A phase II study of dose-dense and dose-intense ABVD (ABVDDD-DI) without consolidation radiotherapy in patients with advanced Hodgkin lymphoma

Filippo Russo, Gaetano Corazzelli, Ferdinando Frigeri, Gaetana Capobianco, Luigi Aloj, Francesco Volzone, Annarosaria De Chiara, Annamaria Bonelli, Tindaro Gatani, Gianpaolo Marcacci, Daniela Donnarumma, Cristina Becchimanzi, Elisabetta de Lutio, Franco Ionna, Rosaria De Filippi, Secondo Lastoria, Antonello Pinto

Research output: Contribution to journalArticlepeer-review

Abstract

We explored activity and safety of a dose-dense/dose-intense adriamycin, bleomycin, vinblastine and dacarbazine regimen (ABVDDD-DI) in 82 patients with advanced Hodgkin Lymphoma. Patients entered a two-stage Bryant-Day Phase II study to receive six cycles of ABVDDD-DI without consolidation radiotherapy. Cycles were supported with granulocyte colony-stimulating factor and delivered every 21 d; drugs were administered on days 1 and 11 at the same doses of standard ABVD except for doxorubicin (35 mg/m2; first four cycles only). Co-primary endpoints were complete response (CR) rate and severe acute cardiopulmonary toxicity; secondary endpoints were event-free (EFS) and disease-free survival (DFS). All patients received the four doxorubicin-intensified courses and 96% concluded all six cycles (82·3% within the intended 18 weeks). This translated into a 66·9% increase of received dose-intensity for doxorubicin and 31·8% for the other agents over standard ABVD. The CR rate was 95·1% (78/82) and 87·8% (72/82) achieved a metabolic CR after two cycles. Cardiopulmonary toxicity never exceeded grade 2 and affected 14·6% of patients. Most frequent toxicities were grade 4 neutropenia (10%) and anaemia (9%), grade 3 infection (17%) and grade 2 mucocutaneous changes (30%). Five-year EFS and DFS was 88·3% and 93·7%, respectively. ABVDDD-DI regimen was well-tolerated and ensured substantial CR and EFS rates without radiotherapy.

Original languageEnglish
Pages (from-to)118-129
Number of pages12
JournalBritish Journal of Haematology
Volume166
Issue number1
DOIs
Publication statusPublished - 2014

Keywords

  • ABVD
  • Dose intensity
  • Doxorubicin
  • Hodgkin lymphoma
  • Radiotherapy

ASJC Scopus subject areas

  • Hematology

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