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Annals of Oncology Advance Access published online on August 14, 2009
Annals of Oncology, doi:10.1093/annonc/mdp331
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Initial dose intensity has limited impact on the outcome of ABVD chemotherapy for advanced Hodgkin lymphoma (HL): data from UKLG LY09 (ISRCTN97144519)

W. S. Owadally1, M. R. Sydes2, J. A. Radford3, B. W. Hancock4, M. H. Cullen5, S. P. Stenning2 and P. W. M. Johnson1,*

1 Cancer Sciences Division, Cancer Research UK Clinical Centre, Southampton
2 Cancer Division, Medical Research Council Clinical Trials Unit, London
3 Department of Medical Oncology, Christie Hospital, Manchester
4 Department of Medical Oncology, Weston Park Hospital, Sheffield
5 Cancer Centre, Birmingham University Hospitals, Birmingham, UK

* Correspondence to: Prof. P. W. M. Johnson, Cancer Sciences Division, Cancer Research UK Clinical Centre, Somers Cancer Research Building, MP 824, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK. Tel: +44-2380-796186; Fax: +44-2380-795152; E-mail: johnsonp{at}soton.ac.uk

Background: This analysis was undertaken to assess the relationship between the dose intensity (DI) of initial chemotherapy and outcome in a large cohort of patients with advanced Hodgkin lymphoma treated in a randomised controlled trial, in which detailed dose data were collected prospectively.

Patients and methods: Three-hundred and eighty patients randomly assigned to receive standard doxorubicin, bleomycin, vinblastine and dacarbazine who underwent at least two cycles of treatment were studied. With a median follow-up of 6.9 years, progression-free survival (PFS) from the end of cycle 2 was analysed according to DI during those cycles.

Results: During the first two cycles, 25% of patients received >97% of planned DI, 37% received between 86% and 97% and 38% received <86%. DI during the first two cycles was correlated with DI during the remainder of the course, but there was no evidence that early DI influenced PFS (hazard ratio 0.87, 95% confidence interval 0.67–1.11; P = 0.265). Multivariate analysis also failed to confirm the influence of early DI on PFS or overall survival.

Conclusions: At the range of DI delivered in a multicentre trial using conventional therapy, there is no clear evidence that early DI influences outcome. This should be tested in a prospective study.

ABVD, chemotherapy, dose intensity, Hodgkin lymphoma

Received for publication March 8, 2009. Revision received May 17, 2009. Accepted for publication May 18, 2009.


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