Abstract P061

Familial Presentation of Classical Hodgkin Lymphoma in First-Degree Relatives

Introduction: Hodgkin lymphoma (HL) is generally considered sporadic malignant lymphoproliferative disease, although familial aggregation has also been described. Several studies have demonstrated an elevated risk among first-degree relatives, suggesting a possible hereditary predisposition. Genetic susceptibility and shared environmental factors may both contribute to disease development.

Case presentation: A 38-year-old woman with a history of psoriasis was diagnosed with lymphocyte rich cHL in 2012. She received six cycles of ABVD followed by 36 Gy IFRT to the neck and mediastinum. Due to refractory disease, salvage DHAP chemotherapy and autologous stem cell transplantation (APSCT) were performed, resulting in complete metabolic remission (CMR) lasting more than 10 years. In 2024, she developed bilateral axillary lymphadenopathy and B symptoms. Histolopathology confirmed diffuse larege B-cell lymphoma (DLBCL). After 6 cycles of R-CHOP21 and consolidative ISRT, CMR was achived. Shortly after the the patient presented symmetrical lower-extremity paresis and secondary CNS involvment was confirmed by PET/CT, brain MRI and malignant B-cells was also identified in the cerebrospinal fliud. After R-MPV and IT therapy, imaging studies showed CMR. Urgent APSCT was performed. Unfortunately the patient died from multi organ failure due to an agressive fungal infection.

Her daughter was diagnosed at the age of 20 after an incidental radiological finding following a household accident. Histology confirmed cHL nodular sclerosis subtype. Based on staging PET/CT, she was classified having advanced-stage (IV/BE) disease. Treatment was started with A+AVD and after 2 cycles the interim PET/CT showed CMR, than we followed with Nivolumab+AVD. Her teatment is ongoing and she is in good clinical condition.

Results: The occurrence of classical HL in a mother–daughter pair represents a rare example of familial aggregation. Despite differences in histological subtype and clinical course, the diagnosis of cHL in two first-degree relatives is notable given the predominantly sporadic nature of the disease. This observation is unlikely to be purely coincidental.

Conclusion: Although familial HL has been described, the development of subsequent DLBCL in one affected family member is particularly unusual and may indicate a broader inherited risk of lymphoid malignancies. Further genetic and molecular studies are needed to better understand the mechanisms underlying familial clustering.