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Abstract：
Hodgkin lymphoma (HL) represents ~11% of all lymphoma cases. This disease occurs in young adults, but also affects people over 55 years of age. Despite the fact that >80% of all newly diagnosed patients under 60 will achieve a sustained complete response (CR), 5%-10% of HL patients are refractory to initial treatment and 10%-30% of patients will eventually relapse after an initial CR. The treatment recommendation for primary refractory or relapsed HL patients is salvage therapy followed by high-dose chemotherapy and autologous stem cell transplantation. Following this approach, a significant part will still relapse at any moment. Thus, further research and new drugs or combinations are required. Overexpression of COX-2 has been associated with poor prognosis in relapse/refractory HL patients, so it could be a potential therapeutic target in HL. For this purpose, several drugs may have a role: specific COX-2 inhibitors such as celecoxib or other anti-inflammatory drugs such as lenalidomide may further inhibit lipopolysaccharide-mediated induction of COX-2. Moreover, lenalidomide and COX-2 inhibitors (celecoxib) have been tested in solid tumors with encouraging results. We present a case of a young female diagnosed with a heavily pretreated HL nodular sclerosis subtype who, after failing six treatment lines, only achieved clinical and radiological CR after six cycles of lenalidomide/celecoxib that resulted in an event-free survival of 22 months. We explain the rationale of using this chemotherapy regimen and our patient follow-up.
摘要：
霍奇金淋巴瘤（HL）占所有淋巴瘤病例的约11％。这种疾病发生在年轻人中，但也会影响55岁以上的人。尽管>80％的60岁以下的新诊断患者将实现持续完全缓解（CR），5%-10%的HL患者对初始治疗是难治性的,并且10%-30%的患者在初始CR后最终将复发。原发性难治性或复发性HL患者的治疗建议是抢救治疗，然后是大剂量化疗和自体干细胞移植。按照这种方法，很大一部分仍然会随时复发。因此，需要进一步的研究和新药或组合。COX-2的过表达与复发/难治性HL患者的不良预后相关。因此它可能是HL的潜在治疗靶点。为此,几种药物可能具有一定的作用:特定的COX-2抑制剂如塞来考昔或其他抗炎药如来那度胺可能进一步抑制脂多糖介导的COX-2诱导.此外，来那度胺和COX-2抑制剂（塞来昔布）已在实体瘤中进行了测试，结果令人鼓舞。我们介绍了一例年轻女性，被诊断为严重预处理的HL结节性硬化症亚型，在六条治疗线失败后，来那度胺/塞来昔布治疗6个周期后,无事件生存期为22个月,才达到临床和放射学CR.我们解释了使用这种化疗方案的理由和我们的患者随访。
