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Blood, 3 September 2009, Vol. 114, No. 10, pp. 2051-2059. Prepublished online as a Blood First Edition Paper on July 7, 2009; DOI 10.1182/blood-2008-10-184143. This Article Full Text Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2008-10-184143v1 114/10/2051    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Google Scholar Articles by Schwartz, C. L. Articles by Chauvenet, A. PubMed PubMed Citation Articles by Schwartz, C. L. Articles by Chauvenet, A. Related Collections Free Research Articles Lymphoid Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS A risk-adapted, response-based approach using ABVE-PC for children and adolescents with intermediate- and high-risk Hodgkin lymphoma: the results of P9425 Cindy L. Schwartz1, Louis S. Constine2, Doojduen Villaluna3, Wendy B. London4, Robert E. Hutchison5, Richard Sposto6, Steven E. Lipshultz7, Charles S. Turner8, Pedro A. deAlarcon9, and Allen Chauvenet10 1 Hasbro Children's Hospital, Alpert Medical School of Brown University, Providence, RI; 2 University of Rochester Medical Center, NY; 3 Children's Oncology Group, Operations Center, Arcadia, CA; 4 Children's Oncology Group, Statistics and Data Center, University of Florida, Gainesville; 5 State University of New York Upstate Medical University, Syracuse; 6 Children's Hospital Los Angeles, CA; 7 University of Miami Miller School of Medicine, FL; 8 Wake Forest University School of Medicine, Winston-Salem, NC; 9 St Jude Midwest Affiliate, Peoria, IL; and 10 West Virginia University Health Sciences Center, Charleston Current treatment strategies for Hodgkin lymphoma result in excellent survival but often confer significant long-term toxicity. We designed ABVE-PC (doxorubicin, bleomycin, vincristine, etoposide, prednisone, cyclophosphamide) to (1) enhance treatment efficacy by dose-dense drug delivery and (2) reduce risk of long-term sequelae by response-based reduction of cumulative chemotherapy. Efficient induction of early response by dose-dense drug delivery supported an early-response–adapted therapeutic paradigm. The 216 eligible patients were younger than 22 years with intermediate- or high-risk Hodgkin lymphoma. ABVE-PC was administered every 21 days. Rapid early responders (RERs) to 3 ABVE-PC cycles received 21 Gy radiation to involved regions; RER was documented in 63% of patients. Slow early responders received 2 additional ABVE-PC cycles before 21 Gy radiation. Five-year event-free-survival was 84%: 86% for the RER and 83% for the slow early responders (P = .85). Only 1% of patients had progressive disease. Five-year overall survival was 95%. With this regimen, cumulative doses of alkylators, anthracyclines, and epipodophyllotoxins are below thresholds usually associated with significant long-term toxicity. ABVE-PC is a dose-dense regimen that provides outstanding event-free survival/overall survival with short duration, early-response–adapted therapy. This trial was registered at www.clinicaltrials.gov as #NCT00005578 [ClinicalTrials.gov] . CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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