case_images: PMC10950903_01
case_images: Summary of the antitumor treatments received by the patient since diagnosis in March 2017. ABVD, Adriamycin, bleomycin, vinblastine, dacarbazine; ICE, ifosfamide, carboplatin, etoposide; BV, Brentuximab-Vedotin; Benda, bendamustine; Auto-HSCT, autologous hematopoietic stem cell transplantation; BEAM, carmustine, etoposide, cytarabine, melphalan; Gem, Gemcitabine; Allo-HSCT, allogeneic hematopoietic stem cell transplantation; MUD, matched unrelated donor; Flu Cy Mel, fludarabine, cyclophosphamide, melphalan; DLI, Donor lymphocyte infusion; GVD, gemcitabine, vinorelbine, liposomal doxorubicine; RTx, radiotherapy; Ibru, ibrutinib; Haplo-HSCT, haploidentical hematopoietic stem cell transplantation, RIC, reduced intensity conditioning; TFT, thiotepa fludarabine treosulfan; Pembro, pembrolizumab.
case_images: fimmu-15-1360275-g001.jpg
case_images: PMC10950903_01_fimmu-15-1360275-g001.jpg
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case_images: An autologous stem cell transplant was performed in July 2018 after high-dose BEAM (carmustine, etoposide, cytarabine, and melphalan) conditioning ( Figure 1  summarizes the antitumor treatments received). A sequential conditioning regimen (clofarabine, cyclophosphamide, fludarabine, and melphalan) was administered and peripheral blood stem cells from a matched unrelated donor (MUD) were infused in August 2019 ( Figure 1 ). The patient underwent haploidentical HSCT with peripheral blood stem cells from his father in December 2020, after a reduced intensity conditioning with thiotepa, fludarabine, and treosulfan ( Figure 1 ).
case_images: 18F-fluorodeoxy-glucose-positron-emission tomography (FDG-PET)-CT images before and after therapy with BV-pembrolizumab. (A) Progression of nodal and bone lesions 11 months after haplo-HSCT and three doses of DLI; (B) PET-CT performed after two cycles of BV 1.8 mg/kg in combination with pembrolizumab 100 mg every 3 weeks showing CR of HL as per Figure 1.
case_images: fimmu-15-1360275-g002.jpg
case_images: PMC10950903_01_fimmu-15-1360275-g002.jpg
case_images: f2
case_images: A third dose of DLI was given (107/kg) and ibrutinib continued for 1 additional month and then stopped due to documentation of further nodal and bone progression on PET/CT ( Figure 2A ). A PET/CT scheduled the same day showed morpho-metabolic regression of the nodal and bone lesions revealing a CR (Deauville score of two) of HL ( Figure 2B ).