Why the study?
Does parenteral ascorbic acid infusion improve cytokine release syndrome in a patient with relapsed Hodgkin's Lymphoma following stem cell transplantation?
Does parenteral ascorbic acid infusion improve cytokine release syndrome in a patient with relapsed Hodgkin's Lymphoma following stem cell transplantation?
Parenteral ascorbic acid may be an effective management strategy for cytokine release syndrome following stem cell transplantation in patients previously treated with checkpoint inhibitors.
Nivolumab before ASCT may trigger severe cytokine storm in relapsed Hodgkin lymphoma; this Level 5 case leaves optimal sequencing open.
Checkpoint inhibitor therapy is effective in the treatment of relapsed classical Hodgkin's Lymphoma. Here, we report a patient with relapsed Hodgkin's Lymphoma who received nivolumab prior to autologous stem cell mobilization. She went on to develop cytokine storm shortly following transplantation, with marked T-cell proliferation coincident with myeloid engraftment. Non-cardiogenic pulmonary edema and alveolar hemorrhage developed despite corticosteroid therapy. There was rapid and complete resolution of these complications with parenteral ascorbic acid infusion. Our case illustrates the risk of cytokine release syndrome following infusion of stem cells mobilized after checkpoint inhibitor therapy and the role of ascorbic acid in its management.
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Sindel et al. (2019) studied this question.
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