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Posted by on Jun 24, 2018 in Hodgkin's lymphoma | 0 comments

In a nutshell

This study investigated the effects of increasing the initial dose of chemotherapy in patients with classical Hodgkin’s lymphoma (cHL). The main finding was that it is necessary to assess each treatment plan based on the patient’s individual disease.

Some background

Chemotherapy plus stem cell transplant (SCT; meaning the transfer of stem cells) and radiation are common treatments for cHL. Event free survival (EFS – did not show a specific cancer symptom over a specific period of time), positron-emission tomography (PET – used to diagnose and monitor cancer) scanning and red blood cell sedimentation (blood test for inflammation) are commonly monitored in trials for new therapies/regimes for cHL Different doses and combinations of therapies have different effects in cHL. It is necessary to investigate the effects of different treatment strategies for cHL.

Methods & findings

Two hundred and seventy-eight patients with cHL were studied.  Patients who had received the minimum chemotherapy alone and that had reached remission (no signs of active cancer) were included. EFS and red blood cell sedimentation rate were monitored and PET scanning was carried out.

After 4 years, 49% of patients had received the minimum chemotherapy without radiation. Remission was achieved by 88.8% of patients without receiving high dose chemotherapy plus SCT or high dose radiation. Almost 100% of patients survived. Nearly 76% of patients with nodular sclerosis (a common type of cHL) were event free. A slow red blood cell sedimentation rate was linked to greater EFS. Negative PET scan results after 1 cycle of chemotherapy was linked with event free survival.

The bottom line

The study conlcuded that lower doses of chemotherapy were effective in patients who had negative PET scan results and slow red blood cell sedimentation. Higher doses of chemotherapy should be considered for patients with nodular sclerosis plus high ESR or positive PET scan results.

The fine print

Only patients up to the age of 21 were included in this study. Therefore the results may not be representative of patients over 21.

What’s next?

If you have questions about managing cHL, please ask your doctor.

Published By :

Cancer

Date :

May 08, 2018

Original Title :

Results of the AHOD0431 trial of response adapted therapy and a salvage strategy for limited stage, classical Hodgkin lymphoma: A report from the Children’s Oncology Group.

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