TY - JOUR
T1 - Survival of pediatric Hodgkin lymphoma patients treated with doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide (ABVE-PC) versus doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) at a single institution
AU - de Armas, Sebastian
AU - Huertas-Ayala, Carolina
AU - Chan, Randall Y.
AU - Chi, Yueh Yun
AU - Huh, Winston W.
AU - Termuhlen, Amanda
AU - Gaynon, Paul S.
AU - Kovach, Alexandra E.
AU - Doan, Andrew
N1 - Publisher Copyright:
© 2022 Wiley Periodicals LLC
PY - 2022/5
Y1 - 2022/5
N2 - Background: Adriamycin, bleomycin, vinblastine, dacarbazine (ABVD), the de facto standard of care in adult-onset Hodgkin lymphoma (HL), has not been directly compared to doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide (ABVE-PC), a pediatric-aimed regimen designed to reduce late effects. We aimed to describe the single-institution experience of using both regimens in patients with pediatric HL. Methods: This retrospective cohort study evaluated a total of 224 patients diagnosed with HL between 1999 and 2018 at Children's Hospital Los Angeles (CHLA), of which 93 patients were eligible having received ABVD (n = 46) or ABVE-PC (n = 47) chemotherapy as their initial treatment. Descriptive analyses were performed using the Student's t-test or Fisher's exact test. Survival analysis used the Kaplan–Meier method. Events included death, relapse, and secondary malignancy. We also describe the use of radiation therapy, pulmonary toxicity, and cardiomyopathy determined by shortening fraction <29%. Analyses followed an intention-to-treat principle. Results: There was no difference in baseline characteristics between the patients receiving ABVE-PC or ABVD in regard for stage, risk group, or prognostic variables, such as the presence or absence of “B” symptoms, bulky disease, and extra-nodal involvement. A greater proportion of patients treated with ABVE-PC received consolidating external beam radiation treatment (XRT) either by randomization or by response compared to ABVD (59.6% vs. 32.6%, respectively, p =.01). While not statistically significant, response to therapy, assessed by positron emission tomography/computerized tomography (PET/CT) where available, mirrored the use for radiation (rapid response 58.3% vs. 90.0%, n = 34, p =.11). The median dose of anthracycline (doxorubicin) was the same in patients receiving ABVE-PC versus ABVD (200 vs. 200 mg/m2, interquartile range 200–250 vs. 200–300 mg/m2, p =.002). There was no difference in event-free survival (p =.63) or overall survival (p =.37) with a median follow-up length of 3.9 years. Conclusions: ABVD and ABVE-PC achieved similar survival outcomes in our single-institution cohort.
AB - Background: Adriamycin, bleomycin, vinblastine, dacarbazine (ABVD), the de facto standard of care in adult-onset Hodgkin lymphoma (HL), has not been directly compared to doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide (ABVE-PC), a pediatric-aimed regimen designed to reduce late effects. We aimed to describe the single-institution experience of using both regimens in patients with pediatric HL. Methods: This retrospective cohort study evaluated a total of 224 patients diagnosed with HL between 1999 and 2018 at Children's Hospital Los Angeles (CHLA), of which 93 patients were eligible having received ABVD (n = 46) or ABVE-PC (n = 47) chemotherapy as their initial treatment. Descriptive analyses were performed using the Student's t-test or Fisher's exact test. Survival analysis used the Kaplan–Meier method. Events included death, relapse, and secondary malignancy. We also describe the use of radiation therapy, pulmonary toxicity, and cardiomyopathy determined by shortening fraction <29%. Analyses followed an intention-to-treat principle. Results: There was no difference in baseline characteristics between the patients receiving ABVE-PC or ABVD in regard for stage, risk group, or prognostic variables, such as the presence or absence of “B” symptoms, bulky disease, and extra-nodal involvement. A greater proportion of patients treated with ABVE-PC received consolidating external beam radiation treatment (XRT) either by randomization or by response compared to ABVD (59.6% vs. 32.6%, respectively, p =.01). While not statistically significant, response to therapy, assessed by positron emission tomography/computerized tomography (PET/CT) where available, mirrored the use for radiation (rapid response 58.3% vs. 90.0%, n = 34, p =.11). The median dose of anthracycline (doxorubicin) was the same in patients receiving ABVE-PC versus ABVD (200 vs. 200 mg/m2, interquartile range 200–250 vs. 200–300 mg/m2, p =.002). There was no difference in event-free survival (p =.63) or overall survival (p =.37) with a median follow-up length of 3.9 years. Conclusions: ABVD and ABVE-PC achieved similar survival outcomes in our single-institution cohort.
KW - ABVD
KW - ABVE-PC
KW - Hodgkin lymphoma
KW - pediatric
UR - http://www.scopus.com/inward/record.url?scp=85125804871&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85125804871&partnerID=8YFLogxK
U2 - 10.1002/pbc.29601
DO - 10.1002/pbc.29601
M3 - Article
C2 - 35187850
AN - SCOPUS:85125804871
SN - 1545-5009
VL - 69
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
IS - 5
M1 - e29601
ER -