In:
British Journal of Haematology, Wiley, Vol. 178, No. 5 ( 2017-09), p. 709-718
Abstract:
This multicentre study evaluated 5‐year progression‐free ( PFS ) and overall survival ( OS ) in early and advanced Hodgkin lymphoma ( HL ), where therapy was individualized based on initial prognostic factors and positron emission tomography‐computed tomography performed after two cycles ( PET ‐2). Between September 2006 and August 2013, 359 patients aged 18–60 years, were recruited in nine Israeli centres. Early‐ HL patients initially received ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) ×2. Depending on initial unfavourable prognostic features, PET ‐2‐positive patients received additional ABVD followed by involved‐site radiotherapy ( ISRT ). Patients with negative PET ‐2 and favourable disease received ISRT or ABVD ×2; those with unfavourable disease received ABVD ×2 with ISRT or, alternatively, ABVD ×4. Advanced‐ HL patients initially received ABVD ×2 or escalated BEACOPP (bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone; EB ) ×2 based on their international prognostic score (≤2 or ≥3). PET ‐2‐negative patients further received ABVD ×4; PET ‐2‐positive patients received EB ×4 and ISRT to residual masses. With a median follow‐up of 55 (13–119) months, 5‐year PFS was 91% and 69% for PET ‐2‐negative and positive early‐ HL , respectively; 5‐year OS was 100% and 95%, respectively. For advanced‐ HL , the PFS was 81% and 68%, respectively ( P = 0·08); 5‐year OS was 98% and 91%, respectively. PET ‐2 positivity is associated with inferior prognosis in early‐ HL , even with additional ABVD and ISRT . Advanced‐ HL patients benefit from therapy escalation following positive PET ‐2. EB can be safely de‐escalated to ABVD in PET ‐2‐negative patients.
Type of Medium:
Online Resource
ISSN:
0007-1048
,
1365-2141
DOI:
10.1111/bjh.2017.178.issue-5
Language:
English
Publisher:
Wiley
Publication Date:
2017
detail.hit.zdb_id:
1475751-5
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