Annals of Oncology Advance Access originally published online on October 27, 2006
Annals of Oncology 2007 18(2):376-380; doi:10.1093/annonc/mdl397
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© 2006 European Society for Medical Oncology
hematologic malignancies |
ABVD for Hodgkin's lymphoma: full-dose chemotherapy without dose reductions or growth factors
Department of Medical Oncology, Southampton General Hospital, CRUK Clinical Centre, Southampton, Hampshire, UK
* Correspondence to: Dr E. Boleti, Department of Medical Oncology, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, Hampshire, UK. Tel: +44-2380-798639; Fax: +44-2380-795176; E-mail: ekaterini.boleti{at}suht.swest.nhs.uk
Background: We investigated whether administration of full-dose ABVD (Adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy without growth factors, and irrespective of the granulocyte count, caused treatment delays or increased the number of infective episodes, in patients with Hodgkin's lymphoma (HL).
Patients and methods: Thirty-eight patients with confirmed predominantly early-stage HL were treated with ABVD outside clinical trial protocols over a 5-year period on an outpatient basis.
Results: Ninety-five per cent of patients completed their scheduled ABVD regimen without adverse effects despite the development of neutropenia. Anaemia and thrombocytopenia did not present problems. Febrile neutropenia complicated 0.57% of combination chemotherapy injections. No growth factors were used and no dose modifications were carried out apart from the omission of bleomycin in one patient for the last two cycles of treatment due to the development of lung toxicity. All patients are currently disease-free, although three (7.8%) required salvage high-dose therapy (one relapsed and two with refractory disease).
Conclusions: ABVD administration irrespective of granulocyte counts allowed the treatment to be given at full dose without delays or significant number of infective episodes. There was no need for growth factor support, minimising treatment costs. The use of full-dose ABVD irrespective of granulocyte count should be evaluated in future protocols for HL.
Key words: ABVD, chemotherapy, GCSF, growth factors, Hodgkin lymphoma, neutropenia
Received for publication August 16, 2006. Revision received September 8, 2006. Accepted for publication September 14, 2006.
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