Details

Autor(en) / Beteiligte

• ARAKELYAN, Nina
• BERTHOU, Christian
• DESABLENS, Bernard
• DE GUIBERT, Sophie
• DELWAIL, Vincent
• MOLES, Marie-Pierre
• QUITTET, Philippe
• JAIS, Jean-Philippe
• COLONNA, Pierre
• ANDRIEU, Jean-Marie

Titel

Early Versus Late Intensification for Patients With High-Risk Hodgkin Lymphoma-3 Cycles of Intensive Chemotherapy Plus Low-Dose Lymph Node Radiation Therapy Versus 4 Cycles of Combined Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine Plus Myeloablative Chemotherapy With Autologous Stem Cell Transplantation Five-Year Results of a Randomized Trial on Behalf of the GOELAMS Group

Ist Teil von

• Cancer, 2008-12, Vol.113 (12), p.3323-3330

Ort / Verlag

Hoboken, NJ: Wiley-Blackwell

Erscheinungsjahr

2008

Quelle

Wiley Online Library - AutoHoldings Journals

Beschreibungen/Notizen

• The 5-year freedom from treatment failure (FFTF) rate, with treatment failure defined as the lack of post-treatment complete remission (CR), recurrence, or death, ranges from 60% to 70% after 6 to 8 cycles of combined doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD), which is the reference treatment for patients with advanced Hodgkin lymphoma (HL). In this randomized, phase 2 study, the authors tested 2 intensive chemotherapy regimens in 158 patients with clinical stage (CS) IIB through IV HL accompanied by high-risk factors who were recruited between May 1997 and December 2004. High-risk CS IIB, III, and IV were defined by the presence of > or =5 involved lymphoid areas, and/or a mediastinal mass ratio > or =0.45, and/or > or =2 extra lymph node sites affected by the disease (for CS IV). In Arm V, 82 patients received 3 courses of combined vindesine (5 mg/m(2)), doxorubicin (99 mg/m(2)), carmustine (140 mg/m(2)), etoposide (600 mg/m(2)), and methylprednisolone (600 mg/m(2)) (VABEM) followed by low-dose lymph node irradiation. In Arm A, 76 patients received 4 cycles of ABVD followed by myeloablative combined carmustine (300 mg/m(2)), etoposide (800 mg/m(2)), cytarabine (1600 mg/m(2)), and melphalan (140 mg/m(2)) and underwent autologous stem cell transplantation. After 3 cycles of VABEM, the CR rate was 89% versus 60% after 4 cycles of ABVD. However, after the completion of treatment, the CR rates for Arms V and A were similar (89% and 88%, respectively). The 5-year FFTF rates for Arms V and A also were similar (79% and 75%, respectively) along with the 5-year overall survival rates (87% and 86%, respectively). Early intensification (Arm V) and late intensification (Arm A) were equally effective for treating patients with high-risk/advanced HL.