A risk-adapted, response-based approach using ABVE-PC for children and adolescents with intermediate- and high-risk Hodgkin lymphoma: The results of P9425

Cindy L. Schwartz, Louis S. Constine, Doojduen Villaluna, Wendy B. London, Robert E. Hutchison, Richard Sposto, Steven E. Lipshultz, Charles S. Turner, Pedro A. DeAlarcon, Allen Chauvenet

Research output: Contribution to journalArticle

131 Scopus citations

Abstract

Current treatment strategies for Hodgkin lymphoma result in excellent survival but often confer significant long-term toxicity. We designed ABVE-PC (doxorubicin, bleomycin, vincristine, etoposide, prednisone, cyclophosphamide) to (1) enhance treatment efficacy by dose-dense drug delivery and (2) reduce risk of long-term sequelae by response-based reduction of cumulative chemotherapy. Efficient induction of early response by dose-dense drug delivery supported an early-response-adapted therapeutic paradigm. The 216 eligible patients were younger than 22 years with intermediate-or high-risk Hodgkin lymphoma. ABVE-PC was administered every 21 days. Rapid early responders (RERs) to 3 ABVE-PC cycles received 21 Gy radiation to involved regions; RER was documented in 63% of patients. Slow early responders received 2 additional ABVE-PC cycles before 21 Gy radiation. Five-year event free-survival was 84%: 86% for the RER and 83% for the slow early responders (P = .85). Only 1% of patients had progressive disease. Five-year overall survival was 95%. With this regimen, cumulative doses of alkylators, anthracyclines, and epipodophyllotoxins are below thresholds usually associated with significant long-term toxicity. ABVE-PC is a dose-dense regimen that provides outstanding event-free survival/overall survival with short duration, early-response-adapted therapy. This trial was registered at www.clinicaltrials.gov as #NCT00005578.

Original languageEnglish (US)
Pages (from-to)2051-2059
Number of pages9
JournalBlood
Volume114
Issue number10
DOIs
StatePublished - 2009
Externally publishedYes

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Schwartz, C. L., Constine, L. S., Villaluna, D., London, W. B., Hutchison, R. E., Sposto, R., Lipshultz, S. E., Turner, C. S., DeAlarcon, P. A., & Chauvenet, A. (2009). A risk-adapted, response-based approach using ABVE-PC for children and adolescents with intermediate- and high-risk Hodgkin lymphoma: The results of P9425. Blood, 114(10), 2051-2059. https://doi.org/10.1182/blood-2008-10-184143