Iatrogenic Immunodeficiency Lymphoproliferative Disorder with Hepatic Impairment Treated with Salvage Gemcitabine

Other iatrogenic immunodeficiency-associated lymphoproliferative disorders, classic Hodgkin lymphoma-type, is a subclassification of lymphoproliferative disorders typically seen in patients taking immunosuppressive medications in the setting of autoimmune diseases. Standard of care is currently Adriamycin, Bleomycin, Vinblastine, and Dacarbazine (ABVD) as it is for typical Hodgkin lymphoma, however, the side effect profile of these drugs include transaminase elevations which restrict their use in patients with underlying liver dysfunction. In patients in this clinical scenario gemcitabine has been infrequently used in the literature as salvage therapy as well as other alternative strategies. We report a case of classic hodgkin lymphoma-type other iatrogenic immunodeficiency disorder with impaired liver function who was treated empirically with salvage therapy of gemcitabine who developed symptomatic thrombocytopenia without recovery.