DOI QR코드

DOI QR Code

Efficacy and Safety of First Line Vincristine with Doxorubicin, Bleomycin and Dacarbazine (ABOD) for Hodgkin's Lymphoma: a Single Institute Experience

  • Ozdemir, Nuriye (Department of Medical Oncology, Faculty of Medicine, Yildirim Beyazit University) ;
  • Dogan, Mutlu (Department of Medical Oncology, Ankara Numune Education and Research Hospital) ;
  • Sendur, Mehmet Ali Nahit (Department of Medical Oncology, Faculty of Medicine, Yildirim Beyazit University) ;
  • Yazici, Ozan (Department of Medical Oncology, Ankara Numune Education and Research Hospital) ;
  • Abali, Huseyin (Department of Medical Oncology, Hacettepe University Cancer Institute) ;
  • Yazilitas, Dogan (Department of Medical Oncology, Ankara Numune Education and Research Hospital) ;
  • Akinci, Muhammed Bulent (Department of Medical Oncology, Faculty of Medicine, Yildirim Beyazit University) ;
  • Aksoy, Sercan (Department of Medical Oncology, Faculty of Medicine, Adana Baskent University) ;
  • Zengi, Nurullah (Department of Medical Oncology, Ankara Numune Education and Research Hospital)
  • Published : 2014.11.06

Abstract

Background: ABVD (doxorubicin, bleomycin, vinblastine (Vb) and dacarbazine) is the standard regimen in Hodgkin's lymphoma (HL).Vincristine (O) is a mitotic spindle agent like Vb. We aimed to evaluate the efficacy and safety of O as a part of ABOD in HL. Materials and Methods: Patients who had ABOD were enrolled. Stage I-II HL were evaluated for unfavorable risk factors according to NCCN. National Cancer Institute Common Toxicity Criteria was used for toxicity. Results: Seventy-nine HL patients in our center between 2003 and 2007 were evaluated retrospectively. Median follow-up was 54 months. Most of the patients were male in their third decade. Median ABOD cycles were 6 (2-8). Primary refractory disease rate was 17.7% whereas it was 5.1% for early relapse and 5.1% for late relapse disease. Response rates were as 82.3% for complete response, 11.4% for partial response, 5.1% for stable disease and 1.3% for progressive disease. Half of relapsed patients had autologous stem cell transplantation. Estimated 5-year failure-free survival was 71% and significantly longer in early stage patients without risk factors, bulky disease or radiotherapy (RT) (p=0.05, p<0.0001, p=0.02; respectively). Estimated 5-year overall survival was 74% and significantly longer in those who had no RT (p=0.001). Dose modification rate was 5.1% and chemotherapy delay rate was 19%. There were no toxicity-related deaths. Conclusions: ABOD seems to be effective with managable toxicity in HL, even in those with poor prognostic factors.

Keywords

Hodgkin's lymphoma;chemotherapy;vincristine;prognostic factors

References

  1. Abu-Khalaf MM HL (2011). Antimicrotubule agents. In: DeVita VT, Lawrence TS, Rosenberg SA, Editors. Cancer Principles and Practice of Oncology. Philedelphia: Lippincott Williams and Wilkins. 413-21.
  2. Advani RH, Hoppe RT, Baer D, et al (2013). Efficacy of abbreviated Stanford V chemotherapy and involved-field radiotherapy in early-stage Hodgkin lymphoma: mature results of the G4 trial. Ann Oncol, 24, 1044-8. https://doi.org/10.1093/annonc/mds542
  3. Bonadonna G, Zucali R, Monfardini S, et al (1975). Combination chemotherapy of Hodgkin's disease with adriamycin, bleomycin, vinblastine, and imidazole carboxamide versus MOPP. Cancer, 36, 252-9. https://doi.org/10.1002/1097-0142(197507)36:1<252::AID-CNCR2820360128>3.0.CO;2-7
  4. Canellos GP, Anderson JR, Propert KJ, et al (1992). Chemotherapy of advanced Hodgkin's disease with MOPP, ABVD, or MOPP alternating with ABVD. N Engl J Med, 327, 1478-84. https://doi.org/10.1056/NEJM199211193272102
  5. Chakrabarti S, Sarkar S, Goswami BK, et al (2010). Hodgkin's and non-Hodgkin's lymphomas in an indian rural medical institution: comparative clinicopathologic analysis. Asian Pac J Cancer Prev, 11, 1605-8.
  6. Cullen MH, Stuart NS, Woodroffe C, et al (1994). ChlVPP/PABlOE and radiotherapy in advanced Hodgkin's disease. The Central Lymphoma Group. J Clin Oncol, 12, 779-87.
  7. Diehl V, Franklin J, Hasenclever D, et al (1998). BEACOPP, a new dose-escalated and accelerated regimen, is at least as effective as COPP/ABVD in patients with advanced-stage Hodgkin's lymphoma: interim report from a trial of the German Hodgkin's Lymphoma Study Group. J Clin Oncol, 16, 3810-21.
  8. Engert A, Diehl V, Franklin J, et al (2009). Escalated-dose BEACOPP in the treatment of patients with advanced-stage Hodgkin's lymphoma: 10 years of follow-up of the GHSG HD9 study. J Clin Oncol, 27, 4548-54. https://doi.org/10.1200/JCO.2008.19.8820
  9. Fatima S, Ahmed R, Ahmed A (2011). Hodgkin lymphoma in Pakistan: an analysis of subtypes and their correlation with Epstein Barr virus. Asian Pac J Cancer Prev, 12, 1385-8.
  10. Hancock BW, Gregory WM, Cullen MH, et al (2001). ChlVPP alternating with PABlOE is superior to PABlOE alone in the initial treatment of advanced Hodgkin's disease: results of a British National Lymphoma Investigation/Central Lymphoma Group randomized controlled trial. Br J Cancer, 84, 1293-300. https://doi.org/10.1054/bjoc.2001.1778
  11. Meyer RM, Gospodarowicz MK, Connors JM, et al (2005). Randomized comparison of ABVD chemotherapy with a strategy that includes radiation therapy in patients with limited-stage Hodgkin's lymphoma: National Cancer Institute of Canada Clinical Trials Group and the Eastern Cooperative Oncology Group. J Clin Oncol, 23, 4634-42. https://doi.org/10.1200/JCO.2005.09.085
  12. Meyer RM, Gospodarowicz MK, Connors JM, et al (2012). ABVD alone versus radiation-based therapy in limited-stage Hodgkin's lymphoma. N Engl J Med, 366, 399-408. https://doi.org/10.1056/NEJMoa1111961
  13. Viviani S, Zinzani PL, Rambaldi A, et al (2011). ABVD versus BEACOPP for Hodgkin's lymphoma when high-dose salvage is planned. N Engl J Med, 365, 203-12. https://doi.org/10.1056/NEJMoa1100340