{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T10:55:58Z","timestamp":1764327358118,"version":"3.46.0"},"reference-count":36,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hematology Reports"],"abstract":"<jats:p>Background\/Objectives: Hodgkin lymphoma (HL) represents a rare but clinically significant complication in patients with Common Variable Immunodeficiency (CVID). Immune dysregulation, impaired viral control, and Epstein\u2013Barr virus (EBV) infection may contribute to pathogenesis and adversely affect treatment tolerance. This case-based review aims to highlight the impact of early CVID recognition and multidisciplinary management on outcomes in CVID-associated HL. Methods: A retrospective screening of 224 patients with HL treated at our institution between 2010 and 2023 identified two individuals with CVID and EBV-positive HL. These cases are presented in detail and contextualized within a structured review of the published literature. Results: The first patient, diagnosed with CVID prior to HL onset, received immunoglobulin replacement and a modified chemotherapy regimen substituting bleomycin with brentuximab vedotin, resulting in sustained complete remission. The second patient, in whom CVID was recognized only after HL relapse, experienced recurrent infections, intolerance to therapy, and fatal disease progression despite treatment with brentuximab vedotin, checkpoint inhibition, and rituximab. The literature review revealed only eight comparable cases, underscoring the rarity and complexity of this association. Conclusions: Early identification of CVID facilitates infection control and enhances tolerance to HL therapy, thereby improving clinical outcomes. Multidisciplinary, individualized management and incorporation of targeted agents are pivotal in optimizing care for this vulnerable population.<\/jats:p>","DOI":"10.3390\/hematolrep17060065","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T09:56:02Z","timestamp":1764323762000},"page":"65","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hodgkin Lymphoma Associated with Common Variable Immunodeficiency: The Role of Early Diagnosis and Multidisciplinary Management"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0225-3145","authenticated-orcid":false,"given":"D\u00e1vid","family":"T\u00f3thfalusi","sequence":"first","affiliation":[{"name":"Division of Haematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"Doctoral School of Clinical Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Guly\u00e1s","sequence":"additional","affiliation":[{"name":"Division of Haematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"Doctoral School of Clinical Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Koncz","sequence":"additional","affiliation":[{"name":"Division of Haematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c9va","family":"Z\u00f6ld","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1rp\u00e1d","family":"Ill\u00e9s","sequence":"additional","affiliation":[{"name":"Division of Haematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"Doctoral School of Clinical Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3507-9997","authenticated-orcid":false,"given":"Zs\u00f3fia","family":"Milt\u00e9nyi","sequence":"additional","affiliation":[{"name":"Division of Haematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"Doctoral School of Clinical Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ho, H., and Cunningham-Rundles, C. (2020). Non-infectious Complications of Common Variable Immunodeficiency: Updated Clinical Spectrum, Sequelae, and Insights to Pathogenesis. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.00149"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1080\/1744666X.2023.2198208","article-title":"Treatment of inflammatory complications in common variable immunodeficiency (CVID): Current concepts and future perspectives","volume":"19","author":"Fevang","year":"2023","journal-title":"Expert Rev. Clin. Immunol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"260","DOI":"10.2500\/ajra.2013.27.3899","article-title":"Common variable immunodeficiency","volume":"27","author":"Tam","year":"2013","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Fekrvand, S., Khanmohammadi, S., Abolhassani, H., and Yazdani, R. (2022). B- and T-Cell Subset Abnormalities in Monogenic Common Variable Immunodeficiency. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.912826"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1007\/s12016-017-8638-z","article-title":"Common Variable Immunodeficiency and Liver Involvement","volume":"55","author":"Song","year":"2018","journal-title":"Clin. Rev. Allerg. Immunol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Latour, S., and Winter, S. (2018). Inherited Immunodeficiencies With High Predisposition to Epstein\u2013Barr Virus-Driven Lymphoproliferative Diseases. Front. Immunol., 9.","DOI":"10.3389\/fimmu.2018.01103"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Pociupany, M., Snoeck, R., Dierickx, D., and Andrei, G. (2024). Treatment of Epstein-Barr Virus infection in immunocompromised patients. Biochem. Pharmacol., 225.","DOI":"10.1016\/j.bcp.2024.116270"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1038\/s41572-020-0189-6","article-title":"Hodgkin lymphoma","volume":"6","author":"Connors","year":"2020","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"101514","DOI":"10.1016\/j.beha.2023.101514","article-title":"Hodgkin Lymphoma: A disease shaped by the tumor micro- and macroenvironment","volume":"36","author":"Masel","year":"2023","journal-title":"Best Pract. Res. Clin. Haematol."},{"key":"ref_10","first-page":"116","article-title":"Hodgkin lymphoma: A review and update on recent progress","volume":"68","author":"Shanbhag","year":"2018","journal-title":"CA Cancer J. Clin."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1200\/JCO.23.01799","article-title":"Classic Hodgkin Lymphoma in Adolescents and Young Adults","volume":"42","author":"Kelly","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2690","DOI":"10.1200\/JCO.2016.66.4482","article-title":"PD-L1 and PD-L2 Genetic Alterations Define Classical Hodgkin Lymphoma and Predict Outcome","volume":"34","author":"Roemer","year":"2016","journal-title":"J. Clin. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/j.aller.2017.01.006","article-title":"Epidemiology and pathophysiology of malignancy in common variable immunodeficiency?","volume":"45","author":"Azizi","year":"2017","journal-title":"Allergol. Immunopathol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1111\/bjh.19255","article-title":"Epstein\u2013Barr virus-associated lymphomas decoded","volume":"204","author":"Bednarska","year":"2024","journal-title":"Br. J. Haematol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1182\/blood.2020005466","article-title":"EBV+ lymphoproliferative diseases: Opportunities for leveraging EBV as a therapeutic target","volume":"139","author":"Toner","year":"2022","journal-title":"Blood"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Alibrahim, M.N., Gloghini, A., and Carbone, A. (2025). Immune Deficiency\/Dysregulation-Associated EBV-Positive Classic Hodgkin Lymphoma. Cancers, 17.","DOI":"10.3390\/cancers17091433"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.anai.2021.03.005","article-title":"State-of-the-art diagnostic evaluation of common variable immunodeficiency","volume":"127","author":"Lee","year":"2021","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_18","first-page":"e58989","article-title":"Common Variable Immunodeficiency and Hodgkin Lymphoma in a 50-Year-Old Male","volume":"16","author":"Kishore","year":"2024","journal-title":"Cureus"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4642","DOI":"10.1182\/blood.V106.11.4642.4642","article-title":"Common Variable Immunodeficiency Presenting with Hodgkin\u2019s Disease","volume":"106","author":"Ellwood","year":"2005","journal-title":"Blood"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Rael, E., Rakszawski, K., Koller, K., Bayerl, M., Butte, M., and Zheng, H. (2016). Treatment with rituximab and brentuximab vedotin in a patient of common variable immune deficiency-associated classic Hodgkin lymphoma. Biomark. Res., 4.","DOI":"10.1186\/s40364-016-0061-8"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"583","DOI":"10.4274\/imj.galenos.2018.46514","article-title":"Development of Hodgkin Lymphoma in a Patient with Common Variable Immunodeficiency","volume":"20","author":"Orhan","year":"2019","journal-title":"Istanb. Med. J."},{"key":"ref_22","first-page":"000121","article-title":"Hodgkin Lymphoma in a Girl with Common Variable Immune Deficiency: A Case Report and Review of Literature","volume":"5","author":"Tootoonchi","year":"2023","journal-title":"JCSTM"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"259","DOI":"10.2967\/jnmt.116.175745","article-title":"18F-FDG PET\/CT Imaging of Hodgkin Lymphoma in a Child with Common Variable Immunodeficiency","volume":"44","author":"Tatci","year":"2016","journal-title":"J. Nucl. Med. Technol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1080\/08880010701369982","article-title":"Hodgkin Lymphoma in Two Siblings with Common Variable Immunodeficiency","volume":"24","author":"Aghamohammadi","year":"2007","journal-title":"Pediatr. Hematol. Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1002\/jha2.1","article-title":"Partial omission of bleomycin for early-stage Hodgkin lymphoma patients treated with combined modality therapy: Does incomplete ABVD lead to inferior outcomes?","volume":"1","author":"Gunther","year":"2020","journal-title":"eJHaem"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"6374","DOI":"10.1182\/blood-2024-203962","article-title":"Bleomycin Induced Lung Toxicity in Hodgkin Lymphoma Patients Treated with ABVD Regimen- a Single Center Experience from Riyadh, Saudi Arabia","volume":"144","author":"Yahia","year":"2024","journal-title":"Blood"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1056\/NEJMoa2206125","article-title":"Overall Survival with Brentuximab Vedotin in Stage III or IV Hodgkin\u2019s Lymphoma","volume":"387","author":"Ansell","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Yang, Y., Liu, S., Wang, L., Zhang, R., and Xie, J. (2025). Frontline brentuximab vedotin-based therapy for newly diagnosed classical Hodgkin lymphoma: A meta-analysis of randomized controlled trials. Front. Oncol., 15.","DOI":"10.3389\/fonc.2025.1636923"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/S0140-6736(24)01315-1","article-title":"Assessing the efficacy and tolerability of PET-guided BrECADD versus eBEACOPP in advanced-stage, classical Hodgkin lymphoma (HD21): A randomised, multicentre, parallel, open-label, phase 3 trial","volume":"404","author":"Borchmann","year":"2024","journal-title":"Lancet"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1056\/NEJMoa2405888","article-title":"Nivolumab+AVD in Advanced-Stage Classic Hodgkin\u2019s Lymphoma","volume":"391","author":"Herrera","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2181749","DOI":"10.1080\/16078454.2023.2181749","article-title":"Safety and efficacy of PD-1 and PD-L1 inhibitors in relapsed and refractory Hodgkin\u2019s lymphoma: A systematic review and meta-analysis of 20 prospective studies","volume":"28","author":"Sun","year":"2023","journal-title":"Hematology"},{"key":"ref_32","first-page":"637","article-title":"Persistent Immune Activation in CVID and the Role of IVIg in Its Suppression","volume":"5","author":"Sandberg","year":"2014","journal-title":"Front. Immunol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Baek, D.W., Song, G.-Y., Lee, H.S., Do, Y.R., Lee, J.H., Yhim, H.-Y., Moon, J.H., and Yang, D.-H. (2024). Clinical efficacy of prophylactic intravenous immunoglobulin for elderly DLBCL patients with hypogammaglobulinemia in the COVID-19 pandemic era. Front. Oncol., 14.","DOI":"10.3389\/fonc.2024.1380492"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1182\/blood-2010-01-254417","article-title":"How I treat common variable immune deficiency","volume":"116","year":"2010","journal-title":"Blood"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1126\/science.1255904","article-title":"Immune dysregulation in human subjects with heterozygous germline mutations in CTLA4","volume":"345","author":"Kuehn","year":"2014","journal-title":"Science"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.ajhg.2015.07.008","article-title":"Haploinsufficiency of the NF-\u03baB1 Subunit p50 in Common Variable Immunodeficiency","volume":"97","author":"Fliegauf","year":"2015","journal-title":"Am. J. Hum. Genet."}],"container-title":["Hematology Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2038-8330\/17\/6\/65\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T10:52:51Z","timestamp":1764327171000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2038-8330\/17\/6\/65"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,27]]},"references-count":36,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["hematolrep17060065"],"URL":"https:\/\/doi.org\/10.3390\/hematolrep17060065","relation":{},"ISSN":["2038-8330"],"issn-type":[{"value":"2038-8330","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,27]]}}}