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International Journal of Clinical Pharmacy

, Volume 37, Issue 6, pp 1033–1037 | Cite as

De-escalation chemotherapy and hematological profiles in patients with advanced Hodgkin’s lymphoma

  • Antoine Seignez
  • Olivier Casasnovas
  • Emmanuelle Ferrant
  • Jean Noel Bastie
  • Pauline Mondoloni
  • Ludwig Serge Aho
  • Mathieu BoulinEmail author
Short Research Report

Abstract

Background There is a need to develop treatment strategies that are less toxic than BEACOPPescalated x6 cycles, the standard-of-care in advanced Hodgkin’s lymphoma patients. Objective To compare short-term hematological toxicity in advanced Hodgkin’s lymphoma patients treated with either BEACOPPescalated x6 cycles (standard group) or BEACOPPescalated x2 followed by ABVD x4 cycles (experimental group). Method In 27 patients, we compared injections of erythropoiesis stimulating agent and granulocyte colony-stimulating factor, transfusions, hospitalization days, as well as hemoglobin, platelet, leukocyte levels. Method In 27 patients, we compared injections of erythropoiesis stimulating agent and granulocyte colony-stimulating factor, transfusions, hospitalization days, as well as hemoglobin, platelet, leukocyte levels. Results The mean number of erythropoiesis stimulating agent and granulocyte colony-stimulating factor injections, platelet transfusions and hospitalization days was significantly lower in the experimental group (erythropoiesis stimulating agents: mean difference −6.6 ± 2.4, p = 0.005; granulocyte colony-stimulating factors: mean difference −8.3 ± 3.6, p = 0.020, platelet transfusions: mean difference −0.6 ± 0.3, p = 0.035; hospitalization days: mean difference: −8.5 ± 1.7 days, p < 10−3). There were no differences in terms of red cell transfusions, platelet counts or leukocyte levels between the two groups. From the 3rd chemotherapy cycle, hemoglobin levels decreased to a significantly lesser extent in the experimental group. Conclusion We demonstrated an overall better short-term hematological profile in advanced Hodgkin’s lymphoma patients who received a de-escalation chemotherapy regimen with significant differences mainly in terms of hemoglobin levels, erythropoiesis stimulating agent injections, and hospitalization days.

Keywords

ABVD Advanced Hodgkin’s lymphoma BEACOPPescalated Chemotherapy Hematological toxicity 

Abbreviations

ABVD

Doxorubicin 25 mg/m2 (days 1 and 15), bleomycin 10 mg/m2 (days 1 and 15), vinblastine 6 mg/m2 (days 1 and 15), and dacarbazine 375 mg/m2 (days 1 and 15), repeated on day 29

AE

Adverse event

aHL

Advanced Hodgkin’s lymphoma

BEACOPPesc

Bleomycin 10 mg/m2 (day 8), etoposide 200 mg/m2 (days 1–3), doxorubicin 35 mg/m2 (day 1), cyclophosphamide 1250 mg/m2 (day 1), vincristine 1.4 mg/m2 (day 8 maximum, 2 mg), procarbazine 100 mg/m2 (days 1–7), and prednisone 40 mg/m2 (days 1–14), repeated on day 22

EG

Experimental group

ESA

Erythropoiesis stimulating agent

G-CSF

Granulocyte colony-stimulating factor

PET

Positron emission tomography

SG

Standard group

Notes

Acknowledgments

We think Philip Bastable for his kind proofreading and Pierrick Pastore for his help in data collection.

Funding

No funding was received for the study.

Conflicts of interest

The authors have no conflicts of interest to declare.

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Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2015

Authors and Affiliations

  • Antoine Seignez
    • 1
    • 2
  • Olivier Casasnovas
    • 3
  • Emmanuelle Ferrant
    • 3
  • Jean Noel Bastie
    • 2
    • 3
  • Pauline Mondoloni
    • 4
  • Ludwig Serge Aho
    • 5
  • Mathieu Boulin
    • 4
    • 6
    Email author
  1. 1.Department of Immunology and Internal MedicineUniversity HospitalDijonFrance
  2. 2.Inserm U866University of BurgundyDijonFrance
  3. 3.Department of HematologyUniversity HospitalDijonFrance
  4. 4.Department of PharmacyUniversity HospitalDijonFrance
  5. 5.Department of Hospital Hygiene and EpidemiologyUniversity HospitalDijonFrance
  6. 6.EA4184University of BurgundyDijonFrance

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