Background: No consensus has been reached yet concerning treatment strategies for a sequential classic Hodgkin lymphoma (CHL) following gray zone lymphoma (GZL). Prognosis of GZL after a failed autologous hematopoietic stem-cell transplantation (auto-HCT) is poor and treatment strategy is very limited. As yet there are limited data showing clinical outcomes of brentuximab vedotin (BV) for GZL, especially for sequential CHL after GZL.
Case presentation: We report a case of CHL following primary refractory GZL after a failed auto-HCT and showed favorable response to first-line CHL-directed chemoradiotherapy consisting of BV plus doxorubicin, vinblastine, and dacarbazin (AVD) followed by irradiation. The sequential cases with an early evolution, whose diagnosis of second lymphoma was made within a year, have been recently reported very poor survival shorter than a year. Whether a sequential CHL following GZL should be treated as a primary or relapsed disease has not been clearly elucidated. Our patient showed favorable response to first-line CHL-directed chemoradiotherapy without allogenic hematopoietic stem-cell transplantation and has in continuous remission for 2 years.
Conclusions: The management of our case could help for physicians to make better treatment decisions and provide insights for further exploration in future studies.
Keywords: BV+AVD, brentuximab vedotin doxorubicin, vinblastine, and dacarbazin; CHL, classic Hodgkin lymphoma; FDG PET/CT, 18F-fluorodeoxyglucose positron emission tomography-computed tomography; GZL, Gray zone lymphoma; Gray zone lymphoma; R-CHOP, rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone; brentuximab vedotin; involved-node radiotherapy; sequential relapse.