PMC5319147_01
PMC5319147_02
Radiographic and hematologic responses with therapy. a Response as assessed by sequential PET scan images. Images are shown for Patients 2 and 3. The response for Patient 1 was more difficult to illustrate on PET scan as his disease was primarily confined to the bone marrow. b Serial complete blood counts during treatment with nivolumab demonstrating significant tri-lineage improvement for Patient 1. *Platelet units (x10^3/uL) are provided on the left y-axis, while hemoglobin (g/dL) and white blood cell count units (x10^3/uL) are on the right y-axis
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Fig1
All patients had objective partial responses to treatment based on the results of interim PET scans (Fig. 1a). In addition to radiographic responses, one patient with severe pancytopenia due to marrow involvement by cHL achieved a marked improvement in peripheral blood counts, as well as an objective improvement in bone marrow involvement by cHL (Fig. 1b).
Immunohistochemistry changes with therapy. Immunohistochemistry results on bone marrow biopsies from patient 1 before and after 5 cycles of nivolumab. There is an increase in tumor-infiltrating CD8+ T cells and a decrease in CD4+ T cells with treatment. PD-L1 staining was positive both before and after treatment. Images were captured using a Jenoptik ProgRes  Speed XT core 5 series camera on an Olympus BX53 microscope at 50x magnification using Adobe Photoshop Software
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Fig2
Immunohistochemistry studies on bone marrow biopsy samples before and after 5 cycles of nivolumab therapy in this patient demonstrated abundant PD-L1 expression in Hodgkin cells, with an increase in tumor-infiltrating CD8+ T cells and decreased CD4+ T cells with therapy (Fig. 2).