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- Title
G-CSF is not necessary to maintain over 99% dose–intensity with ABVD in the treatment of Hodgkin lymphoma: low toxicity and excellent outcomes in a 10-year analysis.
- Authors
Evens, Andrew M.; Cilley, Jeffrey; Ortiz, Taylor; Gounder, Mrinal; Nanjiang Hou; Rademaker, Alfred; Miyata, Sarah; Catsaros, Kara; Augustyniak, Connie; Bennett, Charles L.; Tallman, Martin S.; Variakojis, Daina; Winter, Jane N.; Gordon, Leo I.
- Abstract
Dose–intensity of chemotherapy is important in the treatment of Hodgkin lymphoma (HL) and granulocyte-colony stimulating factor (G-CSF) is commonly used to maintain it. We reviewed all newly diagnosed HL patients who were treated at our institution between 1996 and 2005. Fifty-nine patients received adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy with no dose reductions, treatment delays, and without G-CSF, regardless of absolute neutrophil count (ANC). The median ANC on all ABVD treatment days ( n = 658) was 0·925 × 109/l, and was <0·5 × 109/l on 26% of treatment days. Median normalised ABVD dose–intensity was 99·1% (range, 93–100%) and median cycle duration was 28·2 d. Incidence of bleomycin lung toxicity was 1·6%, 0·44% treatments were complicated by febrile neutropenia, and no secondary malignancies have occurred (median follow-up 48 months; range, 11–130 months). Five-year event-free (EFS) and overall survival (OS) were 92·9% and 97·4% respectively. Furthermore, the 5-year EFS and OS (87·4% and 94·1% respectively) for advanced stage patients compared favourably with a similar ABVD patient group who received routine prophylactic G-CSF ( n = 23) with EFS 80·0% and OS 91·3% ( P = 0·46 and 0·67 respectively). Our experience suggests that ABVD may be safely and effectively administered at >99% dose–intensity without G-CSF support, regardless of the ANC.
- Subjects
HODGKIN'S disease; DOXORUBICIN; DRUG therapy; GRANULOCYTE-colony stimulating factor; BLEOMYCIN; VINBLASTINE; FEBRILE neutropenia
- Publication
British Journal of Haematology, 2007, Vol 137, Issue 6, p545
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/j.1365-2141.2007.06598.x