Contributions
Abstract: PB1863
Type: Publication Only
Background
ABVD therapy has been for a long time the reference to advanced stage hodgkin lymphoma (LH). More recently, the emergence of more sustained dose / intensity regimens like BEACOPP has improved the progression-free survival of patients, in particular due to better initial control of the disease. The choice between these two regimens of treatment is always controversial in particular because of an immediate and delayed toxicity potentially increased after BEACOPP. With the use of PET-scanner, escalation and de-escalation protocols based on the PET response were studied. Recent studies have looked at the impact of the PET response to adapt the treatment: de-escalation after BEACOPP in case of a good response, escalation with more aggressive regimens after ABVD in positive PET.
Aims
Methods
Among the 102 patients with Hodgkin lymphoma treated between 2008 and 2016, 50 patients had advanced disease (Stage III or IV of Ann Arbor). The majority of patients were treated on front line by ABVD (47 patients), 2 by BEACOPP and 1 by VABEM. All patients underwent PET evaluation at diagnosis and after 2 cycles of treatment. The analysis of the metabolic response was carried out according to the Deauville criteria.
Results
The median age of the patients was 48 years (min-max: 19-85). 20 patients (40%) had an unfavorable prognosis, 24 (48%) had an intermediate prognosis. 11 patients (22%) were refractory to the ABVD protocol and had an escalation of treatment. The median PFS was 66 months (47-85). The median overall survival was not achieved; OS at 60 months was 65%. We found no difference in survival between patients with negative PET and those with positive PET with escalation of treatment. The study of PET 2 response, its impact on survival, as well as escalation of treatment will be presented to the EHA with update of follow-up.
Conclusion
This study evaluated the value of escalating treatment in patients with advanced PET 2 in patients with advanced Hodgkin lymphoma treated in first-line by ABVD. This management aims to reduce the toxicity of intensive treatments. The aim of our study is also to identify the higher risk patients for whom more intensive treatment could be used as first-line treatment.
Session topic: 17. Hodgkin lymphoma - Clinical
Keyword(s): PET, Hodgkin's Lymphoma
Abstract: PB1863
Type: Publication Only
Background
ABVD therapy has been for a long time the reference to advanced stage hodgkin lymphoma (LH). More recently, the emergence of more sustained dose / intensity regimens like BEACOPP has improved the progression-free survival of patients, in particular due to better initial control of the disease. The choice between these two regimens of treatment is always controversial in particular because of an immediate and delayed toxicity potentially increased after BEACOPP. With the use of PET-scanner, escalation and de-escalation protocols based on the PET response were studied. Recent studies have looked at the impact of the PET response to adapt the treatment: de-escalation after BEACOPP in case of a good response, escalation with more aggressive regimens after ABVD in positive PET.
Aims
Methods
Among the 102 patients with Hodgkin lymphoma treated between 2008 and 2016, 50 patients had advanced disease (Stage III or IV of Ann Arbor). The majority of patients were treated on front line by ABVD (47 patients), 2 by BEACOPP and 1 by VABEM. All patients underwent PET evaluation at diagnosis and after 2 cycles of treatment. The analysis of the metabolic response was carried out according to the Deauville criteria.
Results
The median age of the patients was 48 years (min-max: 19-85). 20 patients (40%) had an unfavorable prognosis, 24 (48%) had an intermediate prognosis. 11 patients (22%) were refractory to the ABVD protocol and had an escalation of treatment. The median PFS was 66 months (47-85). The median overall survival was not achieved; OS at 60 months was 65%. We found no difference in survival between patients with negative PET and those with positive PET with escalation of treatment. The study of PET 2 response, its impact on survival, as well as escalation of treatment will be presented to the EHA with update of follow-up.
Conclusion
This study evaluated the value of escalating treatment in patients with advanced PET 2 in patients with advanced Hodgkin lymphoma treated in first-line by ABVD. This management aims to reduce the toxicity of intensive treatments. The aim of our study is also to identify the higher risk patients for whom more intensive treatment could be used as first-line treatment.
Session topic: 17. Hodgkin lymphoma - Clinical
Keyword(s): PET, Hodgkin's Lymphoma