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International Journal of Hematology

, Volume 106, Issue 1, pp 141–145 | Cite as

Successful treatment with low-dose nivolumab in refractory Hodgkin lymphoma after allogeneic stem cell transplantation

  • Makoto Onizuka
  • Minoru Kojima
  • Keiko Matsui
  • Shinichiro Machida
  • Masako Toyosaki
  • Yasuyuki Aoyama
  • Hidetsugu Kawai
  • Jun Amaki
  • Ryujiro Hara
  • Akifumi Ichiki
  • Yoshiaki Ogawa
  • Hiroshi Kawada
  • Naoya Nakamura
  • Kiyoshi Ando
Case Report

Abstract

Previous studies have reported that an antibody that blocks programmed cell death 1 (PD-1) has therapeutic activity in patients with refractory/relapsed Hodgkin lymphoma (HL). However, the safety and efficacy of these agents in the post-allogeneic stem cell transplantation (allo-SCT) setting are not well known. Here, we describe a patient who was diagnosed as classical HL and treated with five regimens of chemotherapies with autologous SCT. Complete remission (CR) was not achieved following this initial treatment, so we performed allo-SCT from an HLA-matched sibling donor. Since his disease progressed at day 403 after allo-SCT, we decided to use nivolumab in the treatment of his refractory disease. To prevent the worsening of his chronic graft-versus-host disease (GVHD), we reduced the initial dose and frequency of nivolumab compared with the previous report. After four courses of 0.5 mg/kg of nivolumab every three weeks, FDG-PET imaging showed partial response (PR) to the treatment, a remarkable result. However, since the escalated dose of 2 mg/kg resulted in worsening of dyspnea and skin sclerosis, we initiated systemic administration of prednisolone and reduced nivolumab to 1 mg/kg. At the time of this report, his HL is in stable PR with three weekly administration of nivolumab and steroid controlled mild chronic GVHD.

Keywords

Hodgkin lymphoma Nivolumab GVHD PDL-1 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.

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Copyright information

© The Japanese Society of Hematology 2017

Authors and Affiliations

  • Makoto Onizuka
    • 1
  • Minoru Kojima
    • 1
    • 2
  • Keiko Matsui
    • 1
  • Shinichiro Machida
    • 1
  • Masako Toyosaki
    • 1
  • Yasuyuki Aoyama
    • 1
  • Hidetsugu Kawai
    • 1
  • Jun Amaki
    • 1
    • 2
  • Ryujiro Hara
    • 1
  • Akifumi Ichiki
    • 1
  • Yoshiaki Ogawa
    • 1
  • Hiroshi Kawada
    • 1
  • Naoya Nakamura
    • 3
  • Kiyoshi Ando
    • 1
  1. 1.Department of Hematology and OncologyTokai University School of MedicineIseharaJapan
  2. 2.Department of HematologyEbina General HospitalEbinaJapan
  3. 3.Department of PathologyTokai University School of MedicineIseharaJapan

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