In a nutshell
This study aimed to evaluate the long-term effectiveness and safety of high-dose chemotherapy (HDC) for the treatment of patients with unfavorable Hodgkin lymphoma (HL).
The authors concluded that HDC increased the control of the disease in the long-term.
Some background
HDC with radiotherapy is a standard treatment of HL. 4 cycles of the ABVD regimen (doxorubicin, bleomycin, vinblastine, dacarbazine) has long been the standard HDC combination for HL. However, patient outcomes could be improved.
Other HDC regimens are currently being tested to find the best long-term HDC programs. An alternative treatment includes an intensified regimen including 2 cycles of BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) paired with 2 cycles of ABVD (2+2). However, the long-term safety and effectiveness of this combination regimen remain uncertain.
Methods & findings
This study recruited 1686 patients with HL. 847 received 4 cycles of ABVD and 837 received 2 cycles of BEACOPP and 2 cycles of ABVD (2+2). Both groups also received radiotherapy. The average follow-up period was 10 years.
After 10 years, 94.1% of both groups were alive. However, significantly more patients treated with 2+2 were alive without cancer worsening after 10 years (91.2%) compared to the ABVD group (85.6%). The 2+2 regimen was associated with a 50% lower risk of cancer worsening. The risk of a second cancer at 10 years was small and similar in both groups (2.3% – ABVD and 2.5% – 2+2).
The bottom line
The authors concluded that the BEACOPP and ABVD combined regimen (2+2) was safe and had improved long-term outcomes in patients with HL.
The fine print
This study does not contain information on long-term organ toxicity outcomes.
Published By :
The Lancet. Haematology
Date :
Apr 01, 2021
