International Journal of Hematology

, Volume 109, Issue 3, pp 356–360 | Cite as

Relationship between clinical course of nivolumab-related myositis and immune status in a patient with Hodgkin’s lymphoma after allogeneic hematopoietic stem cell transplantation

  • Takahiro KobayashiEmail author
  • Yong-mei Guo
  • Takaya Yamashita
  • Miho Nara
  • Tomoko Yoshioka
  • Yoshihiro Kameoka
  • Takahiro Fukuda
  • Naoto Takahashi
Case Report


Although programmed cell death (PD)-1 blockade induces immune-related adverse events (irAEs), little is known about the safety of PD-1 blockade after allogeneic hematopoietic stem cell transplantation (HSCT). Here, we describe immune system changes during nivolumab-related myositis in a patient with Hodgkin’s lymphoma after allogeneic HSCT; to our knowledge, this is the first such report in the literature. At the onset of myositis, the patient lost lower limb mobility against gravity, and had an activated immune profile with increased cytotoxic CD107a and granzyme B expression, as well as pro-inflammatory cytokines, interferon-γ, tumor necrosis factor-α, interleukin-2 in T and NK cells compared to healthy donor. Pulse steroid therapy decreased creatine kinase levels and induced PD-1 expression and regulatory T cells, but did not improve myositis; previously activated markers remained high. Four-week corticosteroid therapy decreased previously activated markers and the myositis improved. These findings provide new insights into nivolumab-induced irAE pathogenesis and suggest possible optimal treatments for irAEs.


Graft-versus-host disease Nivolumab Immune-related adverse events Myositis Hodgkin’s lymphoma 


Compliance with ethical standards

Conflict of interest

N.T. received grants from Ono Pharmaceutical. The other authors declare no conflict of interest.

Supplementary material

12185_2018_2584_MOESM1_ESM.docx (19 kb)
Supplementary material 1 (DOCX 19 KB)


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Copyright information

© Japanese Society of Hematology 2019

Authors and Affiliations

  1. 1.Department of Hematology, Nephrology and RheumatologyAkita University Graduate School of MedicineAkitaJapan
  2. 2.Clinical Research Promotion and Support CenterAkita University HospitalAkitaJapan
  3. 3.Department of Hematopoietic Stem Cell TransplantationNational Cancer Center HospitalTokyoJapan

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