High-risk, advanced-stage hodgkin lymphoma: The impact of combined escalated BEACOPP and ABVD treatment in patients who rapidly achieve metabolic complete remission on interim FDG-PET/CT scan

Meirav Kedmi, Arie Apel, Tima Davidson, Itai Levi, Eldad J. Dann, Aaron Polliack, Isaac Ben-Bassat, Arnon Nagler, Abraham Avigdor

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

The escalated BEACOPP (escBEACOPP) regimen improves the outcome of patients with advanced-stage Hodgkin lymphoma (HL) but is associated with cumbersome toxicity. We analyzed the survival outcome of high-risk, advanced-stage HL patients treated with response-adapted therapy. escBEACOPP was administered for 2 cycles, and after complete remission (CR) or partial remission (PR) was observed on FDG-PET/CT, treatment was de-escalated to 4 cycles of ABVD. Sixty-nine patients were evaluated, of them 45 participated in the multicenter, phase II prospective study between 2001 and 2007. Sixty patients had an international prognostic score ≥3. At a median follow-up of 5.6 years, 4 patients had died, 2 of them due to advanced HL. After the initial 2 cycles of escBEACOPP, 52 (75%) patients were in CR and 17 (25%) had a PR. Progression-free survival and overall survival (OS) were 79 and 93%, respectively. OS was predicted from the results of early-interim FDG-PET/CT: 98% of the patients in CR and 79% of those with a PR (p = 0.015). Hematological toxicity was more frequent during the first 2 cycles of escBEACOPP than in the ABVD phase. In conclusion, this retrospective analysis indicates that combined escBEACOPP-ABVD therapy is well tolerated and efficacious in HL patients who achieve negative early-interim PET results, while a positive PET result partially identified those with a worse prognosis.

Original languageEnglish
Pages (from-to)156-161
Number of pages6
JournalActa Haematologica
Volume135
Issue number3
DOIs
StatePublished - 1 Mar 2016
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2015 S. Karger AG, Basel.

Keywords

  • ABVD
  • Escalated BEACOPP
  • FDG-PET/CT
  • Hodgkin lymphoma

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