In a nutshell
The current study examined the use of VEPEMB chemotherapy in Hodgkin lymphoma patients 60 years or older. This study determined that VEPEMB was safe and effective in in older patients with few other health problems. This study also demonstrated that patients who saw a complete remission with VEPEMB (no sign of cancer) were more likely to see continuing remission (period without disease).
Some background
While Hodgkin lymphoma occurs more commonly in young adults, it can also occur in older adults (over 60). Older patients may not be able to tolerate the same chemotherapies used in younger patients. These treatments can lead to higher levels of toxicity (negative side effects) in older patients. Studies are examining modified chemotherapy regimens that may be more tolerable.
VEPEMB is a combination of the chemotherapies vinblastine, cyclophosphamide, prednisolone, procarbazine, etoposide, mitoxantrone, and bleomycin. It is not clear whether this chemotherapy option is safe or effective in older adults.
Methods & findings
This study examined the use of VEPEMB in Hodgkin lymphoma patients 60 years or older. 175 patients were included in the study. The frailty of patients was measured based on the number and severity of other health problems. 103 patients who were considered non-frail were treated with VEPEMB. 72 patients who were considered to be frail were treated however their doctor saw fit. Patients were followed for an average of 3 years.
31 patients treated with VEPEMB had early-stage disease (stage I or II without symtoms such as fever, weight loss, or night sweats). 74% of these patients saw a complete remission with treatment. Three-year overall survival (time from treatment until death from any cause) was 81%. Three-year progression-free survival (time from treatment until disease progression) was 74%.
72 patients has advanced disease (stage III or IV or those with other risk factors). 61% saw a complete remission with VEPEMB. Three-year overall survival was 66.2%. Three-year progression-free survival was 58%.
Of the patients who achieved a complete remisison, 13% of the early-stage and 5% of the advanced stage experienced disease progression.
Three patients died due to sepsis (blood infection). The most common severe side effects were sepsis (15.5%) and low levels of different types of blood cells (12.6%).
The bottom line
This study concluded that VEPEMB was safe and effective in non-frail, older Hodgkin lymphoma patients.
Published By :
Blood
Date :
Jun 21, 2012
