Evaluating A+AVD chemotherapy for patients with early-stage Hodgkin lymphoma

This study evaluated the effectiveness and safety of a modified chemotherapy regimen for patients with early-stage Hodgkin lymphoma (HL). This study concluded that this regimen was effective but associated with more side effects.

The most commonly used frontline chemotherapy regimen for HL is ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine). However, bleomycin is associated with serious lung side effects. Brentuximab vedotin (Adcetris) replaces bleomycin in a regimen called A+AVD.

Brentuximab vedotin is a monoclonal antibody. This type of treatment binds the cancer cell, leading to cancer cell death. The safety and effectiveness of the A+AVD regimen for patients with early-stage HL remain under investigation.

This study had 34 patients with early-stage HL. All patients were treated with 2 cycles of brentuximab vedotin only. Then, patients received 4 cycles of A+AVD. Patients were followed-up for an average of 38 months.

After initial treatment with brentuximab vedotin alone, 52.9% of patients had a complete disappearance of all signs of cancer. After 2 cycles of A+AVD therapy, this rate was 97.1%. At the end of treatment, 91.2% of all patients had a complete disappearance of all signs of cancer.

Overall, 97% of patients were still alive 3 years later. 94% of patients were still alive 3 years later without tumor growth or spread.

The most common side effect was numbness or tingling in the hands or feet (79%). 44% of patients still had this side effect at follow-up. Low white blood cell count (76%), tiredness (74%), and nausea (71%) were also reported.

62% of patients had severely low white blood cell count, with 35% of patients having this condition with fever. After treatment with a G-CSF (granulocyte colony-stimulating growth factor), this rate decreased to 6 out of 23 patients (26%). G-CSF treatment helps increase low white blood cell levels. 38% of patients needed a lower dose of brentuximab vedotin due to side effects.

This study concluded that A+AVD was effective for patients with early-stage HL. The authors suggest that long-lasting side effects from this treatment may affect the quality of life for these patients.

This was a small phase 2 study. More studies are needed to confirm these results.