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ABVD Late Effects

Bastian von Tresckow, Stefanie Kreissl, Helen Goergen, Paul J Bröckelmann, Thomas Pabst, Michael Fridrik, Mathias Rummel, Wolfram Jung, Julia Thiemer, Stephanie Sasse, Carolin Bürkle, Christian Baues, Volker Diehl, Andreas Engert, Peter Borchmann
BACKGROUND: Although intensified chemotherapy regimens have improved tumour control and survival in advanced-stage Hodgkin's lymphoma, data on the long-term sequelae are scarce. We did preplanned follow-up analyses of the German Hodgkin Study Group (GHSG) trials HD9 and HD12 to assess whether the primary results of these trials-which had shown that intensive initial therapy in advanced-stage Hodgkin's lymphoma has a beneficial effect on treatment outcomes-would continue with longer follow-up...
October 2018: Lancet Haematology
Elliot Stieglitz, Tu Dinh, Andrew S Phelps, Miguel H Pampaloni, Adam B Olshen, Elizabeth Robbins
Hodgkin lymphoma (HL) is the most common malignancy affecting adolescents and young adults. Treatment with a combination of chemotherapy and radiation results in cure rates of >90%. However, radiation therapy causes significant late effects and avoiding radiation entirely for patients who respond to chemotherapy is an accepted strategy. Since 2011, 28 consecutive patients diagnosed with classic HL have been treated with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) for 4 to 6 cycles. Patients who achieved a complete metabolic response (CMR) as assessed by [F] fluorodeoxyglucose positron emission tomography by the end of chemotherapy did not receive radiation...
May 2018: Journal of Pediatric Hematology/oncology
Carlo Materazzo, Maura Massimino, Elisabetta Schiavello, Marta Podda, Lorenza Gandola, Graziella Cefalo, Serena Catania, Cristina Meazza, Ivan Moschetti, Monica Terenziani
PURPOSE: Cardiac late effects are responsible for a significant burden of mortality and morbidity among pediatric Hodgkin's lymphoma (HL) survivors (HLS). The aim of our study was to assess clinical and subclinical cardiac sequelae in a cohort of childhood HLS treated in the 1980s with doxorubicin, bleomycin, vinblastine, and dacarbazine (the ABVD regimen) and limited-field radiotherapy (RT). METHODS: We retrospectively examined a series of HLS treated from 1979 to 1989...
November 23, 2017: Tumori
Ádám Jóna, Zsófia Miltényi, Szilárd Póliska, Bálint László Bálint, Árpád Illés
BACKGROUND: Bleomycin hydrolase (BLMH), an enzyme that inactivates bleomycin, may be a potential candidate that could influence pulmonary function in ABVD (doxorubicin, bleomycin, vinblastin, dacarbasine)-treated Hodgkin lymphoma (HL) patients. PATIENTS AND METHODS: We hypothesized that the BLMH gene SNP A1450G (rs1050565) influences BLMH activity and late pulmonary toxicity. St. George Respiratory Questionnaire, lung scintigraphy and spirometry were used to determine lung function...
2016: PloS One
Patrice Carde, Matthias Karrasch, Catherine Fortpied, Pauline Brice, Hussein Khaled, Olivier Casasnovas, Denis Caillot, Isabelle Gaillard, Serge Bologna, Christophe Ferme, Pieternella Johanna Lugtenburg, Frank Morschhauser, Igor Aurer, Bertrand Coiffier, Ralph Meyer, Matthew Seftel, Max Wolf, Bengt Glimelius, Anna Sureda, Nicolas Mounier
PURPOSE: To compare patients with high-risk stage III to IV Hodgkin lymphoma (HL) in the phase III European Organisation for Research and Treatment of Cancer 20012 Intergroup trial (Comparison of Two Combination Chemotherapy Regimens in Treating Patients With Stage III or Stage IV Hodgkin's Lymphoma) who were randomly assigned to either doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) or to bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP)...
June 10, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Sandeep Jain, Gauri Kapoor, Ram Bajpai
BACKGROUND: As Hodgkin lymphoma (HL) is a highly curable malignancy, most current pediatric trials focus on strategies aimed at reducing late effects of therapy. We report our results with doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) therapy. PROCEDURE: We retrospectively analyzed 17 years (1996-2013) data of patients ≤18 years of age with HL. All patients received ABVD chemotherapy and involved field radiotherapy (IFRT) was reserved for those with bulky disease or partial response...
June 2016: Pediatric Blood & Cancer
Ali H Algiraigri, Mohammed F Essa
Even though more than 90% of adolescents with low-risk classical Hodgkin lymphoma (LRcHL) will be cured with first-line therapy, many will suffer serious late toxic effects from radiotherapy (RT). The goals for care have shifted toward minimizing late toxic effects without compromising the outstanding cure rates by adapting a risk and response-based therapy. Recent published and ongoing randomized clinical trials, using functional imaging, may allow for better identification of those patients for whom RT may be safely omitted while maintaining excellent cure rates...
March 2016: Journal of Adolescent and Young Adult Oncology
Rachna Seth, Rashmi Ranjan Das, Kirti Puri, Prashant Singh
INTRODUCTION: Optimal treatment strategy in children with advance stage Hodgkin Lymphoma (HL) still remains controversial. AIM: To evaluate the clinical profile and the efficacy of chemotherapy (CT) as a treatment modality in paediatric HL. MATERIAL AND METHODS: Retrospective case record evaluation of paediatric HL cases over 5 years (October 2005 to October 2010) period. RESULTS: Thirty five cases (31 boys) with a median age of eight years were studied...
November 2015: Journal of Clinical and Diagnostic Research: JCDR
Emanuele Cencini, Alberto Fabbri, Luigi Rigacci, Stefano Lazzi, Guido Gini, Maria Christina Cox, Salvatrice Mancuso, Elisabetta Abruzzese, Sofia Kovalchuk, Gaia Goteri, Arianna Di Napoli, Roberto Bono, Stefano Fratoni, Simonetta Di Lollo, Alberto Bosi, Lorenzo Leoncini, Monica Bocchia
In Hodgkin Lymphoma (HL), about 20% of patients still have relapsed/refractory disease and late toxic effects rate continue to rise with time. 'Early FDG-PET' and tissue macrophage infiltration (TAM) emerged as powerful prognostic predictors. The primary endpoint was to investigate the prognostic role of both early FDG-PET and TAM; the secondary endpoint was to test if early FDG-PET positivity could correlate with high TAM score. A cohort of 200 HL patients was analysed. Induction treatment plan consisted of two to six courses of ABVD and, if indicated, involved field radiation therapy...
March 2017: Hematological Oncology
Jordan A Torok, Yuan Wu, Leonard R Prosnitz, Grace J Kim, Anne W Beaven, Louis F Diehl, Chris R Kelsey
PURPOSE: The German Hodgkin Study Group (GHSG) trial HD11 established 4 cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) and 30 Gy of radiation therapy (RT) as a standard for early stage (I, II), unfavorable Hodgkin lymphoma (HL). Additional cycles of ABVD may allow for a reduction in RT dose and improved toxicity profile. METHODS AND MATERIALS: Patients treated with combined modality therapy at the Duke Cancer Institute for early stage, unfavorable HL by GHSG criteria from 1994 to 2012 were included...
May 1, 2015: International Journal of Radiation Oncology, Biology, Physics
Luca Castagna, Carmelo Carlo-Stella, Rita Mazza, Armando Santoro
Classical Hodgkin lymphoma (cHL) is a relatively rare disease, with approximately 9,200 estimated new cases and 1,200 estimated deaths per year in the United States. First-line chemo-radiotherapy leads to cure rates approaching 80% in patients with advanced-stage disease. However, 25 to 30% of these patients are not cured with chemotherapy alone (i.e., the ABVD regimen) and show either primary refractoriness to chemotherapy, early disease relapse or late disease relapse. Second-line salvage high-dose chemotherapy (HDC) and autologous stem cell transplantation (SCT) have an established role in the management of refractory/relapsed cHL, leading to durable responses in approximately 50% of relapsed patients and a minority of refractory patients...
2015: Mediterranean Journal of Hematology and Infectious Diseases
Nuriye Ozdemir, Mutlu Dogan, Mehmet Ali Nahit Sendur, Ozan Yazici, Huseyin Abali, Dogan Yazilitas, Muhammed Bulent Akinci, Sercan Aksoy, Nurullah Zengin
BACKGROUND: ABVD (doxorubicin, bleomycin, vinblastine (Vb) and dacarbazine) is the standard regimen in Hodgkin's lymphoma (HL).Vincristine (O) is a mitotic spindle agent like Vb. We aimed to evaluate the efficacy and safety of O as a part of ABOD in HL. MATERIALS AND METHODS: Patients who had ABOD were enrolled. Stage I-II HL were evaluated for unfavorable risk factors according to NCCN. National Cancer Institute Common Toxicity Criteria was used for toxicity. RESULTS: Seventy-nine HL patients in our center between 2003 and 2007 were evaluated retrospectively...
2014: Asian Pacific Journal of Cancer Prevention: APJCP
Anthony J Swerdlow, Rosie Cooke, Andrew Bates, David Cunningham, Stephen J Falk, Dianne Gilson, Barry W Hancock, Sarah J Harris, Alan Horwich, Peter J Hoskin, David C Linch, Andrew Lister, Helen H Lucraft, John Radford, Andrea M Stevens, Isabel Syndikus, Michael V Williams
BACKGROUND: Modern treatment of Hodgkin's lymphoma (HL) has transformed its prognosis but causes late effects, including premature menopause. Cohort studies of premature menopause risks after treatment have been relatively small, and knowledge about these risks is limited. METHODS: Nonsurgical menopause risk was analyzed in 2127 women treated for HL in England and Wales at ages younger than 36 years from 1960 through 2004 and followed to 2003 through 2012. Risks were estimated using Cox regression, modified Poisson regression, and competing risks...
September 2014: Journal of the National Cancer Institute
Ádám Jóna, Zsófia Miltényi, Zsófia Ujj, Ildikó Garai, Mária Szilasi, Árpád Illés
INTRODUCTION: Survival of Hodgkin lymphoma (HL) patients has significantly improved in recent decades. The current first-line therapy is doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) ± irradiation and may cause pulmonary toxicity. Strategies to reduce late toxicity as well as increase survival rate are of interest. PATIENTS AND METHODS: Pulmonary function of previously treated HL patients was collected over a 12-month period using St. George Respiratory Questionnaire (SGRQ), chest X-ray, dynamic inhalation lung scintigraphy and spirometry...
October 2014: Expert Opinion on Drug Safety
Dennis A Eichenauer, Andreas Engert
Hodgkin lymphoma (HL) is a B cell-derived lymphoid malignancy most often affecting young adults. More than 80% of HL patients achieve long-term remission after appropriate first-line treatment consisting of multiagent chemotherapy and/or radiotherapy (RT). In addition, approximately 50% of patients with disease recurrence remain relapse-free after salvage therapy with high-dose chemotherapy followed by autologous stem cell transplantation (ASCT). However, patients with multiple relapses are mostly in a palliative situation, and novel drugs for this patient group are needed...
July 2014: European Journal of Haematology
Minh-Phuong Huynh-Le, Amanda J Walker, Scott Duke Kominers, Ido Paz-Priel, Moody D Wharam, Stephanie A Terezakis
BACKGROUND: Involved field radiation therapy (IFRT) is integral in curative therapy for Hodgkin lymphoma (HL), although primarily used in patients with intermediate/high-risk HL. We present failure patterns and clinical outcomes in a cohort of pediatric and young adult patients with HL treated with IFRT at the Johns Hopkins Hospital. PROCEDURE: Patients ≤40 years old with intermediate/high-risk HL who received chemotherapy and IFRT from 1997 to 2012 were included in this retrospective analysis...
July 2014: Pediatric Blood & Cancer
Stephen M Ansell
The goal of therapy for patients with advanced-stage Hodgkin lymphoma is to ensure that as many patients as possible are healthy and free of disease decades after completing treatment. To achieve this, the treating physician needs to select the most effective therapeutic regimen, but also needs to choose a treatment strategy that limits long-term toxicity. One approach to achieve this is to use a less intense combination, such as ABVD chemotherapy, as initial treatment and intensify therapy only in those patients who do not become PET negative or who subsequently relapse...
February 2014: Hematology/oncology Clinics of North America
Marc P E André
Combination chemoradiotherapy achieves excellent results for the treatment of localized Hodgkin lymphoma. However, late toxic effects occur, mostly related to the radiotherapy administered after the standard adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy. The most serious sequelae are radiation-induced secondary cancers. Reducing radiotherapy has not yet prevented late malignancies. However, when radiotherapy was omitted, tumor control was inferior, with more relapses necessitating rescue treatment including high-dose chemotherapy with stem cell support...
February 2014: Hematology/oncology Clinics of North America
A E Hay, B Klimm, B E Chen, H Goergen, L E Shepherd, M Fuchs, M K Gospodarowicz, P Borchmann, J M Connors, J Markova, M Crump, A Lohri, J N Winter, B Dörken, R G Pearcey, V Diehl, S J Horning, H T Eich, A Engert, R M Meyer
BACKGROUND: Treatment options for patients with nonbulky stage IA-IIA Hodgkin lymphoma include combined modality therapy (CMT) using doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) plus involved-field radiation therapy (IFRT), and chemotherapy with ABVD alone. There are no mature randomized data comparing ABVD with CMT using modern radiation techniques. PATIENTS AND METHODS: Using German Hodgkin Study Group HD10/HD11 and NCIC Clinical Trials Group HD...
December 2013: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Nancy L Bartlett
Approximately 90% of patients with early-stage Hodgkin lymphoma (HL) will be cured with first-line therapy. Chemotherapy alone or combined-modality therapy are both acceptable standard treatment options for nonbulky early-stage HL. Combined-modality therapy is associated with more serious late effects and, in at least one study, showed inferior survival rates compared with chemotherapy alone. Modern radiotherapy fields and doses are likely to result in fewer complications, but given the common involvement of the mediastinum in HL, complete avoidance of the heart, lungs, and breasts in the radiotherapy field is unlikely...
2013: American Society of Clinical Oncology Educational Book
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