Acute Pancreatitis Following Brentuximab Vedotin T

Authors: S A M Urru E Mariotti P Carta S Massidda M Marcias R Murru P Sanna E Angelucci

Publish Date: 2014/02/04

Volume: 14, Issue: 1, Pages: 9-11

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Abstract

Here we present a patient with brentuximab vedotinassociated pancreatitis diagnosed on the basis of clinical and radiologic findings and laboratory data To our knowledge there have been no published reports of pancreatitis occurring with this medicationA 65 year old white man was diagnosed in December 2011 with Hodgkin lymphoma mixed cellularity subtype stage IIa nonbulky disease involving abdominal sites without retroperitoneal lymph node involvement The patient denied a personal or family history of gastrointestinal disease smoking or alcohol abuse and was not obeseFrom January to July 2012 the patient received six standard cycles of adriamycin bleomycin vinblastine and dacarbazine treatment and because of lymphoma refractoriness from November to January 2013 four cycles of ifosfamide gemcitabine vinorelbine and prednisone salvage therapy without experiencing any gastrointestinal disorder Unfortunately postchemotherapy computed tomography positron emission tomography and inguinal lymph node biopsy showed disease progression Therefore on April 2013 the patient began treatment with 18 mg/kg brentuximab vedotin total dose 150 mg intravenously once every 3 weeks The patient did not receive premedicationA few days after the second brentuximab vedotin infusion the patient developed nausea stypsis and epigastric pain He was hospitalized 7 days after the second administration of brentuximab with persistent nausea abdominal tenderness dehydration and acute constant pain in the epigastric area that gradually worsened He was afebrile and his only medication was lansoprazole Abdomen ultrasound examination was negative for gallstonesPancreas enzymes returned to within normal levels in 3 weeks and the third cycle of brentuximab vedotin was given at the same dose at 50 days from the second infusion and at 30 days from the onset of acute pancreatitis Administration of subsequent chemotherapy cycles was decided based on improvement of clinical conditions normalization of amylase and lipase values and partial reduction of abdominal nodes abdominal US After every brentuximab vedotin administration the patient required subcutaneous granulocyte colonystimulating factor for 4 days to prevent neutropenia but did not present with any other severe adverse event No recurrence of pancreatitis or any other side effect was recorded

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