Treatment with chemotherapy plus brentuximab vedotin in anaplastic large cell lymphoma and pregnancy: A case report

Abstract

Introduction: Brentuximab vedotin (BV) is a CD-30 directed antibody and microtubule inhibitor conjugate indicated for the treatment of multiple types of lymphoma, including anaplastic large cell lymphoma (ALCL). Consensus-based guidelines recommend BV with cyclophosphamide, doxorubicin, and prednisone (CHP) as first-line treatment in a patient with ALCL. Alternative treatment options for ALCL can be limited due to patient-specific factors. Lymphomas account for approximately 11% of cancers in pregnancy. Brentuximab vedotin has not been studied in pregnancy; therefore, making the use of an antibody drug conjugate in this patient the first documented use in pregnancy. Case Report: A 26-year-old female was diagnosed with anaplastic large cell lymphoma at 14 weeks gestation. The patient has a past medical history of ALCL in 2004 at eight years old and a prior miscarriage. Consensus-based guidelines recommend BV with cyclophosphamide, doxorubicin, and prednisone (CHP) as first-line treatment in a patient with ALCL. Treatment with BV plus CHP was initiated at 15 weeks gestation for a total of 6 cycles during the antepartum period. At 33 weeks gestation, the patient delivered a 4-pound infant male without complications, birth defects, or health disparities. Two additional cycles of BV and CHP were administered during the postpartum period. Complete remission has been achieved in this patient. Conclusion: The outcomes in this case indicate the potential safety of BV in patients after the first trimester of pregnancy.