Reactions 1680, p72 - 2 Dec 2017 was switched to foscarnet. He was given fourth brentuximab vedotin infusion. The therapy was complicated by septic shock Brentuximab vedotin/ with multiple putative origins (colitis, pneumonia, catheter- immunosuppressants related bacteraemia). In a context of renal toxicity, he was treated with a combination of foscarnet and ganciclovir. A Cytomegalovirus retinitis: 3 case reports month later (4 months after the first diagnosis of CMV In a case series, an adult man [specific age not stated] and reactivation), a rapidly progressive bilateral vision loss was two men (a 44-year-old and a 83-year-old) were described, noted and a diagnosis of bilateral retinitis was made. Plasma who developed cytomegalovirus (CMV) retinitis during CMV PCR was found to be positive. He then received treatment with brentuximab vedotin, cyclophosphamide, intravitreal and IV ganciclovir, followed by valganciclovir. His prednisone and vincristine (1 patient), brentuximab vedotin, brentuximab vedotin therapy was discontinued. Seven weeks cyclophosphamide, prednisone, vincristine and later, the retinitis relapsed on the right eye and was associated dexamethasone (1 patient) and brentuximab vedotin and with mild viraemia despite maintenance therapy with dexamethasone (1 patient) [dosages not stated; not all routes valganciclovir. and outcomes stated]. Author comment: "This is the first report describing An 83-year-old man, who had a history of stage IV [cytomegalovirus] retinitis after [brentuximab vedotin] therapy Hodgkin’s lymphoma, received one cycle of ABVD regimen for CD30+ lymphoma, highlighting an unknown adverse which includes doxorubicin [adriamycin], bleomycin, event of this drug." "The 3 patients depicted here had vinblastine and dacarbazine. However, the regimen was individual immunosuppression factors such as lymphoma and ceased due to toxicity including deep neutropenia and right history of cytotoxic therapy, but none of them received ankle arthritis. Further, he completed five cycles of mini-CHOP allogeneic HSCT. Cytomegalovirus retinitis seems to be regimen which includes cyclophosphamide, doxorubicin, associated with deep immunosuppression conditions." vincristine and prednisone, which led to a partial response. He received six cycles of MOPP regimen which includes Tudesq J-J, et al. Cytomegalovirus infection with retinitis after brentuximab vedotin treatment for CD30+ lymphoma. Open Forum Infectious Diseases 4: prednisone, vincristine, procarbazine and chlormethine ofx091, No. 2, 1 Apr 2017. Available from: URL: http://doi.org/10.1093/ofid/ [Mustargen], on which a complete response was achieved. ofx091 - France 803283913 Three months later, a relapse occurred and he was administered brentuximab vedotin at 75% of the standard dose (i.e, 1.35 mg/kg), every three weeks. Thirteen days following the third cycle, he experienced left vision loss. A diagnosis of left eye retinitis was made. CMV PCR was found to be positive in aqueous humour. Plasma CMV PCR was also positive. He was treated with ganciclovir for two weeks, followed by valganciclovir, which led to clinical remission. Four weeks following the diagnosis, he received a fourth cycle of brentuximab vedotin. Two days later, he had vision loss and recurrent left retinitis was confirmed. This relapse was effectively treated with valganciclovir. His brentuximab vedotin therapy was discontinued. An adult man, who had a history stage IV Hodgkin’s lymphoma, started receiving treatment with two cycles of DHAC regimen which includes dexamethasone, cytarabine and carboplatin for a relapse. His disease progressed and he received four cycles of brentuximab vedotin infusion, after which a complete response was achieved. Twenty days following the fourth cycle (12 months after the first infusion), he presented with a left vision loss. His symptoms grew progressively for nine days until diagnosis of a left necrotic and haemorrhagic chorio-retinitis. CMV DNA was found in plasma as well as in the vitreous humour. Moderate cytolysis and cholestasis suggested hepatic involvement. He was treated with ganciclovir. However, he developed toxic neutropenia, due to which his ganciclovir therapy was switched to foscarnet, followed by valganciclovir with a neutrophil recovery. He successfully underwent autologous haematopoietic stem cell transplantation under foscarnet maintenance therapy without CMV reactivation. He was again administered brentuximab vedotin for an early relapse without CMV reactivation. A 44-year-old man, who had a history of stage IV peripheral CD30+ T-cell lymphoma, received four cycles of CHOEP regimen which includes cyclophosphamide, doxorubicin, vincristine, prednisone and etoposide and then progressed. He successively received two cycles of DHAC regimen which includes dexamethasone, cytarabine and carboplatin with one cycle of CEP regimen including cyclophosphamide, etoposide and prednisone. Finally, he was started on a treatment with brentuximab vedotin infusion. Two weeks after the second cycle, he developed a febrile dyspnoea, which led to the diagnosis of systemic CMV disease. The blood CMV PCR test was found to be strongly positive. Hepatitis and putative pneumonia were also noted. He was treated with valganciclovir. He was then administered third course of brentuximab vedotin. Despite treatment, his plasma CMV PCR remained positive after three weeks, due to which his therapy 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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