Long-term Remission by Brentuximab Vedotin for Non-mediastinal Gray Zone Lymphoma Refractory to Autologous Stem Cell Transplantation.

Abstract

Abstract Treatment for B-cell lymphoma unclassifiable with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma, especially in relapsed or refractory case, is not established. A 35-year-old Japanese woman with this type of lymphoma relapsed after ABVD chemotherapy received salvage chemotherapies. Even after hidh-dose chemotherapy followed by autologous stem cell transplantation, only partial response could be achieved. Consolidative involved-field radiation therapy did not induce complete response and four months later a new lesion appeared at the skin inside the irradiated field. Based on the strong expression of CD30, brentuximab vedotin was administered and complete response was attained. Although brentuximab vedotin was discontinued after 9 cycles due to peripheral neuropathy, the response has been maintained for three years without subsequent allogeneic transplantation. There has been no report that patient with the lymphoma who were successfully managed only with brentuximab vedotin after progression following autologous SCT. Our case suggested not only that it might be a potential therapeutic agent for bridging therapy before allogenic transplantation, but also that it could confer long-term remission without it to some proportion of patients.