Complete remission on 18-fluorodeoxyglucose positron emission tomography/computed tomography after nivolumab treatment in a patient with indolent Hodgkin lymphoma

Most patients with Hodgkin lymphoma (HL) get a remission after induction chemotherapy with or without radiation therapy (RT). However, relapse rates range from 10–20% in cases of stage I–II disease to 30–40% in patients with more stage III–IV disease. In addition, approximately 10–15% of patients suffer disease progression after a partial initial response. Nivolumab is an immunotherapeutic antineoplastic developed as a totally human immunoglobulin G4 (IgG4) monoclonal antibody against programmed death-1 (PD-1), an immune checkpoint inhibitor that negatively controls T-cell proliferation and functions. Intravenous administration of nivolumab was approved for the treatment of unresectable malignant melanoma in 2014 in Japan. Phase 1 or 2 studies in certain malignities including HL has been going on. Herein, we present a patient with relapsed/refractory HL not responded to multiple protocols, but successfully treated by nivolumab as depicted on 18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT).