Nivolumab for Methotrexate-associated Classic Hodgkin's Lymphoma in a Rheumatoid Arthritis Patient

Intern Med. 2020 Mar 15;59(6):829-833. doi: 10.2169/internalmedicine.3772-19. Epub 2019 Nov 22.

Abstract

Nivolumab exerts therapeutic activity in patients with classic Hodgkin's lymphoma (CHL) but may cause several types of immune-related adverse events. Some rheumatoid arthritis (RA) patients develop CHL during methotrexate therapy (MTX-CHL); however, the efficacy and safety of nivolumab for these patients remain unclear. A 68-year-old woman was diagnosed with CHL after six years of MTX therapy for RA. The disease did not respond to any type of chemotherapy. Nivolumab was then initiated, and the patient was successfully treated without the reactivation of RA. The reactivation of RA always needs to be considered with the administration of nivolumab.

Keywords: classic Hodgkin's lymphoma; methotrexate; nivolumab; rheumatoid arthritis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Antirheumatic Agents / adverse effects*
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / drug therapy
  • Female
  • Hodgkin Disease / chemically induced*
  • Hodgkin Disease / drug therapy*
  • Humans
  • Methotrexate / adverse effects*
  • Methotrexate / therapeutic use
  • Nivolumab / therapeutic use*

Substances

  • Antineoplastic Agents, Immunological
  • Antirheumatic Agents
  • Nivolumab
  • Methotrexate