The efficacy and tolerability of adriamycin, bleomycin, vinblastine, dacarbazine and Stanford V in older Hodgkin lymphoma patients: a comprehensive analysis from the North American intergroup trial E2496
Authors
Evens, AndrewHong, Fangxin
Gordon, Leo I.
Fisher, Richard I.
Bartlett, Nancy L.
Connors, Joseph M.
Gascoyne, Randy D.
Wagner, Henry
Gospodarowicz, Mary
Cheson, Bruce D.
Stiff, Patrick J.
Advani, Ranjana
Miller, Thomas P.
Hoppe, Richard T.
Kahl, Brad S.
Horning, Sandra J.
UMass Chan Affiliations
Department of Medicine, Division of Hematology/OncologyDocument Type
Journal ArticlePublication Date
2013-04-01Keywords
Age FactorsAged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
effects
Bleomycin
Dacarbazine
Doxorubicin
Etoposide
Female
Hematologic Diseases
Hodgkin Disease
Humans
Lung Diseases
Male
Mechlorethamine
Middle Aged
Neoplasm Staging
Prednisone
Survival Analysis
Treatment Outcome
Vinblastine
Vincristine
Clinical Epidemiology
Hematology
Hemic and Lymphatic Diseases
Oncology
Metadata
Show full item recordAbstract
There is a lack of contemporary prospective data examining the adriamycin, bleomycin, vinblastine, dacarbazine (ABVD) and Stanford V (SV; doxorubicin, vinblastine, mechlorethamine, vincristine, bleomycin, etoposide, prednisone) regimens in older Hodgkin lymphoma (HL) patients. Forty-four advanced-stage, older HL patients (aged >/=60 years) were treated on the randomized study, E2496. Toxicities were mostly similar between chemotherapy regimens, although 24% of older patients developed bleomycin lung toxicity (BLT), which occurred mainly with ABVD (91%). Further, the BLT-related mortality rate was 18%. The overall treatment-related mortality for older HL patients was 9% vs. 0.3% for patients aged (P < 0.001). Among older patients, there were no survival differences between ABVD and SV. According to age, outcomes were significantly inferior for older versus younger patients (5-year failure-free survival: 48% vs. 74%, respectively, P = 0.002; 5-year overall survival: 58% and 90%, respectively, P < 0.0001), although time-to-progression (TTP) was not significantly different (5-year TTP: 68% vs. 78%, respectively, P = 0.37). Furthermore, considering progression and death without progression as competing risks, the risk of progression was not different between older and younger HL patients (5 years: 30% and 23%, respectively, P = 0.30); however, the incidence of death without progression was significantly increased for older HL patients (22% vs. 9%, respectively, P < 0.0001). Altogether, the marked HL age-dependent survival differences appeared attributable primarily to non-HL events.Source
Br J Haematol. 2013 Apr;161(1):76-86. doi: 10.1111/bjh.12222. Epub 2013 Jan 29. Link to article on publisher's siteDOI
10.1111/bjh.12222Permanent Link to this Item
http://hdl.handle.net/20.500.14038/28810PubMed ID
23356491Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1111/bjh.12222