title: PD-1 blockade induces remissions in relapsed classical Hodgkin lymphoma following allogeneic hematopoietic stem cell transplantation.
abstract: Allogeneic hematopoietic stem cell transplantation and checkpoint blockade therapy are immune-based therapies that have activity in selected refractory hematologic malignancies. Interest has developed in combining these treatments for high-risk hematologic diseases. However, there is concern that checkpoint blockade could augment graft-versus-host disease, and very few studies have evaluated the safety of checkpoint blockade in the post-allogeneic setting. Here, we report the outcomes of three patients with relapsed classical Hodgkin's lymphoma following allogeneic transplant that were treated with the anti-PD-1 antibody, nivolumab.
  
  
  
  Three patients with Hodgkin's lymphoma relapsed following allogeneic transplant received nivolumab therapy at our institution. All patients were free of graft-versus-host disease and were off of all systemic immunosuppressive medications at the time of nivolumab treatment. Nivolumab was well-tolerated in two of the patients. However, nivolumab had to be discontinued in one patient due to development of immune-related polyarthritis requiring treatment with systemic corticosteroids and methotrexate. Objective responses were observed in all three patients.
  
  
  
  Our case series demonstrates that anti-PD-1 therapy with nivolumab can be highly effective following allogeneic transplant for Hodgkin's lymphoma, but serious immune-related adverse events can occur, requiring very close monitoring and interruption of therapy.
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL USA.
authors.forename: James
authors.initials: J
authors.lastname: Godfrey
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Bishop
authors.affiliation: Department Pathology, University of Chicago, Chicago, IL USA.
authors.forename: Sahr
authors.initials: S
authors.lastname: Syed
authors.affiliation: Department Pathology, University of Chicago, Chicago, IL USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hyjek
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL USA.
authors.forename: Justin
authors.initials: J
authors.lastname: Kline
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077594:Nivolumab; D061026:Programmed Cell Death 1 Receptor / Q000037:antagonists & inhibitors*; D012008:Recurrence; D012074:Remission Induction; D014184:Transplantation, Homologous
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; C105992:PDCD1 protein, human; D061026:Programmed Cell Death 1 Receptor; D000077594:Nivolumab
keywords: Allogeneic transplant; Checkpoint blockade; Hodgkin lymphoma; PD-1