Document Detail


Stage-adapted treatment of HIV-associated Hodgkin lymphoma: results of a prospective multicenter study.
MedLine Citation:
PMID:  23045592     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Although the outcome of patients with HIV-related Hodgkin lymphoma (HIV-HL) has markedly improved since the introduction of combined antiretroviral therapy, standard therapy is still poorly defined. This prospective study investigates a stage- and risk-adapted treatment strategy in patients with HIV-HL.
PATIENTS AND METHODS: Patients with early favorable HIV-HL received two to four cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by 30 Gy of involved-field (IF) radiation. In patients with early unfavorable HIV-HL, four cycles of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP baseline) or four cycles of ABVD + 30 Gy of IF radiation were administered. Six to eight cycles of BEACOPP baseline were given in patients with advanced-stage HIV-HL. In patients with advanced HIV infection, BEACOPP was replaced with ABVD.
RESULTS: Of 108 patients (including eight female patients) included in the study, 23 (21%) had early favorable HL, 14 (13%) had early unfavorable HL, and 71 (66%) had advanced-stage HL. The median CD4 count at HL diagnosis was 240/μL. The complete remission rates for patients with early favorable, early unfavorable, and advanced-stage HL were 96%, 100%, and 86%, respectively. The 2-year progression-free survival of the entire study population was 91.7%. Eleven patients (11%) have died, and treatment-related mortality was 5.6%. The 2-year overall survival rate was 90.7% with no significant difference between early favorable (95.7%), early unfavorable (100%), and advanced-stage HL (86.8%).
CONCLUSION: In patients with HIV-HL, stage- and risk-adapted treatment is feasible and effective. The prognosis for patients with HIV-HL may approach that of HIV-negative patients with HL.
Authors:
Marcus Hentrich; Marcel Berger; Christoph Wyen; Jan Siehl; Jürgen K Rockstroh; Markus Müller; Gerd Fätkenheuer; Elisabeth Seidel; Maike Nickelsen; Timo Wolf; Ansgar Rieke; Dirk Schürmann; Ralf Schmidmaier; Manfred Planker; Jürgen Alt; Franz Mosthaf; Andreas Engert; Keikawus Arasteh; Christian Hoffmann
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2012-10-08
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  30     ISSN:  1527-7755     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-19     Completed Date:  2013-03-06     Revised Date:  2013-03-25    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4117-23     Citation Subset:  IM    
Affiliation:
Department of Hematology, Oncology and Palliative Care, Harlaching Hospital, Academic Teaching Hospital of the University of Munich, Sanatoriumsplatz 2, 81545 Munich, Germany. marcus.hentrich@klinikum-muenchen.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols / administration & dosage,  adverse effects,  therapeutic use*
Bleomycin / administration & dosage,  adverse effects
Combined Modality Therapy
Cyclophosphamide / administration & dosage,  adverse effects
Dacarbazine / administration & dosage,  adverse effects
Disease-Free Survival
Doxorubicin / administration & dosage,  adverse effects
Etoposide / administration & dosage,  adverse effects
Female
HIV Infections / complications*
Hodgkin Disease / drug therapy*,  pathology,  radiotherapy
Humans
Lymphoma, AIDS-Related / drug therapy*,  pathology,  radiotherapy
Male
Middle Aged
Neoplasm Staging
Prednisone / administration & dosage,  adverse effects
Procarbazine / administration & dosage,  adverse effects
Prognosis
Prospective Studies
Remission Induction
Treatment Outcome
Vinblastine / administration & dosage,  adverse effects
Vincristine / administration & dosage,  adverse effects
Young Adult
Chemical
Reg. No./Substance:
11056-06-7/Bleomycin; 23214-92-8/Doxorubicin; 33419-42-0/Etoposide; 4342-03-4/Dacarbazine; 50-18-0/Cyclophosphamide; 53-03-2/Prednisone; 57-22-7/Vincristine; 671-16-9/Procarbazine; 865-21-4/Vinblastine
Comments/Corrections
Comment In:
J Clin Oncol. 2012 Nov 20;30(33):4056-8   [PMID:  23045587 ]
Erratum In:
J Clin Oncol. 2012 Dec 20;30(36):4590

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