RESULTS AND OUTCOME WITH ABVD-PLATINE PROTOCOL IN HODGKIN LYMPHOMA WITH BULKY MEDIASTINAL INVOLVEMENT
(Abstract release date: 05/19/16)
EHA Library. Hamladji R. 06/09/16; 132693; E1144
Prof. R-M Hamladji
Contributions
Contributions
Abstract
Abstract: E1144
Type: Eposter Presentation
Background
Mediastinal lymph node involvement can be large in 50 – 60% of Hodgkin lymphoma ( HD ) wich may be discovered on imaging in asymptomatic patients ( pts ) or pts with respiratory signs or chest pain. Bulky form is defined as a mediastinal mass exceeding one third of the maximum transverse thoracic diameter on standard chest X-Ray at the level of 5th and 6th thoracic vertebra = mediastinal tumor ratio (MDR) ≥ 35.
Aims
We report the results of 179 HD with bulky mediastinal treated by ABVD-Platine protocol.
Methods
Over a period of 9 years (2004 – 2012), 341 pts / 674 (50,6 %) with HD had mediastinal involvement with bulky’s one in 200 (58,6%), median MTR = 0,43 (0 -35- 0,80) among them 179 were treated with ABVD-P : median age 25 years (11 – 64), sex ratio 1,03. The most frequent revealing symptom was lymphadenopathy (51%), fonctionnal respiratory signs (23%) and superior cava vein syndrome in 5 pts. The histopathologic patterns are nodular sclerosis (65%), mixed cellularity (28 %) lymphocyte depleted 06 pts or predominant 1 pt and unclassified 5 pts. The clinical Ann Arbor staging was stage II : 53%, stage III 32% and stade IV 15%. According to prognostic score GHSG (German Hodgkin Lymphoma Study Group) : 18 pts (10 %) were in intermediate stage and 161 (90 %) in advanced stage. The protocol treatment is ABVD with platine 30 mg/m2 D2, D3 and D16, D17) monthly : 3 cycles for stage II, 4 for stage III and IV. After chemotherapy (CT), 122 pts received radiotherapy (RT), 24 pts high dose CT (HDC) with autologous stem cell transplantation(ASCT) and 25 pts were followed after CT alone. At december 2015, the median follow-up is 98 months (39 – 143)
Results
After CT, 177pts / 179 are evaluable, the overall response (OR) is 96,6% with 32,2% in complete remission (CR) and 64,4% partial remission (PR),6 pts are in failure treatment. At term follow-up 158 pts are alive, among them 155 CR, 3 relapse and 19 died. The overall (OS) and event free (EFS) actuarial survival are 90% and 83% respectively at 8 years. Among the 171 pts in response after CT : 122 pts with CT-RT, 24 pts with CT-ASCT and 25 pts followed after CT alone, the OS were 94,8%, 71,6%, 77,4% respectively and EFS 93,8%,46,8% and 49,7%.
Conclusion
The protocol ABVD-Platine in HD with bulky mediastinal involvement allowed good results in association with RT better than in association with CT-ASCT (p<0,001), but no with CT alone (p=0,08) on OS. Concerning EFS the association CT-RT is better than CT-ASCT and CT alone p<10-8)
Session topic: E-poster
Keyword(s): Autograft, Chemotherapy, Hodgkin's lymphoma, Radiotherapy
Type: Eposter Presentation
Background
Mediastinal lymph node involvement can be large in 50 – 60% of Hodgkin lymphoma ( HD ) wich may be discovered on imaging in asymptomatic patients ( pts ) or pts with respiratory signs or chest pain. Bulky form is defined as a mediastinal mass exceeding one third of the maximum transverse thoracic diameter on standard chest X-Ray at the level of 5th and 6th thoracic vertebra = mediastinal tumor ratio (MDR) ≥ 35.
Aims
We report the results of 179 HD with bulky mediastinal treated by ABVD-Platine protocol.
Methods
Over a period of 9 years (2004 – 2012), 341 pts / 674 (50,6 %) with HD had mediastinal involvement with bulky’s one in 200 (58,6%), median MTR = 0,43 (0 -35- 0,80) among them 179 were treated with ABVD-P : median age 25 years (11 – 64), sex ratio 1,03. The most frequent revealing symptom was lymphadenopathy (51%), fonctionnal respiratory signs (23%) and superior cava vein syndrome in 5 pts. The histopathologic patterns are nodular sclerosis (65%), mixed cellularity (28 %) lymphocyte depleted 06 pts or predominant 1 pt and unclassified 5 pts. The clinical Ann Arbor staging was stage II : 53%, stage III 32% and stade IV 15%. According to prognostic score GHSG (German Hodgkin Lymphoma Study Group) : 18 pts (10 %) were in intermediate stage and 161 (90 %) in advanced stage. The protocol treatment is ABVD with platine 30 mg/m2 D2, D3 and D16, D17) monthly : 3 cycles for stage II, 4 for stage III and IV. After chemotherapy (CT), 122 pts received radiotherapy (RT), 24 pts high dose CT (HDC) with autologous stem cell transplantation(ASCT) and 25 pts were followed after CT alone. At december 2015, the median follow-up is 98 months (39 – 143)
Results
After CT, 177pts / 179 are evaluable, the overall response (OR) is 96,6% with 32,2% in complete remission (CR) and 64,4% partial remission (PR),6 pts are in failure treatment. At term follow-up 158 pts are alive, among them 155 CR, 3 relapse and 19 died. The overall (OS) and event free (EFS) actuarial survival are 90% and 83% respectively at 8 years. Among the 171 pts in response after CT : 122 pts with CT-RT, 24 pts with CT-ASCT and 25 pts followed after CT alone, the OS were 94,8%, 71,6%, 77,4% respectively and EFS 93,8%,46,8% and 49,7%.
Conclusion
The protocol ABVD-Platine in HD with bulky mediastinal involvement allowed good results in association with RT better than in association with CT-ASCT (p<0,001), but no with CT alone (p=0,08) on OS. Concerning EFS the association CT-RT is better than CT-ASCT and CT alone p<10-8)
Session topic: E-poster
Keyword(s): Autograft, Chemotherapy, Hodgkin's lymphoma, Radiotherapy
Abstract: E1144
Type: Eposter Presentation
Background
Mediastinal lymph node involvement can be large in 50 – 60% of Hodgkin lymphoma ( HD ) wich may be discovered on imaging in asymptomatic patients ( pts ) or pts with respiratory signs or chest pain. Bulky form is defined as a mediastinal mass exceeding one third of the maximum transverse thoracic diameter on standard chest X-Ray at the level of 5th and 6th thoracic vertebra = mediastinal tumor ratio (MDR) ≥ 35.
Aims
We report the results of 179 HD with bulky mediastinal treated by ABVD-Platine protocol.
Methods
Over a period of 9 years (2004 – 2012), 341 pts / 674 (50,6 %) with HD had mediastinal involvement with bulky’s one in 200 (58,6%), median MTR = 0,43 (0 -35- 0,80) among them 179 were treated with ABVD-P : median age 25 years (11 – 64), sex ratio 1,03. The most frequent revealing symptom was lymphadenopathy (51%), fonctionnal respiratory signs (23%) and superior cava vein syndrome in 5 pts. The histopathologic patterns are nodular sclerosis (65%), mixed cellularity (28 %) lymphocyte depleted 06 pts or predominant 1 pt and unclassified 5 pts. The clinical Ann Arbor staging was stage II : 53%, stage III 32% and stade IV 15%. According to prognostic score GHSG (German Hodgkin Lymphoma Study Group) : 18 pts (10 %) were in intermediate stage and 161 (90 %) in advanced stage. The protocol treatment is ABVD with platine 30 mg/m2 D2, D3 and D16, D17) monthly : 3 cycles for stage II, 4 for stage III and IV. After chemotherapy (CT), 122 pts received radiotherapy (RT), 24 pts high dose CT (HDC) with autologous stem cell transplantation(ASCT) and 25 pts were followed after CT alone. At december 2015, the median follow-up is 98 months (39 – 143)
Results
After CT, 177pts / 179 are evaluable, the overall response (OR) is 96,6% with 32,2% in complete remission (CR) and 64,4% partial remission (PR),6 pts are in failure treatment. At term follow-up 158 pts are alive, among them 155 CR, 3 relapse and 19 died. The overall (OS) and event free (EFS) actuarial survival are 90% and 83% respectively at 8 years. Among the 171 pts in response after CT : 122 pts with CT-RT, 24 pts with CT-ASCT and 25 pts followed after CT alone, the OS were 94,8%, 71,6%, 77,4% respectively and EFS 93,8%,46,8% and 49,7%.
Conclusion
The protocol ABVD-Platine in HD with bulky mediastinal involvement allowed good results in association with RT better than in association with CT-ASCT (p<0,001), but no with CT alone (p=0,08) on OS. Concerning EFS the association CT-RT is better than CT-ASCT and CT alone p<10-8)
Session topic: E-poster
Keyword(s): Autograft, Chemotherapy, Hodgkin's lymphoma, Radiotherapy
Type: Eposter Presentation
Background
Mediastinal lymph node involvement can be large in 50 – 60% of Hodgkin lymphoma ( HD ) wich may be discovered on imaging in asymptomatic patients ( pts ) or pts with respiratory signs or chest pain. Bulky form is defined as a mediastinal mass exceeding one third of the maximum transverse thoracic diameter on standard chest X-Ray at the level of 5th and 6th thoracic vertebra = mediastinal tumor ratio (MDR) ≥ 35.
Aims
We report the results of 179 HD with bulky mediastinal treated by ABVD-Platine protocol.
Methods
Over a period of 9 years (2004 – 2012), 341 pts / 674 (50,6 %) with HD had mediastinal involvement with bulky’s one in 200 (58,6%), median MTR = 0,43 (0 -35- 0,80) among them 179 were treated with ABVD-P : median age 25 years (11 – 64), sex ratio 1,03. The most frequent revealing symptom was lymphadenopathy (51%), fonctionnal respiratory signs (23%) and superior cava vein syndrome in 5 pts. The histopathologic patterns are nodular sclerosis (65%), mixed cellularity (28 %) lymphocyte depleted 06 pts or predominant 1 pt and unclassified 5 pts. The clinical Ann Arbor staging was stage II : 53%, stage III 32% and stade IV 15%. According to prognostic score GHSG (German Hodgkin Lymphoma Study Group) : 18 pts (10 %) were in intermediate stage and 161 (90 %) in advanced stage. The protocol treatment is ABVD with platine 30 mg/m2 D2, D3 and D16, D17) monthly : 3 cycles for stage II, 4 for stage III and IV. After chemotherapy (CT), 122 pts received radiotherapy (RT), 24 pts high dose CT (HDC) with autologous stem cell transplantation(ASCT) and 25 pts were followed after CT alone. At december 2015, the median follow-up is 98 months (39 – 143)
Results
After CT, 177pts / 179 are evaluable, the overall response (OR) is 96,6% with 32,2% in complete remission (CR) and 64,4% partial remission (PR),6 pts are in failure treatment. At term follow-up 158 pts are alive, among them 155 CR, 3 relapse and 19 died. The overall (OS) and event free (EFS) actuarial survival are 90% and 83% respectively at 8 years. Among the 171 pts in response after CT : 122 pts with CT-RT, 24 pts with CT-ASCT and 25 pts followed after CT alone, the OS were 94,8%, 71,6%, 77,4% respectively and EFS 93,8%,46,8% and 49,7%.
Conclusion
The protocol ABVD-Platine in HD with bulky mediastinal involvement allowed good results in association with RT better than in association with CT-ASCT (p<0,001), but no with CT alone (p=0,08) on OS. Concerning EFS the association CT-RT is better than CT-ASCT and CT alone p<10-8)
Session topic: E-poster
Keyword(s): Autograft, Chemotherapy, Hodgkin's lymphoma, Radiotherapy
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