Assessment of the efficiency of Brentuximab Vedotin in patients with pulmonary Hodgkin Lymphoma by the mean of neutrophil to lymphocyte ratio

Abstract

Background: Lung involvement, an uncommon initial presentation of Hodgkin Lymphoma (HL), may appear as primary or secondary pulmonary HL. Although the combination of Brentuximab vedotin (BV) with AVD is suggested as an alternative treatment to combinations including bleomycin for patients with pulmonary involvement. The efficacy and adverse effects of BV have not been specialized on pulmonary HL. There is insufficient data about neutrophil to lymphocyte ratio (NLR) of cases treated with BV. We performed this retrospective study to evaluate the efficacy and toxicity of BV in patients with pulmonary HL and to demonstrate the prognostic role of NLR in patients treated with BV. Methods: Data of 10 CD 30 (+) HL patients who treated with BV between years 2011–2016 were analyzed retrospectively. Relapsed cases after autologous bone marrow transplantation (ABMT) and/or resistant cases to at least two lines of chemotherapy, and treated with BV were included in the study. Results: Patients underwent a median of 8.5 cycles BV. Eight patients (80%) achieved an objective response including 2 of them (20%) with complete response and six of them (60%) with a partial response at the end of the 3rd cycle. At a median follow-up of 16.8 months, median progression-free survival for all patients was 6 months and 3 patients died because of progression. BV, as a single agent, revealed well response in HL cases with pulmonary involvement and other clinical types. No pulmonary toxicity has been occurred due to BV. NLR was found to be o good indicator of prognosis and mortality in pulmonary HL patients and other HL patients. While NLR was not influenced by BV, it can be suggested as an easy prognostic marker in patients treated with BV. Conclusion: BV may be used as a bridge therapy to the next curative treatment in order to obtain minimal tumor burden in pulmonary HL patients, and NLR can be used as a prognostic marker in these patients. We believe that this study contributes the current literature in terms of being the first research on the referred issue. Keywords: Brentuximab vedotin, Hodgkin lymphoma, Pulmonary infiltration