Сlinical case of a patient with Hodgkin's lymphoma

Clinical case
Patient X
Age: 18 years (June 1996)
Sex: female
Date of diagnosis: 09.2014

Clinical case
Diagnosis:
Hodgkin’s lymphoma, stage III A. Variant of nodular sclerosis, with affection cervical, supraclavicular, axillary, mediastinal, retroperitoneal lymphatic nodes.

Clinical case
Therapy
8 courses of chemotherapy according to the ABVD protocol (09.2014- 04.2015)
Result
partial effect:
Limphatic node biopsy - Hodgkin’s lymphoma cells

Belorussian Hematology and BMT Centre
19 - 28.05.2015 - courses of reinduction therapy DHAP
26.-29.06.2015 – DHAP
28.07-13.08.2015 – DHAP and 2 sessions of stem cells apheresis
Result
- partial remission

Belorussian Hematology and BMT Centre
13.11-01.12.2015
high-dose chemotherapy (BEAM) + autologous HSCT
СD34+ 4.12*106/kg
nucleated cells -6.63x 108/kg
Hematopoietic recovery: day +9

Well done!

But…
November 2016 - Relapse (lesion of cervical, supraclavicular, mediastinal , retrocrural, paraaortal, retroperitoneal lymphatic nodes and soft tissues of the right lunq, thyroid) confermed by PET CT.

PET –CT 24.02.2017

PET –CT 16.05.2017

Further tactics is…

Further tactic?
Way #1 – monotherapy with Brentuximab
Way#2 – modified courses PCT with Brentuximab
(DHAP+Brentuximab,
Bendamustine+Brentuximab..?)
Way #3 – HD PCT and the second transplantation
Way #4 - your advises