PMC6188182_01
CT scan showing an axillary node transiently controlled with radiotherapy in June 2009.. Abbreviation: CT, computed tomography.
ott-11-6599Fig1.jpg
PMC6188182_01_ott-11-6599Fig1.jpg
f1-ott-11-6599
Considering the basal comorbidities of the patient, we decided to pursue a watch-and-wait policy from 2008 to 2010, treating localized areas of progression with radiotherapy and obtaining transient partial responses (Figure 1).
PET/CT scan before lenalidomide/celecoxib (A) and after six cycles of lenalidomide/celecoxib (B).. Abbreviations: CT, computed tomography; PET, positron emission tomography.
ott-11-6599Fig2.jpg
PMC6188182_01_ott-11-6599Fig2.jpg
f2-ott-11-6599
August 2014, the HL progressed again with significant B symptoms and worsening clinical status (Figure 2A). At this point, based on our experience of the potential role of COX-2 expression in HL and that the patient was not a candidate for intensive chemotherapy and brentuximab was still not available in our center, we decided to start an experimental treatment with celecoxib 200 mg every 12 hours and lenalidomide 20 mg (for 3 of every 4 weeks). Our patient received this treatment from August 2014 to January 2015 (six cycles) with unremarkable toxicity and excellent tolerance, finally showing a CR for the first time in both the interim after three cycles and the final CT/PET after six cycles (Figure 2B).