PPubMed4 Jun 2025Cited 1×

Nivolumab Induces Durable Remission in Relapsed/Refractory ALK‐Negative ALCL After Allogeneic Blood Stem Cell Transplantation—A Case Report and Literature Review

Ben‐Niklas Baermann, Kathrin Nachtkamp, Paul Jäger, Paula Kessler, Emil Novruzov, Frederik L. Giesel, Helena Peters, Maximilian Seidl, Mark Uhlenbruch, Sascha Dietrich, Guido Kobbe

Abstract

1## Introduction While intensive chemoimmunotherapy results in 3-year overall survival rates of 90% in anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL), the outcome of ALK-negative ALCL remains poor . Brentuximab vedotin, a CD30-antibody, offered a major improvement for remission induction at first line as well as in the treatment of patients with relapsed/refractory disease, especially in combination with consolidating autologous or allogeneic stem cell transplantation . Since the rapid development of immune checkpoint blockade in Hodgkin lymphoma, efforts have

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Here, we report successful and durable remission induction for more than 2 years with nivolumab for r/r-ALCL even without any evidence of PD-L1 expression.

What’s new

i.First reported case of ALK‑negative ALCL responding to nivolumab after alloHSCT despite lack of PD‑L1 expression
ii.Demonstrated a durable complete metabolic remission lasting at least 34 months
iii.Highlighted the potential role of graft‑versus‑lymphoma effect combined with PD‑1 blockade
iv.Provided a literature review summarizing similar cases and outcomes

How they did it

The authors present a retrospective case report of a 58‑year‑old patient with relapsed ALK‑negative ALCL after allogeneic stem‑cell transplantation. The patient received nivolumab 240 mg every two weeks (22 doses) and response was monitored with serial [18F]FDG PET/CT scans and histopathologic analysis. Clinical outcomes and adverse events were documented up to January 2024.

What they found

Complete metabolic remission confirmed by PET/CT in March 2022 after 22 doses of nivolumab
Remission ongoing for at least 34 months (over 2 years) as of January 2024 with no disease relapse
No further anti‑lymphoma treatment required; patient remained in good health with full donor chimerism

Caveats

✕Single‑patient case report limits generalizability
✕Potential severe adverse events (e.g., heart failure) required discontinuation of nivolumab
✕Optimal dosing and treatment duration after alloHSCT remain undefined

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