Randomized Comparison of ABVD and MOPP/ABV Hybrid for the Treatment of Advanced Hodgkin’s Disease: Report of an Intergroup Trial

Duggan, David B.; Petroni, Gina R.; Johnson, Jeffrey L.; Glick, John H.; Fisher, Richard I.; Connors, Joseph M.; Canellos, George P.; Peterson, Bruce A.

doi:10.1200/jco.2003.12.086

Cited by 445 publications

(251 citation statements)

References 20 publications

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“…Three groups have reported the results based on the use of brief exposure to ABVD followed by irradiation for clinical stage IA or IIA non-bulky HL [47], [48] and [49]. The results from these studies favour this approach in minimising the risks for later infertility, premature menopause, leukaemia as well as cardiopulmonary toxicity [50] and [51].…”

Section: Limitedmentioning

confidence: 99%

“…Here chemotherapy alone has emerged as optimum [50] and [51]. Specifically protocol ABVD given on schedule, without delay and no growth factor support regardless of the absolute neutrophil count on the day of treatment, is advocated.…”

Section: Advancedmentioning

confidence: 99%

“…Emergence of secondary acute leukaemia is strongly associated with the use of alkylating chemotherapy as well as mechlorethamine, which is one component of the MOPP regimen [50]. Since these regimens, having poor survival [79] and [83], are less used there has been fall in the incidence of this late effect [83] and [84].…”

Section: Long-term Complicationsmentioning

confidence: 99%

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Human immunodeficiency and Hodgkin lymphoma

Sissolak

Jacobs

2010

Transfusion and Apheresis Science

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Presentation of Hodgkin lymphoma (HL) is distinctive in the infected individual being more advanced, accompanied by B symptoms and the presence of extranodal disease particularly lymphadenopathy of the head and neck. Bone marrow involvement may be found in over 50% of cases. Virtually all co express gamma-herpesvirus. Phenotypically there is prominence of the mixed-cellularity and lymphocyte depleted histopathologic subtypes that define an aggressive clinical course in comparison to other variants. Prior to the induction of cART, median survival was only 1-2 years. Notably the first chemotherapy trial using ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) in 21 patients, without treating the viral infection, resulted in a 43% complete remission rate accompanied by severe haematological toxicities but did not extend median survival with this being 1.5 years matching the negative cases.Significant change accompanied concomitant anti-retroviral therapy that could be given safely even with dose intensive regimens exemplified by BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) in 12 patients or the Stanford V regimen (doxorubicin, vinblastine, mechlorethamine, etoposide, vincristine, bleomycin, prednisone) coupled with involved-field radiation for bulky disease studied in 59 patients. BEACOPP extended overall survival (OS) to 83% at 2 years. A similar trend was seen 1 when using the Stanford V regimen with an OS rate of 51% at 3 years, disease-free survival (DFS) of 68% and freedom from progression (FFP) in 60%. Additional benefits accrued from supportive care with stimulatory peptides such as G-CSF and when combined with bacterial prophylaxis results approached that found in the uninfected reference group. Current consensus holds this particular lymphoma as still among the non-AIDS defining cancers being lung, stomach, liver or anal despite these having recently gained more attention as several of these neoplasms may be occurring more commonly in the era of cART.While the relative risk of developing a non-AIDS-defining neoplasm in HIV-infected persons on the average is 2-3 times, the risk for developing HL in HIV-infected cases impressively ranges between 5 and 25 times when compared to the general population. Based on the precedent in which Kaposi sarcoma and the non-Hodgkin lymphomas distinctively alter the course of this retroviral infection in a way indistinguishable from concurrent Hodgkin lymphoma we propose that this entity be similarly regarded and the hypothesis tested in large randomised prospective study.

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Section: Limitedmentioning

confidence: 99%

Section: Advancedmentioning

confidence: 99%

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Human immunodeficiency and Hodgkin lymphoma

Sissolak

Jacobs

2010

Transfusion and Apheresis Science

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“…Two further studies compared the MOPP/ABVD hybrid regimen to MOPP chemotherapy alternating with ABVD and these regimens were found to have equivalent outcomes [7,8]. When the MOPP/ABVD hybrid regimen was then compared to ABVD chemotherapy, patients receiving ABVD chemotherapy had a better outcome with less toxicity [9]. Overall, these results showed superiority for ABVD chemotherapy and ABVD chemotherapy became the treatment of choice for patients with Hodgkin lymphoma.…”

Section: Initial Chemotherapy Approachesmentioning

confidence: 95%

Hodgkin lymphoma: MOPP chemotherapy to PD‐1 blockade and beyond

Ansell

2015

American J Hematol

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Hodgkin lymphoma is a rare lymphoid malignancy affecting~9,200 new patients in the United States annually. Progress in the management of this disease over the past 50 years has been remarkable and the prognosis of this malignancy has changed from a uniformly fatal process to one in which the vast majority of patients are expected to be cured. This remarkable progress has been due to the use of combination approaches incorporating chemotherapy and radiation therapy, and now more recently antibody-drug conjugates and immune checkpoint inhibitors. The goal for the future is to develop treatment combinations that successfully treat all patients and markedly decrease the long-term side effects.

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“…Most patients with Hodgkin Lymphoma (HL) are cured by primary chemotherapy, typically adriamycin, bleomycin, vincristine, dacarbazine (ABVD) with or without involved field radiotherapy [1]. However, 10-20% of patients, especially those with advanced stage or bulky disease, will be refractory to first-line therapy or will relapse [2].…”

Section: Introductionmentioning

confidence: 99%

Intermediate dose gemcitabine–cisplatin combination chemotherapy without treatment delay for cytopenia followed by autografting—a new standard of care in relapsed or refractory Hodgkin lymphoma?

Todd

Raj²,

Camilleri³

et al. 2009

Ann Hematol

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Ten percent to 20% of patients with Hodgkin Lymphoma (HL) are refractory to first-line therapy or relapse. Existing salvage regimens have response rates of 60-85%, considerable toxicity and frequent treatment delay or dose reduction. We report a gemcitabine, cisplatin, and dexamethasone regimen (GemCis) with intensive growth factor and platelet support and no treatment delay. Seventeen patients with relapsed or refractory biopsy proven HL were treated. Toxicity, transfusion requirement, stem cell harvesting and engraftment data were collected. Response assessment was by computed tomography and positron emission tomography. Overall and complete response rates were high (94% and 65%, respectively). There were no episodes of febrile neutropenia, treatment delays or hospital admissions. All 15 patients intended for autograft were successfully harvested. All engrafted successfully with a median time for the entire group to neutrophil engraftment of 14 days. With a median followup of 22 months, the median survival has not yet been reached, and the estimated 2-year survival is 88%. GemCis is a well-tolerated outpatient regimen for relapsed/ refractory Hodgkin lymphoma which does not inhibit stem cell mobilisation, gives excellent response rates and compares favourably with previously published salvage regimens using these or other chemotherapy agents.

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Randomized Comparison of ABVD and MOPP/ABV Hybrid for the Treatment of Advanced Hodgkin’s Disease: Report of an Intergroup Trial

Abstract: ABVD and the MOPP/ABV hybrid are effective therapies for Hodgkin's disease. MOPP/ABV is associated with a greater incidence of acute toxicity, MDS, and leukemia. ABVD should be considered the standard regimen for treatment of advanced Hodgkin's disease.

Cited by 445 publications

References 20 publications

Human immunodeficiency and Hodgkin lymphoma

Human immunodeficiency and Hodgkin lymphoma

Hodgkin lymphoma: MOPP chemotherapy to PD‐1 blockade and beyond

Intermediate dose gemcitabine–cisplatin combination chemotherapy without treatment delay for cytopenia followed by autografting—a new standard of care in relapsed or refractory Hodgkin lymphoma?

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