Brentuximab-vedotin/gemcitabine/vinorelbine
- PDF / 171,108 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 10 Downloads / 169 Views
1 S
Neutropenia, neutropenic fever and systemic allergic reaction: 2 case reports In a retrospective case series, a 39-year-old man developed neutropenia and neutropenic fever during treatment with brentuximab vedotin for severe liver dysfunction, and a 70-year-old man developed systemic allergic reaction during treatment with gemcitabine and vinorelbine for classical Hodgkin’s lymphoma (cHL) [not all duration of treatments to reaction onsets and outcomes stated]. Case 1: A 39-year-old man was diagnosed with stage IVB mixed cellularity cHL with bone marrow involvement in April 2013. He was treated with ABVD regimen comprising doxorubicin [Adriamycin], bleomycin, vinblastine and dacarbazine with complete remission. Seven months later, his lymphadenopathy progressed that responded to IGEV regimen comprising ifosfamide, gemcitabine, vinorelbine and unspecified steroids, followed by autologous stem cell transplantation (ASCT). He developed jaundice, fever, anaemia and thrombocytopenia four months later (seven months following the ASCT), suggestive of infiltration by HL. Further findings indicated severe liver dysfunction, and he was treated with brentuximab vedotin 1.2 mg/kg [route not stated] with dexamethasone. He developed grade 4 neutropenia and neutropenic fever secondary to brentuximab vedotin, which was treated with unspecified antibiotics and unspecified granulocyte colony stimulating factor. He was administered a second course of brentuximab vedotin at a complete dose of 1.8 mg/kg, followed by a third cycle three weeks later. Subsequently, his bilirubin level and platelet count normalised. After the fourth cycle of brentuximab vedotin, high metabolic activity in multiple lymph nodes above and below the diaphragm and bone marrow foci was noted. His brentuximab vedotin therapy was continued for one additional cycle as the liver lesions resolved. After the fifth cycle, he experienced a disease progression. Hence, brentuximab vedotin was stopped. Case 2: A 70-year-old man, who had been diagnosed with stage IIIA cHL in 1995, had been treated with one cycle of MOPP/ABV hybrid regimen comprising mechlorethamine, vincristine, procarbazine, prednisone, doxorubicin and bleomycin. However, he developed systemic allergic reaction to procarbazine at that time, and his chemotherapy was switched to ABVD regimen comprising doxorubicin [Adriamycin], bleomycin, vinblastine and dacarbazine with complete remission. Twenty years later (at the age of 70 years; current presentation), he was hospitalised due to cHL relapse (stage IVA mixed cellularity cHL) in June 2016. He received one cycle of gemcitabine and vinorelbine [dosages and routes not stated]. However, he developed a severe systemic allergic reaction to gemcitabine and vinorelbine. His gemcitabine and vinorelbine treatment was stopped for the next two months. Two months later, he developed severe liver impairment with jaundice and deteriorating consciousness level. He was treated with brentuximab vedotin, and an improvement was noted leading to discharge. Prior to the sev
Data Loading...