De-escalation chemotherapy and hematological profiles in patients with advanced Hodgkin’s lymphoma
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.
KeywordsABVD Advanced Hodgkin’s lymphoma BEACOPPescalated Chemotherapy Hematological toxicity
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
Advanced Hodgkin’s lymphoma
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
Erythropoiesis stimulating agent
Granulocyte colony-stimulating factor
Positron emission tomography
We think Philip Bastable for his kind proofreading and Pierrick Pastore for his help in data collection.
No funding was received for the study.
Conflicts of interest
The authors have no conflicts of interest to declare.
- 2.Federico M, Luminari S, Iannitto E, Polimeno G, Marcheselli L, Montanini A, et al. ABVD compared with BEACOPP compared with CEC for the initial treatment of patients with advanced Hodgkin’s lymphoma: results from the HD2000 Gruppo Italiano per lo Studio dei Linfomi Trial. J Clin Oncol. 2009;27:805–11.CrossRefPubMedGoogle Scholar