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Tumor Discovery BrECADD-induced ileus and GI hemorrhage

physical condition, with an ECOG performance status of 0. images. The patient agreed to the use of clinical details for
His comorbidities were considered clinically insignificant. academic and publication purposes. All data have been
Therefore, despite his age being over 60 years, we elected to fully anonymized to protect the patient’s identity.
proceed with the more intensive BrECADD regimen.
Availability of data
As this case illustrates, careful patient selection is
critical when considering intensive chemotherapy in older Not applicable.
or comorbid individuals, to minimize the risk of excessive
toxicity, as was unfortunately observed in our patient. References
Based on this experience, we will adopt a more conservative 1. Borchmann P, Ferdinandus J, Schneider G, et al. Assessing
approach moving forward, reserving intensive regimens the efficacy and tolerability of PET-guided BrECADD
such as BrECADD for younger patients with adequate versus eBEACOPP in advanced-stage, classical Hodgkin
performance status and minimal comorbidity burden. lymphoma (HD21): A randomised, multicentre, parallel,
open-label, phase 3 trial. Lancet. 2024;404(10450):341-352.
4. Conclusion doi: 10.1016/S0140-6736(24)01315-1

This case report highlights the rare but potentially life- 2. German Hodgkin Study Group. Therapy - GHSG. Available
threatening complication of chemotherapy-induced ileus from: https://en.ghsg.org/treatment [Last accessed on
in a patient with AS-cHL treated with the BrECADD 2025 Jun 08].
regimen. Although GI toxicity, including diarrhea and 3. Akbarali HI, Muchhala KH, Jessup DK, Cheatham S.
mucositis, is well documented in chemotherapy, bowel Chemotherapy induced gastrointestinal toxicities. Adv
obstruction remains an uncommon manifestation. In Cancer Res. 2022;155:131-166.
this case, chemotherapy-induced enteritis likely triggered doi: 10.1016/bs.acr.2022.02.007
ileus, which was further complicated by GI hemorrhage
and acute renal failure. Despite initial conservative 4. Carraro F, Rivetti E, Romano E, Fagioli F. Two cases
management, the patient required surgical intervention of paralitic ileus in onco-hematologic patients. Pediatr
Rep. 2012;4(1):e3.
due to recurrent bleeding. Our case demonstrates that
careful patient selection is essential when considering doi: 10.4081/pr.2012.e3
intensive chemotherapy regimens such as BrECADD. Close 5. Mourad AP, De Robles MS. Chemoimmunotherapy-related
monitoring for GI symptoms is crucial during treatment. enteritis resulting in a mechanical small bowel obstruction - a
case report. Int J Surg Case Rep. 2021;79:131-134.
Acknowledgments
doi: 10.1016/j.ijscr.2020.12.096
None.
6. Jiao XD, Luo X, Qin WX, Yuan LY, Zang YS. Paralytic ileus
Funding due to a novel anticancer drug, nab-paclitaxel: A case report.
Mol Clin Oncol. 2016;4(5):824-826.
None. doi: 10.3892/mco.2016.782

Conflict of interest 7. Roy R, Sarkar S. Paralytic ileus - a rare but serious
side-effect of oral capecitabine. Int J Anat Radiol Surg.
The authors declare they have no competing interests. 2022;11(1):SC01-SC02.

Author contributions doi: 10.7860/IJARS/2022/56456.2843
Conceptualization: Karl Mayrhofer 8. Kumar KS, Balaji P, Muppa L. Paralytic ileus as a rare
Investigation: Karl Mayrhofer complication of vincristine therapy: A case report. Ind J
Writing – original draft: Karl Mayrhofer Pharm Pract. 2024;14(4):396-399.
Writing – review & editing: Simon Udovica doi: 10.5530/ijopp.17.4.65
9. Balu A, Nagarajan T, Mudawi H. Chemotherapy induced
Ethics approval and consent to participate small bowel obstruction in small cell lung cancer. Arab J
Not applicable. Gastroenterol. 2021;22(3):246-248.
doi: 10.1016/j.ajg.2021.07.001
Consent for publication
10. European Medicines Agency. Adcetris: EPAR - Product
Informed consent was obtained from the patient for the Information. Amsterdam: EMA; 2024. Available from:
publication of this case report and any accompanying https://www.ema.europa.eu/en/documents/product-

Volume 4 Issue 3 (2025) 108 doi: 10.36922/TD025180033