Journal
BLOOD
Volume 114, Issue 10, Pages 2051-2059Publisher
AMER SOC HEMATOLOGY
DOI: 10.1182/blood-2008-10-184143
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Funding
- Chair's [U10 CA98543]
- Statistics and Data Center [U10 CA98413]
- National Cancer Institute
- National Institutes of Health, Bethesda, MD
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Current treatment strategies for Hodgkin lymphoma result in excellent survival but often confer significant long-term toxicity. We designed ABVE-PC ( doxorubicin, bleomycin, vincristine, etoposide, prednisone, cyclophosphamide) to ( 1) enhance treatment efficacy by dose-dense drug delivery and ( 2) reduce risk of long-term sequelae by response-based reduction of cumulative chemotherapy. Efficient induction of early response by dose-dense drug delivery supported an early-response-adapted therapeutic para-digm. The 216 eligible patients were younger than 22 years with intermediateor high-risk Hodgkin lymphoma. ABVE-PC was administered every 21 days. Rapid early responders (RERs) to 3 ABVE-PC cycles received 21 Gy radiation to involved regions; RER was documented in 63% of patients. Slow early responders received 2 additional ABVE-PC cycles before 21 Gy radiation. Five-year event-free-survival was 84%: 86% for the RER and 83% for the slow early responders (P = .85). Only 1% of patients had progressive disease. Five-year overall survival was 95%. With this regimen, cumulative doses of alkylators, anthracyclines, and epipodophyllotoxins are below thresholds usually associated with significant long-term toxicity. ABVE-PC is a dose-dense regimen that provides outstanding event-free survival/overall survival with short duration, early-response-adapted therapy. This trial was registered at www.clinicaltrials.gov as #NCT00005578. (Blood. 2009; 114: 2051-2059)
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