Department of Allergy and Immunology, Stanford University, School of Medicine, Stanford, CA 94305 USA.
Penn State Hershey Cancer Institute, Penn State University College of Medicine, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA.
Biomark Res. 2016 Mar 9;4:7. doi: 10.1186/s40364-016-0061-8. eCollection 2016.
Patients with common variable immunodeficiency (CVID) have an increased risk of developing lymphoproliferative diseases, including non-Hodgkins lymphoma (Blood 116:1228-1234, 2010; Blood 119:1650-7, 2012). The incidence and prognosis of Hodgkin lymphoma in this population is not clear, with only a few case reports in the literature. Conventional cytotoxic chemotherapy, although highly efficacious in treating Hodgkin lymphoma in immune competent patients, is problematic in patients with CVID due to the increased risk of infectious complications (Ther Umsch 69:687-91, 2012; Pediatr Hematol Oncol 24:337-42, 2012). Rituximab and brentuximab vedotin are both targeted agents used to treat lymphomas that express CD20 and CD30, respectively. Compared to cytotoxic chemotherapy typically used in Hodgkin lymphoma, these agents are better tolerated with minimal side effects. This makes them an attractive option for treating lymphoma in patients who have significant co-morbidities, including those with immune deficiencies. Additionally, rituximab has been used safely to treat autoimmune cytopenias in patients with CVID5. However, the role of these targeted therapies in CVID-associated Hodgkin lymphoma has not been reported.
Here we report the case of a 25 year old female diagnosed with CVID-associated classic Hodgkin lymphoma, who achieved a complete remission following treatment with rituximab followed by brentuximab vedotin.
We demonstrate that rituximab and brentuximab are likely safe and effective in CVID-associated Hodgkin lymphoma, providing a feasible and potentially optimal treatment option for this patient population.
患有普通变异性免疫缺陷（CVID）的患者发生淋巴增殖性疾病（包括非霍奇金淋巴瘤）的风险增加（Blood 116:1228-1234, 2010; Blood 119:1650-7, 2012）。该人群中霍奇金淋巴瘤的发病率和预后尚不清楚，文献中仅有少数病例报告。虽然传统细胞毒性化疗在免疫功能正常的患者中治疗霍奇金淋巴瘤非常有效，但由于感染并发症的风险增加，在 CVID 患者中存在问题（Ther Umsch 69:687-91, 2012; Pediatr Hematol Oncol 24:337-42, 2012）。利妥昔单抗和 Brentuximab vedotin 均为靶向药物，分别用于治疗表达 CD20 和 CD30 的淋巴瘤。与霍奇金淋巴瘤中通常使用的细胞毒性化疗相比，这些药物具有更好的耐受性和最小的副作用。这使得它们成为治疗患有严重合并症（包括免疫缺陷）的淋巴瘤患者的一种有吸引力的选择。此外，利妥昔单抗已安全用于治疗 CVID 患者的自身免疫性血细胞减少症 5。然而，这些靶向治疗在 CVID 相关霍奇金淋巴瘤中的作用尚未报道。
在此，我们报告了一例 25 岁女性患者，诊断为 CVID 相关经典霍奇金淋巴瘤，在接受利妥昔单抗治疗后序贯 Brentuximab vedotin 治疗后达到完全缓解。
我们证明利妥昔单抗和 Brentuximab 可能在 CVID 相关霍奇金淋巴瘤中安全有效，为该患者人群提供了一种可行且潜在的最佳治疗选择。
