CALGB 50604: Risk-adapted treatment of nonbulky early-stage Hodgkin lymphoma based on interim PET Academic Article uri icon

Overview

MeSH Major

  • Antineoplastic Agents
  • Colitis
  • Colon
  • Intestinal Mucosa
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Lymphoma, Non-Hodgkin
  • Protein Kinase Inhibitors
  • Purines
  • Quinazolinones

abstract

  • © 2018 by The American Society of Hematology. A negative interim positron emission tomography/computerized tomography (PET/CT) after 1 to 3 cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in patients with newly diagnosed, nonbulky stage I or II Hodgkin lymphoma (HL) predicts a low relapse rate. This phase 2 trial was designed to determine if a population of patients with early-stage disease can be treated with short-course ABVD without radiation therapy (RT) on the basis of a negative interim PET/CT, thereby limiting the risks of treatment. Between 15 May 2010 and 21 February 2013, 164 previously untreated patients with nonbulky stage I/II HL were enrolled, and 149 were included in the final analysis. Patients received 2 cycles of ABVD followed by PET. Deauville scores 1 to 3 were negative (£ liver uptake) based on central review. PET2patients received 2 more cycles of ABVD, and PET1patients received 2 cycles of dose-intense bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (escalated BEACOPP) plus 3060-cGy involved-field RT. The primary objective was to determine 3-year progression-free survival (PFS) for the PET2group. One hundred thirty-five patients (91%) were interim PET2, and 14 patients (9%) were PET1. With median follow-up time of 3.8 years, the estimated 3-year PFS was 91% for the PET2group and 66% for the PET1group (hazard ratio, 3.84; 95% confidence interval, 1.50-9.84; P 5 .011). There was 1 death as a result of suicide. Four cycles of ABVD resulted in durable remissions for a majority of patients with early-stage nonbulky HL and a negative interim PET.

publication date

  • September 6, 2018

Research

keywords

  • Academic Article

Identity

Language

  • eng

PubMed Central ID

  • PMC6128083

Digital Object Identifier (DOI)

  • 10.1182/blood-2018-01-827246

PubMed ID

  • 30049811

Additional Document Info

start page

  • 1013

end page

  • 1021

volume

  • 132

number

  • 10