Brentuximab Vedotin and Bendamustine Protocol in Hodgkin Lymphoma: Report of Two Cases in Abidjan, Côte d'Ivoire

Abstract

Background: Hodgkin lymphoma is the first hematology malignancy to be cured. The Management of mediastinal or pulmonary location, whether inaugural or secondary, is restricted with conventional chemotherapy which contains cardio- or pneumotoxic molecules. The new Advanced therapeutic strategies including targeted therapy Can improve prognosis. Those molecules remain expensive for many patients without social security protection. We reported the contribution of the Brentuximab Vedotin associated with Bendamustine (Bv-B) protocol for two patients with refractory Hodgkin lymphoma pulmonary location. Observation: The first patient is 40years lady who presented lymphadenopathy associated with symptoms such fever and loss of weight the evolution was marked by the pulmonary symptoms cought chest pains the CT scan (TAP): revealed a bilateral mediastino-hilar ganglio-tumoral complex, presence of multiple thoraco-abdomino-pelvic lymphadenopathies; pleuro-pulmonary involvement the patient received two lines of treatment AVD adriblastin velbe Dacarbazine. EACOPP (Etoposide, Doxorubicin, Endoxan (Cyclophosphamide), Oncovin (Vincristine), Procarbazine, Prednisone) without any response the 3rd line treatment was initiated with good remission. The second case was 22 years young adult patients with progressive weight loss associated with evening fever, The appearance a few months later (March 2022) of laterocervical lymphadenopathies of large size (5 cm in greatest diameter on the right and 3 cm on the left) a biopsy was performed with anatomopathological examination revealing the presence of large malignant cells (Reed-Sternberg). classified as Ann Arbor Stage IVBb with unfavorable prognosis according to Hasenclever. The therapeutic protocol adopted was 4 AVD (Doxorubicin, Vincristine and Dacarbazine) without Bleomycin followed by escalation with 2 EACOPP (Etoposide, Doxorubicin, Cyclophosphamide, Vincristine, Procarbazine).unfornately no good response observed the second line of the treatment  was made with DHAP also without good response .the 3rd line a Bv-Benda-Pembro protocol (Brentuximab + Bendamustine + Pembrolizumab) was decided due to appearance of the lymphoadenopathy and administrated the patient died after Conclusion: The Bv-B combination demonstrates its efficacy with good tolerance in patients with relapsed hodgkin lymphoma.