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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 (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 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. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted October 29, 2008 Accepted May 13, 2009 A risk-adapted, response-based approach using ABVE-PC for children and adolescents with intermediate and high risk Hodgkin lymphoma: the results of P9425 from the Children's Oncology Group Cindy L. Schwartz*, Louis S. Constine, Doojduen Villaluna, Wendy B. London, Robert E. Hutchison, Richard Sposto, Steven E. Lipshultz, Charles S. Turner, Pedro A. deAlarcon, and Allen Chauvenet Hasbro Children's Hospital, Alpert Medical School of Brown University, Providence, RI, United States University of Rochester Medical Center, Rochester, NY, United States Children's Oncology Group - Operations Center, Arcadia, CA, United States Children's Oncology Group - Statistics and Data Center, University of Florida, Gainesville, FL, United States SUNY Upstate Medical University, Syracuse, NY, United States Childrens Hospital Los Angeles, Los Angeles, CA, United States University of Miami Miller School of Medicine, Miami, FL, United States Wake Forest University School of Medicine, Winston-Salem, NC, United States St. Jude Midwest Affiliate, Peoria, IL, United States West Virginia University HSC, Charleston, WV, United States * Corresponding author; email: cindy_schwartz{at}brown.edu. Current treatment strategies for Hodgkin Lymphoma (HL) result in excellent survival, but often confer significant long-term toxicity. We designed ABVE-PC chemotherapy 1) to enhance treatment efficacy by dose-dense drug delivery, and 2) to reduce risk of long-term sequelae by response-based reduction of cumulative chemotherapy. Efficient induction of early response by dose-dense drug delivery was tested for feasibility of supporting an early-response adapted therapeutic paradigm. The 216 eligible patients were < 22 years old with intermediate or high risk HL. Cycles of ABVE-PC (doxorubicin, bleomycin, vincristine, etoposide, prednisone, cyclophosphamide) were administered every 21 days. Rapid early responders (RER) to 3 ABVE-PC cycles received 21 Gy radiation to involved regions; RER was documented in 63% of patients. Slow early responders (SER) received 2 additional ABVE-PC cycles before 21 Gy radiation (RT). Five-year event-free-survival (EFS) was 84 ± 3%; 86 ± 3% for the RER and 83 ± 4 % for the SER (p=0.85). Only 1% of patients had progressive disease. Five-year overall survival (OS) was 95 ± 2%. 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 EFS/OS with short duration, early-response adapted therapy. This trial is registered with clinicaltrials.gov under NCT00005578. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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