The efficacy and tolerability of adriamycin, bleomycin, vinblastine, dacarbazine and Stanford V in older Hodgkin lymphoma patients: a comprehensive analysis from the North American intergroup trial E2496

被引：117

作者：

Evens, Andrew M. ^{[1
]}

Hong, Fangxin ^{[2
,3
]}

Gordon, Leo I. ^{[4
]}

Fisher, Richard I. ^{[5
]}

Bartlett, Nancy L. ^{[6
]}

Connors, Joseph M. ^{[7
]}

Gascoyne, Randy D. ^{[7
]}

Wagner, Henry ^{[8
]}

Gospodarowicz, Mary ^{[9
]}

Cheson, Bruce D. ^{[10
]}

Stiff, Patrick J. ^{[11
]}

Advani, Ranjana ^{[12
]}

Miller, Thomas P. ^{[13
]}

Hoppe, Richard T. ^{[12
]}

Kahl, Brad S. ^{[14
]}

Horning, Sandra J. ^{[15
]}

机构：

[1] Univ Massachusetts, Sch Med, Worcester, MA 01655 USA

[2] Dana Farber Canc Inst, Boston, MA 02115 USA

[3] Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA

[4] Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA

[5] Univ Rochester, Rochester, NY USA

[6] Washington Univ, St Louis, MO USA

[7] BC Canc Agcy Ctr Lymphoid Canc, Vancouver, BC, Canada

[8] Penn State Canc Inst, Hershey, PA USA

[9] Princess Margaret Hosp, Toronto, ON M4X 1K9, Canada

[10] Georgetown Univ Hosp, Washington, DC 20007 USA

[11] Loyola Univ, Chicago, IL 60611 USA

[12] Univ Arizona, Tucson, AZ USA

[13] Stanford Univ, Palo Alto, CA 94304 USA

[14] Univ Wisconsin, Madison, WI USA

[15] Genentech Inc, San Francisco, CA 94080 USA

来源：

BRITISH JOURNAL OF HAEMATOLOGY | 2013年 / 161卷 / 01期

基金：

美国国家卫生研究院;

关键词：

Hodgkin lymphoma; elderly; treatment-related toxicity; bleomycin lung toxicity; EPSTEIN-BARR-VIRUS; LONG-TERM SURVIVAL; ELDERLY-PATIENTS; DISEASE PATIENTS; POPULATION; CHEMOTHERAPY; TOXICITY; INTENSITY; PROGNOSIS; OUTCOMES;

D O I：

10.1111/bjh.12222

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

There is a lack of contemporary prospective data examining the adriamycin, bleomycin, vinblastine, dacarbazine (ABVD) and Stanford V (SV; doxorubicin, vinblastine, mechlorethamine, vincristine, bleomycin, etoposide, prednisone) regimens in older Hodgkin lymphoma (HL) patients. Forty-four advanced-stage, older HL patients (aged60years) were treated on the randomized study, E2496. Toxicities were mostly similar between chemotherapy regimens, although 24% of older patients developed bleomycin lung toxicity (BLT), which occurred mainly with ABVD (91%). Further, the BLT-related mortality rate was 18%. The overall treatment-related mortality for older HL patients was 9% vs. 0 center dot 3% for patients aged <60years (P<0 center dot 001). Among older patients, there were no survival differences between ABVD and SV. According to age, outcomes were significantly inferior for older versus younger patients (5-year failure-free survival: 48% vs. 74%, respectively, P=0 center dot 002; 5-year overall survival: 58% and 90%, respectively, P<0 center dot 0001), although time-to-progression (TTP) was not significantly different (5-year TTP: 68% vs. 78%, respectively, P=0 center dot 37). Furthermore, considering progression and death without progression as competing risks, the risk of progression was not different between older and younger HL patients (5years: 30% and 23%, respectively, P=0 center dot 30); however, the incidence of death without progression was significantly increased for older HL patients (22% vs. 9%, respectively, P<0 center dot 0001). Altogether, the marked HL age-dependent survival differences appeared attributable primarily to non-HL events.

引用

页码：76 / 86

页数：11