Notes

22 year old male resident of Karachi came presented first time to hematology clinic _____ with complaints of SOB wt loss decrease appetite and Lymph adenopathy..
Biopsy was done which was reported as a case of classical Hodgkin lymphoma Mixed cellularity. 2019:65427
HB LDH ___ base line workup done and patient PET ct was planned along with bone marrow for staging of the disease./
Pet ct showed Stage IIb disease while bone marrow was negative for disease involvement.
He was started on chemo ABVD after his echo and PFT was done ( which were normal )
he received 1st cycle of ABVD 15&29/10/19 2nd on 12& 26/11/19.
Interim PET (date) was done which showed CMR.
ABVD therapy was continued and further received 3rd cycle(11/12/19_25/12) and cycle 4 on (9-1-20 27-1-20)
End of treatment PET (date) was repeated which sustained / CMR.
And he remained on surveillance afterward 3/4/20 for 1 year with regular follow ups when in march 21 he started having atypical chest pain and upon surveillance PET Ct 29/3/21 showed mediastinal mass with FDG avid Deauville 5 Active disease Recurrence.
We planned for a repeat biopsy which was done ( report awaited ) and to give chemo therapy Brentuximab vdeotin + bendamustine and followed by Autologous transplant