In a nutshell
This study examined whether the number of chemotherapy agents in the combination ABVD could be reduced when treating Hodgkin lymphoma. The authors concluded that to be effective all four chemotherapies need to be included.
Some background
More than 80% of patients with early-stage, favorable Hodgkin lymphoma experience long-term remission (no sign of cancer) after treatment. The main treatment option for early-stage favorable disease is combination chemotherapy and radiation. These treatments can lead to many negative effects, including some many years after treatment.
Studies have shown that decreasing the intensity of chemotherapies still leads to a good response, but with fewer side effects. It is not known whether the number of chemotherapies can be reduced.
Methods & findings
The current study examined whether treatment with fewer chemotherapy agents was effective in early-stage favorable Hodgkin lymphoma. This study included 1502 patients. 556 were treated with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine). 198 were treated with ABV (the dacarbazine was left out). 571 were treated with AVD (the bleomycin was left out). 167 were treated with AV (both bleomycin and dacarbazine were left out). All patients were also treated with radiation. Patients were followed for 52-84 months.
After 5 years, the freedom from treatment failure rate was 93.1% for the ABVD group. It was 81.4% for the ABV group, 89.2% in the AVD group, and 77.1% in the AV group.
Complete remission (no sign of disease) rates were 97.2% with ABVD and 98.1% with AVD. These rates were lower with ABV (95.5%) and AV (88.6%).
Severe side effects occurred in 33% of ABVD and from 26% to 28% in the other groups. The most common negative effect was a decrease in the number of white blood cells.
The bottom line
This study concluded that omitting bleomycin or dacarbazine led to a decrease in effectiveness.
Published By :
Lancet (London, England)
Date :
Apr 11, 2015
