Moderate Dose Escalation for Advanced Stage Hodgkin’s Disease Using the Bleomycin, Etoposide, Adriamycin, Cyclophosphamide, Vincristine, Procarbazine, and Prednisone Scheme and Adjuvant Radiotherapy: A Study of the German Hodgkin’s Lymphoma Study Group

Tesch, Hans; Diehl, Volker; Lathan, B.; Hasenclever, Dirk; Sieber, M.; Rüffer, U.; Engert, Andreas; Franklin, Jeremy; Pfreundschuh, Michael; Schalk, K. P.; Schwieder, G; Wulf, Gerburg M.; Dölken, Gottfried; Worst, P.; Koch, P.; Schmitz, N.; Bruntsch, U; Tirier, C.; Müller, Udo; Loeffler, Markus

doi:10.1182/blood.v92.12.4560.424k07_4560_4567

Cited by 8 publications

(12 citation statements)

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“…In particular, those regimens consisting of multiple and rapidly successive cycles can show considerable cumulative toxicities. In an ongoing randomized phase III multicentre trial of the German Hodgkin's Study Group the newly developed multicycle polychemotherapy regimen BEACOPP for treatment of advanced Hodgkin's disease is being tested in a standard‐dose variant against a dose‐intensified variant with G‐CSF support (Tesch et al , 1998; Diehl et al , 1998a). A recent interim analysis showed an increased efficicacy of the intensified variant compared to the standard variant (Diehl et al , 1998b).…”

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Endogenous thrombopoietin serum levels during multicycle chemotherapy

et al. 1999

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Summary.Little is known about the behaviour of endogenous thrombopoietin (TPO) serum levels during rapid sequences of dose-intensified chemotherapy. To characterize the relationship between TPO levels and platelet counts in this setting we serially measured both parameters over the entire treatment period of patients receiving multicycle polychemotherapy. We found TPO and platelet responses to be generally antagonistic through all cycles. However, a cross-correlation analysis indicated that TPO responses preceded platelet responses by approximately one day in all patients. The cumulative severity of thrombocytopenia observed over successive cycles was accompanied by an increasing TPO response which tended to grow overproportionally in relation to the degree of peripheral thrombocytopenia. These findings are consistent with a model suggesting that both platelet and megakaryocyte mass contribute to a receptor-dependent consumption process regulating the endogenous TPO level. In order to develop optimal schedules for exogenous TPO administration it might be important to consider endogenous TPO response characteristics.

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Endogenous thrombopoietin serum levels during multicycle chemotherapy

et al. 1999

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“…Actualmente es factible curar cerca del 90% de las formas iniciales y más del 70% de las formas avanzadas. Para poder alcanzar estos objetivos es muy importante, al igual que lo comentado anteriormente con los LNH, efectuar un diagnóstico correcto de la enfermedad, un estadiaje clínico [18][19][20] lo más exacto posible, así como una planificación terapéutica adaptada al riesgo de recaída que tenga en cuenta todos y cada uno de los FP que hayan demostrado valor predictivo independiente 18,19 , de cara a conseguir curar el mayor número de pacientes con la menor toxicidad en las formas de buen pronóstico y aplicar en las formas de mal pronóstico la terapéutica más eficaz, asumiendo la toxicidad necesaria, pero de la forma más precoz posible para que la conjunción tiempo y tratamiento permitan obtener el mejor resultado [21][22][23] .…”

Section: Factores Pronósticos En La Ehunclassified

“…Los criterios pronósticos para valorar el riesgo de recaída y como consecuencia de ello para establecer tratamientos de diferente agresividad 18,[20][21][22][23] , no pueden limitarse actualmente a los estadios clínicos. Por tal motivo han surgido en los últimos años nuevas variables con implicaciones pronósticas en la EH, que al igual que lo comentado para los LNH, pueden ser clasificadas según la relación que mantienen con el paciente, el proceso o el tratamiento y la respuesta al mismo (Tabla 6) o a su vez según la naturaleza del FP en sí mismo considerado (Tabla 7).…”

Section: Factores Pronósticos En La Ehunclassified

“…En resumen, la estadificación pronóstica de las neoplasias hematológicas según los FP de riesgo de recidiva, representa un factor de primer orden en la orientación del tratamiento 16,[18][19][20][21][22][23]27,28,[32][33][34] tanto al diagnóstico como en las recaídas así como en la determinación de la repuesta y supervivencia tanto libre de enfermedad como global. Sin embargo, su realización ya no se circunscribe al tipo y subtipo histopatológico y al estadio clínico, sino que precisa de la integración de todos y cada uno de los FP previamente comentados, con lo que se constituye en una actividad clínica hoy por hoy compleja que debe de ser realizada de manera previa a toda valoración terapéutica.…”

Section: Conclusionesunclassified

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Prognostic factors in lymphomas: non-Hodgkin’s lymphomas and Hodgkin’s lymphoma

Rabasa¹

2009

An Sist Sanit Navar

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La patología tumoral linfoide, que incluye tanto los linfomas no hodgkinianos como el linfoma de Hodgkin, representa un grupo muy heterogéneo de neoplasias que tienen en común su origen en la proliferación de células linfoides detenidas en diferentes etapas de su desarrollo madurativo. Así pues, se incluyen dentro de los linfomas enfermedades muy distintas desde el punto de vista histológico, clínico y evolutivo, que precisan de tratamientos que dependen en gran medida de la agresividad del linfoma y deben ajustarse al riesgo que presenta cada enfermo en concreto. Para valorar dicho riesgo resulta imprescindible conocer el pronóstico aproximado de los pacientes, en función de una serie de variables iniciales y evolutivas que se relacionan con el tipo de respuesta al tratamiento y la supervivencia: son los factores pronósticos. Palabras clave: Linfoma no Hodgkin. Enfermedad de Hodgkin. Factores pronósticos.

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“…In order to further improve treatment results, the same drugs at higher doses and with a shorter time-interval and with growth factor support (BEACOPP-escalated) have been tested in 60 patients (83). With a short follow-up (median 32 months), freedom from treatment failure and overall survival were 90 and 91%, respectively.…”

Section: Recommended Chemotherapy Regimensmentioning

confidence: 99%

A Systematic Overview of Chemotherapy Effects in Hodgkin's Disease

Brandt

2001

Acta Oncologica

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A systematic review of chemotherapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for the evaluation of the scienti c literature are described separately (Acta Oncol 2001; 40: 155-65). This synthesis of the literature on chemotherapy for Hodgkin's disease (HD) is based on 113 scienti c reports including four meta-analyses, 44 randomised studies, 18 prospective studies and 40 retrospective studies. These studies involve 69 196 patients. The conclusions reached can be summarised into the following points: Chemotherapy is of utmost importance for the cure of HD. At early stages, extended eld radiotherapy cures most patients. For the majority of patients with relapse after radiotherapy, chemotherapy is curative and the total proportion of cured early stage patients is 75-90%. Chemotherapy in addition to extended eld radiotherapy reduces recurrences but does not improve long-term survival. In early stage HD with a large mediastinal mass and:or with systemic symptoms, combined treatment with chemotherapy and radiotherapy is recommended. It is likely that chemotherapy will play a greater role in the future in the treatment also of early stage patients in order to reduce late consequences from extended eld radiotherapy. However, this conclusion remains to be better documented in the literature. At advanced stages, chemotherapy or a combination of chemotherapy and limited eld radiotherapy are effective treatment options and, using the regimens available 10-20 years ago, 40-50% of the patients are cured. Based upon more favourable short-term (three to eight years) results of more recently developed regimens, it can be expected that today a higher proportion of the patients will become long-term survivors. Several chemotherapy regimens containing four to eight drugs are effective in HD. The best regimen considering both antitumour activity and acute and late side-effects is not known. The choice of regimen is probably best done after considering various pre-treatment factors such as the number of poor prognostic signs, concomitant diseases and individual preferences. The results of chemotherapy are more favourable in young than in elderly patients. The development of less toxic but still effective treatment programmes is therefore particularly important for the elderly. High dose chemotherapy with stem cell support is presently often used in patients who are chemotherapy induction failures, who relapse after a short initial remission or after a longer initial remission and treated initially with seven or eight drugs, or who have had multiple relapses. However, this use is based on data from uncontrolled or small controlled studies, not being fully convincing with respect to effect on survival. Persistent side-effects of treatment are common among long-term survivors, although most patients have an apparently normal life. The relative contributions of chemotherapy and radiotherapy to the persistent effects are not well documented.

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Moderate Dose Escalation for Advanced Stage Hodgkin’s Disease Using the Bleomycin, Etoposide, Adriamycin, Cyclophosphamide, Vincristine, Procarbazine, and Prednisone Scheme and Adjuvant Radiotherapy: A Study of the German Hodgkin’s Lymphoma Study Group

Cited by 8 publications

References 26 publications

Endogenous thrombopoietin serum levels during multicycle chemotherapy

Endogenous thrombopoietin serum levels during multicycle chemotherapy

Prognostic factors in lymphomas: non-Hodgkin’s lymphomas and Hodgkin’s lymphoma

A Systematic Overview of Chemotherapy Effects in Hodgkin's Disease

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