course or relapse of the disease. The effectiveness of therapy of the second and subsequent lines is about 50%. A significant breakthrough in the treatment of recurrent/refractory forms of classical Hodgkin's lymphoma has been the introduction of targeted drugs. The inclusion of new drugs in previously standard rescue therapy regimens significantly improves the effectiveness of the therapy. A clinical case of treating a patient with the progression of classical Hodgkin's lymphoma after first-line therapy, the use of brentuximab vedotin in combination with bendamustine as a rescue therapy with the achievement of complete remission, followed by high-dose consolidation with autologous hematopoietic stem cell transplantation is presented.

About the authors

Elizaveta E. Gushchina

Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre

Author for correspondence.
Email: vdht.mnioi@yandex.ru
ORCID iD: 0000-0002-5625-3635

hematologist

Russian Federation, Moscow

Maria A. Vernyuk

Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre

Email: vdht.mnioi@yandex.ru
ORCID iD: 0000-0003-1497-2436

Cand. Sci. (Med.)

Russian Federation, Moscow

Alevtina M. Chervontseva

Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre

Email: vdht.mnioi@yandex.ru
ORCID iD: 0000-0002-8498-6289

Cand. Sci. (Med.)

Russian Federation, Moscow

Irina V. Cherkashina

Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre

Email: vdht.mnioi@yandex.ru
ORCID iD: 0000-0001-7096-4700

hematologist

Russian Federation, Moscow

Liliya S. Khayrullina

Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre

Email: vdht.mnioi@yandex.ru
ORCID iD: 0000-0001-8520-0711

hematologist

Russian Federation, Moscow

Vladimir V. Lunin

Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre

Email: vdht.mnioi@yandex.ru
ORCID iD: 0000-0001-8689-1227

hematologist, transfusiologist

Russian Federation, Moscow

Alexander A. Fedenko

Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre

Email: vdht.mnioi@yandex.ru
ORCID iD: 0000-0003-4927-5585

D. Sci. (Med.)

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. PET-CT in the debut of the disease (the right supraclavicular, multiple intrathoracic, retroperitoneal, iliac, inguinal lymph nodes metastasis; lesions in the spleen, in the proximal diaphysis of the humerus, in the left lateral mass of the sacrum, in the right iliac wing, in the left inferior pubic ramus and in the femoral necks).

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3. Fig. 2. PET-CT after induction chemotherapy (residual paratracheal lymph nodes).

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4. Fig. 3. PET-CT results showing disease progression (the left cervical, a single intrathoracic, a single retroperitoneal lymph nodes metastasis, multiple lesions in the lungs and spleen, in the right scapula, in the vertebrae (ThIV, ThX–ThXII, LII, LIII, LV), in the right VI and VIII ribs, in the pelvic bones, in the proximal diaphysis of the left femur).

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5. Fig. 4. CT scan of the chest (focal-infiltrative changes in the middle and lower lobes of both lungs, the pleural fluid in the pleural cavities).

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