ascorbic-acid and Hodgkin-Disease

Checkpoint inhibitor therapy is effective in the treatment of relapsed classical Hodgkin's Lymphoma. Here, we report a patient with relapsed Hodgkin's Lymphoma who received nivolumab prior to autologous stem cell mobilization. She went on to develop cytokine storm shortly following transplantation, with marked T-cell proliferation coincident with myeloid engraftment. Non-cardiogenic pulmonary edema and alveolar hemorrhage developed despite corticosteroid therapy. There was rapid and complete resolution of these complications with parenteral ascorbic acid infusion. Our case illustrates the risk of cytokine release syndrome following infusion of stem cells mobilized after checkpoint inhibitor therapy and the role of ascorbic acid in its management.

Topics: Adult; Antineoplastic Agents, Immunological; Ascorbic Acid; Cytokine Release Syndrome; Disease Management; Female; Hematopoietic Stem Cell Mobilization; Hematopoietic Stem Cell Transplantation; Hodgkin Disease; Humans; Immunohistochemistry; Immunophenotyping; Neoplasm Staging; Programmed Cell Death 1 Receptor; Tomography, X-Ray Computed; Transplantation Conditioning

Ascorbic acid (AA) effects on the development of lymphoproliferative process according to the type of a reticular variant of Hodgkin's disease have been investigated in SJL/J mice. An oral AA injection in a 0.05% aqueous solution for 6-8 months (0.625 mg/kg) with a total dose of 0.5 per mouse has not produced any side effects, has reduced both the rate of tumour process development (from 80.5% in control to 68.0% in experiment) and the degree of its extension, and also has led to a statistically significant decrease in the frequency of development of general amyloidosis.

Topics: Aging; Amyloidosis; Animals; Ascorbic Acid; Dose-Response Relationship, Drug; Drug Evaluation, Preclinical; Female; Hodgkin Disease; Lymphoproliferative Disorders; Male; Mice; Mice, Inbred Strains

Three cases are described, 2 of Hodgkin's disease and a further case of bronchial carcinoma, where high dosage ascorbic acid treatment appeared to be associated with the development of potentially dangerous symptoms. It is suggested that mega ascorbic acid therapy should be given with caution in malignant disease, with a slow build-up over several days to high levels of dosage.

Topics: Adult; Aged; Animals; Antineoplastic Agents; Ascorbic Acid; Bronchial Neoplasms; Carcinoma, Small Cell; Dyspnea; Fever; Hodgkin Disease; Humans; Lung Neoplasms; Male; Neoplasms; Orthomolecular Therapy

Topics: Adrenal Cortex Hormones; Ascorbic Acid; Colchicine; Desoxycorticosterone; Hodgkin Disease; Vitamins