Evaluating combined modality treatment for young adults with Hodgkin lymphoma

This study determined the safety and effectiveness of combined modality treatment for young adults with classical Hodgkin lymphoma (cHL). This study concluded that this treatment approach was well-tolerated and effective for these patients.

Chemotherapy regimens for pediatric patients with cHL are different from regimens given to adult patients. For children, combined modality treatment (CMT) is used. CMT combines chemotherapy with radiation therapy. OEPA (vincristine, etoposide, prednisolone, doxorubicin) and COPP (cyclophosphamide, vincristine, procarbazine, prednisolone) are two regimens usually given to children. Whether these regimens are safe and effective in young adults with cHL is unclear.

This study had 47 young adults with cHL. Patients were divided into three groups. 16 patients received 2 cycles of OEPA with or without radiation. 11 patients received 2 cycles of OEPA and COPP plus radiation. 18 patients received 2 cycles of OEPA, 4 cycles of COPP, and radiation. The average follow-up period was 3.3 years.

Overall, all patients responded to treatment. 40% of patients had no signs of cancer after treatment. 20 – 40% of patients had tumor shrinkage.

1 year later, 91% of patients were still alive without signs of cancer. 28 patients had negative PET scan results after treatment, indicating no signs of cancer. None of these patients experienced relapse (cancer recurrence) within 1 year.

41% of patients had mild neuropathy (numbness or tingling in the limbs, hands, or feet). 11% of patients reported serious neuropathy. Mild cases of this side effect were resolved within an average of 74 days. Serious neuropathy was resolved within an average of 91 days. 1 patient reported persistent mild neuropathy.

83% of patients reported seriously low white blood cell count. 56% of patients had side effects from radiation therapy.

This study found that CMT with pediatric-style chemotherapy is effective for young adults with cHL. 

This study had a small number of patients, which may bias these results. Whether the CMT used in this study is also effective in adults with cHL is unclear.