Abstract
Background: Hodgkin's lymphoma (HL) is a hematopoietic tumor that is distinguished by the presence of
Reed-Sternberg cells in a background of inflammatory cells. Advancements in cancer research have driven
significant motions in cancer-related overall survival outcomes, which has led to higher rates of developing
secondary neoplasms.
Case Presentation: A 22-year-old-woman with a past medical history of non-Hodgkin's lymphoma (NHL)
who presents to the hospital for respiratory manifestations and unintentional weight loss. Chest Computed
Tomography (CT) scan showed left axillary lymphadenopathy; biopsy proved nodular sclerosing stage IVB
HL. The patient started an anthracycline free regimen, but unfortunately, she developed an acute kidney
injury, and thus, cisplatin was discontinued and switched to brentuximab therapy with hemodialysis. After
the second cycle of salvage brentuximab therapy, the patient was admitted to the hospital for post obstructive
pneumonia-causing acute hypoxic respiratory failure, and the decision was made to start the patient on
immunotherapy with pembrolizumab. However, during administering pembrolizumab, the patient
developed acute respiratory distress, and she ended up requiring emergent intubation and was admitted to
the medical intensive care unit. Therefore, it was decided that pembrolizumab will not be given again. The
patient later stabilized, and surprisingly, upon follow-up, the patient was found to have negative
fluorodeoxyglucose (FDG) PET/CT scan, which indicates the remission of her HL.
Conclusion: Recognize the critical role of the anti-programmed cell death protein-1 monoclonal antibodies
in patients with chemo-resistant Hodgkin's Lymphoma (HL).