Survival of pediatric Hodgkin lymphoma patients treated with doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide (ABVE-PC) versus doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) at a single institution

Sebastian de Armas, Carolina Huertas-Ayala, Randall Y. Chan, Yueh Yun Chi, Winston W. Huh, Amanda Termuhlen, Paul S. Gaynon, Alexandra E. Kovach, Andrew Doan

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Abstract

BACKGROUND: Adriamycin, bleomycin, vinblastine, dacarbazine (ABVD), the de facto standard of care in adult-onset Hodgkin lymphoma (HL), has not been directly compared to doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide (ABVE-PC), a pediatric-aimed regimen designed to reduce late effects. We aimed to describe the single-institution experience of using both regimens in patients with pediatric HL.

METHODS: This retrospective cohort study evaluated a total of 224 patients diagnosed with HL between 1999 and 2018 at Children's Hospital Los Angeles (CHLA), of which 93 patients were eligible having received ABVD (n = 46) or ABVE-PC (n = 47) chemotherapy as their initial treatment. Descriptive analyses were performed using the Student's t-test or Fisher's exact test. Survival analysis used the Kaplan-Meier method. Events included death, relapse, and secondary malignancy. We also describe the use of radiation therapy, pulmonary toxicity, and cardiomyopathy determined by shortening fraction <29%. Analyses followed an intention-to-treat principle.

RESULTS: There was no difference in baseline characteristics between the patients receiving ABVE-PC or ABVD in regard for stage, risk group, or prognostic variables, such as the presence or absence of "B" symptoms, bulky disease, and extra-nodal involvement. A greater proportion of patients treated with ABVE-PC received consolidating external beam radiation treatment (XRT) either by randomization or by response compared to ABVD (59.6% vs. 32.6%, respectively, p = .01). While not statistically significant, response to therapy, assessed by positron emission tomography/computerized tomography (PET/CT) where available, mirrored the use for radiation (rapid response 58.3% vs. 90.0%, n = 34, p = .11). The median dose of anthracycline (doxorubicin) was the same in patients receiving ABVE-PC versus ABVD (200 vs. 200 mg/m 2 , interquartile range 200-250 vs. 200-300 mg/m 2 , p = .002). There was no difference in event-free survival (p = .63) or overall survival (p = .37) with a median follow-up length of 3.9 years.

CONCLUSIONS: ABVD and ABVE-PC achieved similar survival outcomes in our single-institution cohort.

Original languageEnglish (US)
Article numbere29601
JournalPediatric Blood and Cancer
Volume69
Issue number5
DOIs
StatePublished - May 2022

Bibliographical note

Funding Information:
S.dA. and C.H‐A. were fellows in the USC/CHLA Summer Oncology Research Fellowship Program, supported in part by a National Cancer Institute R25 grant CA225513, the Norris Comprehensive Cancer Center in Los Angeles, Children’s Hospital Los Angeles, Concern Foundation for Cancer Research, and Tri Delta

Publisher Copyright:
© 2022 Wiley Periodicals LLC

Keywords

  • ABVD
  • ABVE-PC
  • Hodgkin lymphoma
  • pediatric

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

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