Single-Dose Pembrolizumab Achieving Remission in Patient with Refractory Hodgkin’s Lymphoma

Abstract

Background: Hodgkin's lymphoma (HL) is a hematopoietic tumor that is distinguished by the presence of Reed-Sternberg cells in a background of inflammatory cells. Advancements in cancer research have driven significant motions in cancer-related overall survival outcomes, which has led to higher rates of developing secondary neoplasms. Case Presentation: A 22-year-old-woman with a past medical history of non-Hodgkin's lymphoma (NHL) who presents to the hospital for respiratory manifestations and unintentional weight loss. Chest Computed Tomography (CT) scan showed left axillary lymphadenopathy; biopsy proved nodular sclerosing stage IVB HL. The patient started an anthracycline free regimen, but unfortunately, she developed an acute kidney injury, and thus, cisplatin was discontinued and switched to brentuximab therapy with hemodialysis. After the second cycle of salvage brentuximab therapy, the patient was admitted to the hospital for post obstructive pneumonia-causing acute hypoxic respiratory failure, and the decision was made to start the patient on immunotherapy with pembrolizumab. However, during administering pembrolizumab, the patient developed acute respiratory distress, and she ended up requiring emergent intubation and was admitted to the medical intensive care unit. Therefore, it was decided that pembrolizumab will not be given again. The patient later stabilized, and surprisingly, upon follow-up, the patient was found to have negative fluorodeoxyglucose (FDG) PET/CT scan, which indicates the remission of her HL. Conclusion: Recognize the critical role of the anti-programmed cell death protein-1 monoclonal antibodies in patients with chemo-resistant Hodgkin's Lymphoma (HL).