title: Treatment with rituximab and brentuximab vedotin in a patient of common variable immune deficiency-associated classic Hodgkin lymphoma.
abstract: BACKGROUND
  Patients with common variable immunodeficiency (CVID) have an increased risk of developing lymphoproliferative diseases, including non-Hodgkins lymphoma (Blood 116:1228-1234, 2010; Blood 119:1650-7, 2012). The incidence and prognosis of Hodgkin lymphoma in this population is not clear, with only a few case reports in the literature. Conventional cytotoxic chemotherapy, although highly efficacious in treating Hodgkin lymphoma in immune competent patients, is problematic in patients with CVID due to the increased risk of infectious complications (Ther Umsch 69:687-91, 2012; Pediatr Hematol Oncol 24:337-42, 2012). Rituximab and brentuximab vedotin are both targeted agents used to treat lymphomas that express CD20 and CD30, respectively. Compared to cytotoxic chemotherapy typically used in Hodgkin lymphoma, these agents are better tolerated with minimal side effects. This makes them an attractive option for treating lymphoma in patients who have significant co-morbidities, including those with immune deficiencies. Additionally, rituximab has been used safely to treat autoimmune cytopenias in patients with CVID5. However, the role of these targeted therapies in CVID-associated Hodgkin lymphoma has not been reported.
  
  
  METHODS
  Here we report the case of a 25 year old female diagnosed with CVID-associated classic Hodgkin lymphoma, who achieved a complete remission following treatment with rituximab followed by brentuximab vedotin.
  
  
  CONCLUSIONS
  We demonstrate that rituximab and brentuximab are likely safe and effective in CVID-associated Hodgkin lymphoma, providing a feasible and potentially optimal treatment option for this patient population.
authors.affiliation: Department of Allergy and Immunology, Stanford University, School of Medicine, Stanford, CA 94305 USA.
authors.forename: Efren
authors.initials: E
authors.lastname: Rael
authors.affiliation: Penn State Hershey Cancer Institute, Penn State University College of Medicine, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Rakszawski
authors.affiliation: Penn State Hershey Cancer Institute, Penn State University College of Medicine, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA.
authors.forename: Kristian
authors.initials: K
authors.lastname: Koller
authors.affiliation: Department of Pathology, Penn State Hershey Medical Center, Penn State University College of Medicine, Hershey, PA 17033 USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Bayerl
authors.affiliation: Department of Allergy and Immunology, Stanford University, School of Medicine, Stanford, CA 94305 USA.
authors.forename: Manish
authors.initials: M
authors.lastname: Butte
authors.affiliation: Penn State Hershey Cancer Institute, Penn State University College of Medicine, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Zheng
keywords: Brentuximab; CVID; Hodgkin lymphoma; Rituximab