Maintenance Therapy with Procarbazin and Chlorambucil without Autologous Stem Cell Transplantation as a New Option for Patient with Hodgkin Lymphoma

Hodgkin lymphoma (HL) affects patients of all ages, particularly adolescents and young adults between 16-34 years. Patients with HL who relapse following effective front-line therapy are offered salvage second-line chemotherapy regimens followed by high-dose therapy and autologous stem cell transplantation. The aim of this study is a report of a HL patient that treated with maintenance therapy without autologous stem cell transplantation (ASCT) and radiotherapy for four months and had a complete response (CR). In Spring 2014, A 54 year-old women referred to our Clinic. Six years ago was treated with diagnosis of HL stage 2B with cervical and mediastinal involvement and she was treated with 6 courses from ABVD (adriamycin, belomycin, vinblastine and dacarbazine) regimen. During last six months ago with chief complaints of abdominal pain, weight loss and fever referred to Hematology Clinic. In restating, after bone marrow biopsy and whole body CT scan, both lungs and right side of liver were involved. We selected secondline chemotherapy individualized, second-line chemotherapy of ICE (ifosfamide, carboplatin, etoposide) regimen. The patient was selected for ASCT but she denied of this recommendation. We decide that continue maintenance therapy of procarbazin and chlorambucil for this patient. Final message of this case is that maintenance therapy can be considered in HL relapse cases that not referred for another new decision (such as ASCT), either by patient or manager team, and this regimen can be a new option for patients with HL.