Early chemotherapy de-escalation strategy in patients with advanced-stage Hodgkin lymphoma with negative positron emission tomography scan after 2 escalated BEACOPP cycles

2019
journal article
article
1
dc.abstract.enEscalated BEACOPP (escBEACOPP: bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) significantly improves overall response rates (ORRs) and prolongs progression‑free survival (PFS) in patients with advanced‑stage Hodgkin lymphoma (HL). However, 6 to 8 cycles of escBEACOPP are associated with increased acute toxicity and late complications. We aimed to determine the role of early positron emission tomography-computed tomography (PET‑CT) response assessment in a de‑escalation strategy. We retrospectively analyzed 188 consecutive patients with advanced‑stage HL treated at diagnosis. Patients received 2 cycles of escBEACOPP followed by an early PET‑CT response assessment performed after 2 cycles of chemotherapy (PET2). Patients with an active disease continued therapy with escBEACOPP, while those with negative PET2 were de‑escalated to ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine). Radiotherapy was allowed in patients with stage IIBX. PET2 allowed for de‑escalation of therapy in 141 patients (75%). Their ORR was 92.2%, with a complete remission (CR) rate of 91.5%; 10‑year PFS and overall survival (OS) were 87.2% and 95%, respectively. In the whole cohort, ORR was 87.8% (CR, 85.6%), while the 10‑year PFS and OS were 79.3% and 89.4%, respectively. Hematological and thromboembolic complications were significantly more frequent in patients treated with 6 escBEACOPP cycles, including febrile neutropenia (25 patients, [53.2%] vs 7 [5%]), serious anemia (35 [74.5%] vs 11 [7.8%]), or thrombocytopenia (16 [34%] vs 7 [5%]) (P <0.001 for all comparisons with de‑escalation strategy) as well as pulmonary embolism (3 [6.4%] vs 0) (P = 0.02). The early de‑escalation strategy allows for effective treatment of advanced HL, with a comparable efficacy to that of 6 to 8 cycles of escBEACOPP, but with significantly reduced toxicity.pl
dc.affiliationWydział Lekarski : Klinika Endokrynologiipl
dc.affiliationWydział Lekarski : Zakład Dydaktyki Medycznejpl
dc.affiliationWydział Lekarski : Klinika Hematologiipl
dc.affiliationWydział Nauk o Zdrowiu : Instytut Fizjoterapiipl
dc.cm.date2020-01-07
dc.cm.id94294
dc.contributor.authorDługosz-Danecka, Monika - 357459 pl
dc.contributor.authorSzmit, Sebastianpl
dc.contributor.authorKocurek, Anna - 130196 pl
dc.contributor.authorKoźlik, Paweł - 162677 pl
dc.contributor.authorGiza, Agnieszka - 255156 pl
dc.contributor.authorZimowska-Curyło, Dagmarapl
dc.contributor.authorMałkowski, Bogdanpl
dc.contributor.authorSowa-Staszczak, Anna - 354560 pl
dc.contributor.authorKużdżał, Jarosław - 199984 pl
dc.contributor.authorJurczak, Wojciech - 129923 pl
dc.date.accessioned2020-01-17T10:09:09Z
dc.date.available2020-01-17T10:09:09Z
dc.date.issued2019pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.number4pl
dc.description.physical259-266pl
dc.description.points70pl
dc.description.versionostateczna wersja wydawcy
dc.description.volume129pl
dc.identifier.doi10.20452/pamw.14786pl
dc.identifier.eissn1897-9483pl
dc.identifier.issn0032-3772pl
dc.identifier.projectROD UJ / OPpl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/146175
dc.languageengpl
dc.language.containerengpl
dc.rightsUdzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Na tych samych warunkach 4.0 Międzynarodowa*
dc.rights.licenceCC-BY-NC-SA
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/legalcode.pl*
dc.share.typeotwarte czasopismo
dc.subject.enBEACOPPpl
dc.subject.ende‑escalationpl
dc.subject.enHodgkin lymphomapl
dc.subject.enpositron emission tomographypl
dc.subject.entoxicitypl
dc.subtypeArticlepl
dc.titleEarly chemotherapy de-escalation strategy in patients with advanced-stage Hodgkin lymphoma with negative positron emission tomography scan after 2 escalated BEACOPP cyclespl
dc.title.journalPolskie Archiwum Medycyny Wewnętrznej = Polish Archives of Internal Medicinepl
dc.typeJournalArticlepl
dspace.entity.typePublication
dc.abstract.enpl
Escalated BEACOPP (escBEACOPP: bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) significantly improves overall response rates (ORRs) and prolongs progression‑free survival (PFS) in patients with advanced‑stage Hodgkin lymphoma (HL). However, 6 to 8 cycles of escBEACOPP are associated with increased acute toxicity and late complications. We aimed to determine the role of early positron emission tomography-computed tomography (PET‑CT) response assessment in a de‑escalation strategy. We retrospectively analyzed 188 consecutive patients with advanced‑stage HL treated at diagnosis. Patients received 2 cycles of escBEACOPP followed by an early PET‑CT response assessment performed after 2 cycles of chemotherapy (PET2). Patients with an active disease continued therapy with escBEACOPP, while those with negative PET2 were de‑escalated to ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine). Radiotherapy was allowed in patients with stage IIBX. PET2 allowed for de‑escalation of therapy in 141 patients (75%). Their ORR was 92.2%, with a complete remission (CR) rate of 91.5%; 10‑year PFS and overall survival (OS) were 87.2% and 95%, respectively. In the whole cohort, ORR was 87.8% (CR, 85.6%), while the 10‑year PFS and OS were 79.3% and 89.4%, respectively. Hematological and thromboembolic complications were significantly more frequent in patients treated with 6 escBEACOPP cycles, including febrile neutropenia (25 patients, [53.2%] vs 7 [5%]), serious anemia (35 [74.5%] vs 11 [7.8%]), or thrombocytopenia (16 [34%] vs 7 [5%]) (P <0.001 for all comparisons with de‑escalation strategy) as well as pulmonary embolism (3 [6.4%] vs 0) (P = 0.02). The early de‑escalation strategy allows for effective treatment of advanced HL, with a comparable efficacy to that of 6 to 8 cycles of escBEACOPP, but with significantly reduced toxicity.
dc.affiliationpl
Wydział Lekarski : Klinika Endokrynologii
dc.affiliationpl
Wydział Lekarski : Zakład Dydaktyki Medycznej
dc.affiliationpl
Wydział Lekarski : Klinika Hematologii
dc.affiliationpl
Wydział Nauk o Zdrowiu : Instytut Fizjoterapii
dc.cm.date
2020-01-07
dc.cm.id
94294
dc.contributor.authorpl
Długosz-Danecka, Monika - 357459
dc.contributor.authorpl
Szmit, Sebastian
dc.contributor.authorpl
Kocurek, Anna - 130196
dc.contributor.authorpl
Koźlik, Paweł - 162677
dc.contributor.authorpl
Giza, Agnieszka - 255156
dc.contributor.authorpl
Zimowska-Curyło, Dagmara
dc.contributor.authorpl
Małkowski, Bogdan
dc.contributor.authorpl
Sowa-Staszczak, Anna - 354560
dc.contributor.authorpl
Kużdżał, Jarosław - 199984
dc.contributor.authorpl
Jurczak, Wojciech - 129923
dc.date.accessioned
2020-01-17T10:09:09Z
dc.date.available
2020-01-17T10:09:09Z
dc.date.issuedpl
2019
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.numberpl
4
dc.description.physicalpl
259-266
dc.description.pointspl
70
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
129
dc.identifier.doipl
10.20452/pamw.14786
dc.identifier.eissnpl
1897-9483
dc.identifier.issnpl
0032-3772
dc.identifier.projectpl
ROD UJ / OP
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/146175
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights*
Udzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Na tych samych warunkach 4.0 Międzynarodowa
dc.rights.licence
CC-BY-NC-SA
dc.rights.uri*
http://creativecommons.org/licenses/by-nc-sa/4.0/legalcode.pl
dc.share.type
otwarte czasopismo
dc.subject.enpl
BEACOPP
dc.subject.enpl
de‑escalation
dc.subject.enpl
Hodgkin lymphoma
dc.subject.enpl
positron emission tomography
dc.subject.enpl
toxicity
dc.subtypepl
Article
dc.titlepl
Early chemotherapy de-escalation strategy in patients with advanced-stage Hodgkin lymphoma with negative positron emission tomography scan after 2 escalated BEACOPP cycles
dc.title.journalpl
Polskie Archiwum Medycyny Wewnętrznej = Polish Archives of Internal Medicine
dc.typepl
JournalArticle
dspace.entity.type
Publication
Affiliations

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