26. Early outcomes of ABVD chemotherapy guided by IPET/CT2 in classical Hodgkin Lymphoma at Vietnam National Cancer Hospital
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Abstract
The treatment strategy for newly diagnosed Hodgkin lymphoma guided by interim PET/CT after two cycles of chemotherapy (iPET/CT2) has only been implemented in Vietnam in recent years. We conducted a descriptive study on 82 patients with classical Hodgkin lymphoma treated with the ABVD regimen at Vietnam National Cancer Hospital from March 2019 to March 2024. After two cycles, treatment response was assessed by iPET/CT2. Patients with negative iPET/CT2 (Deauville scores 1–3) continued with ABVD or AVD; those with positive iPET/CT2 (Deauville scores 4–5) were escalated to eBEACOPP. The results showed that 85.4% of patients had a negative iPET/CT2 after two cycles of ABVD, while 14.6% had a positive scan and were escalated to BEACOPDac. The complete response rate at the end of treatment was 96.3%, including 100% in the early favorable group, 94.7% in the early unfavorable group, and 95.2% in the advanced-stage group. The most common toxicities were neutropenia (97.6%), anemia (61%), and elevated liver enzymes (56.1%), mostly of mild to moderate severity. These findings suggest that ABVD chemotherapy guided by iPET/CT2 is an effective and safe treatment strategy for patients with classical Hodgkin lymphoma.
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Keywords
Classical Hodgkin lymphoma, ABVD, iPET/CT2
References
2. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(2):229-263.
3. Alaggio R, Amador C, Anagnostopoulos I, et al. The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms. Leukemia. 2022;36(7):1720-1748. doi:10.1038/s41375-022-01620-2
4. Carde P, Hagenbeek A, Hayat M, et al. Clinical staging versus laparotomy and combined modality with MOPP versus ABVD in early-stage Hodgkin’s disease: the H6 twin randomized trials from the European Organization for Research and Treatment of Cancer Lymphoma Cooperative Group. J Clin Oncol Off J Am Soc Clin Oncol. 1993;11(11):2258-2272. doi:10.1200/JCO.1993.11.11.2258
5. Gallamini A, Barrington SF, Biggi A, et al. Gallamini - The predictive role of interim positron emission tomography for Hodgkin lymphoma treatment outcome is confirmed using the interpretation criteria of the Deauville five-point scale. Haematologica. 2014;99(6):1107-1113. doi:10.3324/haematol.2013.103218
6. André MPE, Girinsky T, Federico M, et al. Early Positron Emission Tomography Response-Adapted Treatment in Stage I and II Hodgkin Lymphoma: Final Results of the Randomized EORTC/LYSA/FIL H10 Trial. J Clin Oncol Off J Am Soc Clin Oncol. 2017;35(16):1786-1794. doi:10.1200/JCO.2016.68.6394
7. Peter Johnson, Massimo Federico, Amy Kirkwood, et al. Adapted Treatment Guided by Interim PET-CT Scan in Advanced Hodgkin's Lymphoma. N Engl J Med. 2016;374:2419-2429.
8. Engert A, Plütschow A, Eich HT, et al. Reduced treatment intensity in patients with early-stage Hodgkin’s lymphoma. N Engl J Med. 2010;363(7):640-652. doi:10.1056/NEJMoa1000067
9. Lâm Mỹ Hạnh, Trần Thanh Tùng. Đánh giá hiệu quả điều trị u lympho Hodgkin bằng phác đồ ABVD tại Bệnh viện Chợ Rẫy giai đoạn 2015-2020. Tạp chí Y học Việt Nam. 2021;504(2). doi:10.51298/vmj.v504i2.932
10. Cerci JJ, Pracchia LF, Linardi CCG, et al. 18 F-FDG PET After 2 Cycles of ABVD Predicts Event-Free Survival in Early and Advanced Hodgkin Lymphoma. J Nucl Med. 2010;51(9):1337-1343. doi:10.2967/jnumed.109.073197
11. Borchmann P, Plütschow A, Kobe C, et al. PET-guided omission of radiotherapy in early-stage unfavourable Hodgkin lymphoma (GHSG HD17): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2021;22(2):223-234. doi:10.1016/S1470-2045(20)30601-X