A Case of Methotrexate-associated Hodgkin Lymphoma in a Patient with Rheumatoid Arthritis Successfully Treated with Brentuximab Vedotin in Combination with Doxorubicin, Vinblastine, and Dacarbazine (BV+AVD)

Yasunobu Sekiguchi; Hiroko Iizuka; Haruko Takizawa; Keiji Sugimoto; Sakura Sakajiri; Tadaaki Inano; Yasutaka Fukuda; Syuichi Shirane; Yasuharu Hamano; Shigeki Tomita; Hiroshi Izumi; Mitsuo Okubo; Noriko Nakamura; Tomohiro Sawada; Naoya Sekiguchi; Masaaki Noguchi

doi:10.2169/internalmedicine.4417-20

This article has now been updated. Please use the final version.

A Case of Methotrexate-associated Hodgkin Lymphoma in a Patient with Rheumatoid Arthritis Successfully Treated with Brentuximab Vedotin in Combination with Doxorubicin, Vinblastine, and Dacarbazine (BV+AVD)

Yasunobu Sekiguchi, Hiroko Iizuka, Haruko Takizawa, Keiji Sugimoto, Sakura Sakajiri, Tadaaki Inano, Yasutaka Fukuda, Syuichi Shirane, Yasuharu Hamano, Shigeki Tomita, Hiroshi Izumi, Mitsuo Okubo, Noriko Nakamura, Tomohiro Sawada, Naoya Sekiguchi, Masaaki Noguchi

Author information

Yasunobu Sekiguchi
Department of Hematology, Juntendo University Urayasu Hospital, Japan
Hiroko Iizuka
Department of Hematology, Juntendo University Urayasu Hospital, Japan
Haruko Takizawa
Department of Hematology, Juntendo University Urayasu Hospital, Japan
Keiji Sugimoto
Department of Hematology, Juntendo University Urayasu Hospital, Japan
Sakura Sakajiri
Department of Hematology, Juntendo University Urayasu Hospital, Japan
Tadaaki Inano
Department of Hematology, Juntendo University Hospital, Japan
Yasutaka Fukuda
Department of Hematology, Juntendo University Hospital, Japan
Syuichi Shirane
Department of Hematology, Juntendo University Hospital, Japan
Yasuharu Hamano
Department of Hematology, Juntendo University Hospital, Japan
Shigeki Tomita
Department of Pathology, Juntendo University Urayasu Hospital, Japan
Hiroshi Izumi
Department of Pathology, Juntendo University Urayasu Hospital, Japan
Mitsuo Okubo
Department of Transfusion Medicine, Juntendo University Urayasu Hospital, Japan
Noriko Nakamura
Department of Clinical Laboratory, Juntendo University Urayasu Hospital, Japan
Tomohiro Sawada
Department of Clinical Laboratory, Juntendo University Urayasu Hospital, Japan
Naoya Sekiguchi
Urayasu Sekiguchi Clinic, Japan
Masaaki Noguchi
Department of Hematology, Juntendo University Urayasu Hospital, Japan

Keywords: Rheumatoid arthritis (RA), Methotrexate (MTX), Other iatrogenic immunodeficiency associated lymphoproliferative disorders (OIIA-LPDs), Hodgkin lymphoma (HL), BV+AVD (brentuximab vedotin, doxorubicin, vinblastine, dacarbazine)

JOURNAL OPEN ACCESS Advance online publication

Article ID: 4417-20

DOI https://doi.org/10.2169/internalmedicine.4417-20

The final version of this article is now available: Vol. 59 (2020), No. 17 pp. 2165-2171

Details

Abstract

A 53-year-old woman had been diagnosed with rheumatoid arthritis (RA) in X-6. She was started on methotrexate (MTX) in X-1. She developed a cough, and chest computed tomography showed abnormalities. In X, MTX was discontinued, but the cough persisted. A lung biopsy revealed a diagnosis of nodular sclerosis classic Hodgkin lymphoma (CHL-NS). She was considered to have "other iatrogenic immunodeficiency-associated lymphoproliferative disorders" (OIIA-LPD), MTX-associated Hodgkin lymphoma (MTX-HL). She received six courses of brentuximab vedotin (BV) in addition to AVD (BV+AVD). A complete metabolic response was obtained, and the RA went into remission. This is the fourth reported case of BV+AVD for MTX-HL.

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