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The complex decision-making surrounding chemotherapeutic choice with the presence of multiorgan dysfunction is discussed with a review of literature describing regimens in similar clinical circumstances.<\/jats:p>","DOI":"10.1136\/bcr-2025-271364","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T13:35:42Z","timestamp":1782221742000},"page":"e271364","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Vanishing bile duct syndrome in relapsed classic Hodgkin lymphoma: treatment considerations and outcomes"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2770-1546","authenticated-orcid":false,"given":"Maria Lorraine","family":"Bugayong","sequence":"first","affiliation":[{"name":"Pulmonary and Critical Care, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Koo","sequence":"additional","affiliation":[{"name":"Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"2026062306351420000_19.6.e271364.1","doi-asserted-by":"publisher","DOI":"10.1007\/s005340170002"},{"key":"2026062306351420000_19.6.e271364.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2007.11.007"},{"key":"2026062306351420000_19.6.e271364.3","doi-asserted-by":"crossref","first-page":"1001302","DOI":"10.37349\/emed.2025.1001302","article-title":"Vanishing bile duct syndrome in drug-induced liver injury: clinical and pathologic perspectives","volume":"6","author":"Sallapan","year":"2025","journal-title":"Exploration of Medicine"},{"key":"2026062306351420000_19.6.e271364.4","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1002\/hep.1840070311","article-title":"The acute vanishing bile duct syndrome (acute irreversible rejection) after orthotopic liver transplantation","volume":"7","author":"Ludwig","year":"1987","journal-title":"Hepatology"},{"key":"2026062306351420000_19.6.e271364.5","doi-asserted-by":"publisher","DOI":"10.1016\/0270-9139(93)90194-R"},{"key":"2026062306351420000_19.6.e271364.6","doi-asserted-by":"crossref","DOI":"10.1186\/1756-0500-7-529","article-title":"Complete remission of paraneoplastic vanishing bile duct syndrome after the successful treatment of Hodgkin\u2019s lymphoma: a case report and review of the literature","volume":"7","author":"Rota Scalabrini","year":"2014","journal-title":"BMC Res Notes"},{"key":"2026062306351420000_19.6.e271364.7","doi-asserted-by":"crossref","DOI":"10.1097\/MCG.0000000000000548","article-title":"Vanishing Bile Duct Syndrome in Hodgkin\u2019s Lymphoma: A Single Center Experience and Clinical Pearls","volume":"50","author":"Bakhit","year":"2016","journal-title":"J Clin Gastroenterol"},{"key":"2026062306351420000_19.6.e271364.8","doi-asserted-by":"publisher","DOI":"10.1080\/02841860701644078"},{"key":"2026062306351420000_19.6.e271364.9","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.1002\/ajh.27470","article-title":"Hodgkin lymphoma: 2025 update on diagnosis, risk-stratification, and management","volume":"99","author":"Ansell","year":"2024","journal-title":"Am J Hematol"},{"key":"2026062306351420000_19.6.e271364.10","doi-asserted-by":"publisher","DOI":"10.21873\/invivo.12462"},{"key":"2026062306351420000_19.6.e271364.11","unstructured":"Gemcitabine. 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