Abstract
A 37-year-old man with refractory classical Hodgkin lymphoma (cHL) underwent PD-1 blockade therapy with nivolumab, which resulted in a partial response. However, treatment was discontinued due to immune-related adverse events (irAEs), including myasthenia gravis and myositis. Retreatment with nivolumab resulted in a complete metabolic response and hepatic irAE. Subsequently, nivolumab was administered at extended dosing intervals. Intermittent infusion of ten doses of nivolumab for a total dose of 2400 mg/body helped control the relapsed/refractory cHL over three years. During nivolumab treatment, disease progression and emergence of irAEs were associated with the proportion of CD8 + T cells expressing nivolumab-free PD-1 relative to the total number of CD8 + T cells. The findings in this nivolumab-sensitive patient highlight the clinical utility of monitoring immune cells expressing nivolumab-free PD-1 in patients with cHL who have been treated with nivolumab and have experienced irAEs.
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The data that support the findings of this study are available on request from the corresponding author.
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Acknowledgements
We would like to thank Dr. Haruna Miyazawa for the neurological examinations and Editage (www.editage.com) for English language editing.
Funding
This study was financially supported by the JSPS KAKENHI (grant number: JP19K08873).
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SK conducted the study, analyzed the data, and wrote the manuscript. YS performed flow cytometry. YT, TS, KA, TM, AYA, YO, RS, TO, and SI conducted the study and edited the manuscript.
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Under an intermittent infusion of nivolumab, disease progression and the emergence of irAEs were associated with the proportion of CD8+ T cells expressing nivolumab-free PD-1.
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Kowata, S., Seki, Y., Tsukushi, Y. et al. Association of CD8 + T cells expressing nivolumab-free PD-1 with clinical status in a patient with relapsed refractory classical Hodgkin lymphoma. Int J Hematol 118, 751–757 (2023). https://doi.org/10.1007/s12185-023-03644-5
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DOI: https://doi.org/10.1007/s12185-023-03644-5