Patients with
common variable immunodeficiency (CVID) have an increased risk of developing lymphoproliferative diseases, including
non-Hodgkins lymphoma (Blood 116:1228-1234, 2010; Blood 119:1650-7, 2012). The incidence and prognosis of
Hodgkin lymphoma in this population is not clear, with only a few case reports in the literature. Conventional cytotoxic
chemotherapy, although highly efficacious in treating
Hodgkin lymphoma in immune competent patients, is problematic in patients with CVID due to the increased risk of infectious complications (Ther Umsch 69:687-91, 2012; Pediatr Hematol Oncol 24:337-42, 2012).
Rituximab and
brentuximab vedotin are both targeted agents used to treat
lymphomas that express CD20 and CD30, respectively. Compared to cytotoxic
chemotherapy typically used in
Hodgkin lymphoma, these agents are better tolerated with minimal side effects. This makes them an attractive option for treating
lymphoma in patients who have significant co-morbidities, including those with immune deficiencies. Additionally,
rituximab has been used safely to treat autoimmune
cytopenias in patients with CVID5. However, the role of these targeted
therapies in CVID-associated
Hodgkin lymphoma has not been reported.
CASE PRESENTATION: We demonstrate that
rituximab and brentuximab are likely safe and effective in CVID-associated
Hodgkin lymphoma, providing a feasible and potentially optimal treatment option for this patient population.