Evaluating short-course ABVD chemotherapy in patients with early-stage Hodgkin lymphoma

This study evaluated the effectiveness of short-course (2 cycles) ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy with interim PET scanning in previously untreated patients with early-stage (stage 1 – 2) Hodgkin’s lymphoma (HL). This study concluded that short-course ABVD was effective in the majority of patients who had negative PET scan results (no signs of cancer).

The majority of patients with early-stage HL can receive effective treatment with radiation therapy, with or without chemotherapy. However, radiation therapy has been associated with late complications, such as secondary cancers and heart disease.

Previous studies have shown that ABVD chemotherapy alone can achieve good outcomes for these patients without radiotherapy. PET scanning during (interim) and after chemotherapy may help predict treatment outcomes and plan further treatments. The outcomes of patients with early-stage HL after ABVD chemotherapy remain under investigation.

This study involved 149 previously untreated patients with early-stage HL. Patients received 2 cycles of ABVD chemotherapy followed by PET scanning. Patients with negative PET scan results received 2 more cycles of ABVD. Patients with positive PET scan results received further treatments, including radiation. Patients were followed-up for an average of 3.8 years.

After ABVD chemotherapy, 91% of patients had negative PET scan results. 97% of the PET-negative and 85% of the PET-positive patients achieved a complete response (disappearance of all signs of cancer).

At follow-up, the 3-year progression-free survival (patients still alive 3 years later without disease progression; PFS) was 89%. PFS was significantly higher in the PET-negative group compared to the PET-positive group (91% vs. 66%). Positive PET scan results were associated with a 3.84-fold lower PFS.

This study concluded that short-course ABVD was effective in most patients with early-stage HL. This was true especially in patients who had negative PET scan results.

This was a Phase 2 study. Further studies are needed to determine the role of short-course ABVD chemotherapy in the treatment of newly diagnosed patients with early-stage HL.