Complications of Brentuximab Therapy in Patients with Hodgkin’s Lymphoma and Concurrent Autoimmune Pathology—A Case Series

Author:

Preda Oana Diana12,Bădeliță Sorina1ORCID,Ursuleac Iulia12,Irimia Ruxandra Maria12,Balanica Sonia12,Cojocaru Monica12,Cotruta Cristina1,Dobrea Camelia12,Coriu Daniel12

Affiliation:

1. University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania

2. Fundeni Clinical Institute, 022328 Bucharest, Romania

Abstract

Background: Brentuximab Vedotin (BV) has revolutionized the treatment landscape for Hodgkin’s lymphoma, yet its effects on pre-existing autoimmune disorders remain elusive. Methods: Here, we present four cases of patients with concurrent autoimmune conditions—Crohn’s disease, vitiligo, type I diabetes, and minimal change disease—undergoing BV therapy for Hodgkin’s lymphoma. The patients were treated with A-AVD instead of ABVD due to advanced-stage disease with high IPI scores. Results: Our findings reveal the surprising and complex interplay between BV exposure and autoimmune manifestations, highlighting the need for multidisciplinary collaboration in patient management. Notably, the exacerbation of autoimmune symptoms was observed in the first three cases where T-cell-mediated autoimmunity predominated. Additionally, BV exposure precipitated autoimmune thrombocytopenia in the vitiligo patient, underscoring the profound disruptions in immune regulation. Conversely, in the minimal change disease case, a disease characterized by a blend of B- and T-cell-mediated immunity, the outcome was favorable. Conclusions: This paper underscores the critical importance of vigilance toward autoimmune flare-ups induced by BV in patients with concurrent autoimmune conditions, offering insights for tailored patient care.

Publisher

MDPI AG

Reference26 articles.

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3. The ECHELON-2 Trial: 5-year results of a randomized, phase III study of brentuximab vedotin with chemotherapy for CD30-positive peripheral T-cell lymphoma;Horwitz;Ann. Oncol.,2022

4. History of autoimmune conditions and lymphoma prognosis;Kleinstern;Blood Cancer J.,2018

5. Minimal Change Disease: More Than a Podocytopathy?;Maas;Kidney Int Rep.,2022

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