ABVD treatment and lung toxicity in older Hodgkin lymphoma patients

This study examined the safety and effectiveness of ABVD chemotherapy in older patients with Hodgkin lymphoma. The study concluded that ABVD was effective in older patients, but may need some modifications.

Roughly 20% of Hodgkin lymphoma patients are over the age of 60. Older patients are treated with the same therapies as younger patients, but do not respond as well. This could be due to the number of other diseases in an older patient, or due to toxicities from chemotherapy.

There is no standard care specifically for older patients. Prior studies have suggested that four cycles of ABVD chemotherapy (doxorubicin, bleomycin, vinblastine, dacarbazine), the standard for younger patients, led to increased negative effects. Lung toxicity due to bleomycin is very common in older patients. It is not clear whether ABVD is safe and effective in older patients.

This study examined the effects of ABVD chemotherapy treatment in older Hodgkin lymphoma patients. The records of 147 patients were included. All patients were treated with ABVD. Patients were followed for 58 months.

38.1% needed to have their ABVD treatment schedule modified. 36% had bleomycin reduced or removed due to lung toxicity. 42.8% experienced severe side effects, including lung problems and low levels of different types of blood cells.

The 5-year overall survival (time from treatment until death from any cause) was 67%. 51 patients died. 14% of deaths were due to lung problems.

This study concluded that ABVD was effective in older patients, but led to an increase in lung toxicities. The authors suggested that bleomycin be reduced or removed from ABVD treatment in older adults.