The Role of Brentuximab Vedotin (BV) as Second-Line Treatment of Refractory Classical Hodgkin Lymphoma (cHL) in the Era of Pandemic COVID-19

Wulyo Rajabto,1,2 Vitya Chandika,1 Agnes Stephanie Harahap,3 Maria Francisca Ham3 1Division of Hematology-Medical Oncology, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital/ Faculty of Medicine Universitas Indonesia, Central Jakarta, Indonesia; 2Department of Internal Medicine, Metropolitan Medical Centre Hospital, South Jakarta, Indonesia; 3Department of Anatomical Pathology, Dr. Cipto Mangunkusumo General Hospital/ Faculty of Medicine Universitas Indonesia, Central Jakarta, IndonesiaCorrespondence: Vitya Chandika, Division of Hematology-Medical Oncology, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital/ Faculty of Medicine Universitas Indonesia, Jalan Pangeran Diponegoro No. 71, Central Jakarta, 10430, Indonesia, Email vityachandika@gmail.comBackground: Salvage conventional chemotherapy followed by high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) is the treatment of choice for most patients with refractory classical Hodgkin lymphoma (cHL). In the era of pandemic COVID-19, there are obstacles to administering salvage chemotherapy followed by HDT and ASCT due to side effects and toxicities which make the patient more susceptible to COVID-19 infection. The toxicities and side effects of BV are different from salvage chemotherapy, but it has clear efficacy as monotherapy.Case Presentation: A 46-year-old female with a history of cHL nodular sclerosis subtype was presented with right cervical lymph node enlargement, after 3 cycles of first-line chemotherapy ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine) 3 months ago. She was afraid to undergo second-line chemotherapy in the era of pandemic COVID-19 because of the side effects and toxicities; therefore, she was given 8 cycles of BV as monotherapy. The response of the treatment was complete remission.Conclusion: In this particular case of patient, BV as monotherapy can be an option during the pandemic COVID-19 for refractory cHL ineligible for second-line chemotherapy followed by HDT and ASCT.Keywords: brentuximab vedotin, COVID-19, monotherapy, refractory Hodgkin’s lymphoma