Chemoresistance as a function of the pretherapy tumor burden and the chemotherapy regimen administered: Differences observed with 2 current chemotherapy regimens for advanced hodgkin lymphoma

Paolo G. Gobbi, Francesco Valentino, Emilio Bassi, Chiara Coriani, Francesco Merli, Valeria Bonfante, Alfonso Marchianò, Andrea Gallamini, Silvia Bolis, Caterina Stelitano, Alessandro Levis, Massimo Federico, Francesco Angrilli, Giuseppe Di Giulio, Gino R. Corazza

Research output: Contribution to journalArticle

Abstract

Chemoresistance can be disclosed by incomplete response or early relapse. The tumor burden of Hodgkin lymphoma was assessed in 115 patients treated with ABVD and 107 with BEACOPP and demonstrated to be the best predictor of resistance. For the same tumor burden ABVD has higher risk of resistance than BEACOPP and it should be considered in the choice of treatments. Background: The mature results from trials comparing ABVD (Adriamycin [doxorubicin], bleomycin, vinblastine, dacarbazine) and BEACOPP (bleomycin, etoposide, Adriamycin [doxorubicin], cyclophosphamide, Oncovin [vincristine], procarbazine, prednisone) chemotherapies in advanced Hodgkin lymphoma will be available in some years. An early comparison of their curative potential can however be obtained from an assessment of initial tumor burden and chemoresistance. Patients and Methods: Less than a complete remission after treatment and relapse occurring within 12 months thereafter were assumed to be clinical expressions of chemoresistance. The tumor burden was calculated from the measurements of all the lesions documented by staging computed tomography (CT) and was normalized to body surface area to give the relative tumor burden (rTB). Using logistic regression analysis, the relationship between initial rTB, chemoresistance, and chemotherapy regimen administered was retrospectively studied in 222 patients selected from those enrolled in 2 similar randomized trials. Results: The median rTB volumes were 157.9 cm 3/m 2 in the 115 patients treated with ABVD vs. 154.6 cm 3/m 2 in the 107 patients treated with BEACOPP, and the distribution of the volumes was identical in the 2 groups. The rTB was confirmed as the best predictor of early treatment failures (22 less than complete responses plus 21 early relapses). For the same rTB, the risk of chemoresistance to BEACOPP was about half that of the chemoresistance to ABVD or, for a given risk of chemoresistance, BEACOPP cured patients with an rTB 89.1 cm 3/m 2 greater than that cured by ABVD (ie, more than 50% of the median tumor load of patients with advanced-stage disease). Conclusion: This account of rTB allows an early comparative evaluation of the curative ability of different chemotherapy regimens.

Original languageEnglish
Pages (from-to)396-402
Number of pages7
JournalClinical Lymphoma, Myeloma and Leukemia
Volume11
Issue number5
DOIs
Publication statusPublished - Oct 2011

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Keywords

  • Chemoresistance
  • Chemotherapy
  • Hodgkin lymphoma
  • Tumor burden

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology
  • Medicine(all)

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