Complete remission with Brentuximab Vedotin and Nivolumab in a patient with Hodgkin lymphoma refractory to chemotherapy and radiotherapy. A case report

Background: Classical Hodgkin lymphoma (cHL) is a highly curable malignancy in most patients when treated with standard anthracycline-based chemotherapy regimens. However, a significant proportion of individuals experience relapse or demonstrate primary refractory disease. Salvage therapy in these scenarios often includes autologous stem cell transplantation, though not all patients are eligible. The combination of brentuximab vedotin (BV) and nivolumab (Nivo), targeting CD30 and the PD-1 immune checkpoint respectively, has shown considerable promise in heavily pretreated cases.

We report the case of a 47-year-old male with stage IIIB cHL, nodular sclerosis subtype, who failed to achieve complete remission with ABVD followed by radiotherapy. Disease progression with extranodal pulmonary involvement prompted the initiation of BV-Nivo combination therapy. Sixteen cycles were administered without major toxicity, resulting in complete metabolic response. Hematologic parameters remained within acceptable ranges throughout treatment. This case highlights the therapeutic potential of immunotherapy in refractory Hodgkin lymphoma, particularly in patients unfit for further radiotherapy or transplant.

Keywords: Hodgkin lymphoma, brentuximab vedotin, nivolumab, immunotherapy, refractory lymphoma, case report