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Choi, Kim, Seo, Sung, Park, Choi, Kim, Oh, Seo, Choi, Shin, Kim, and Kim: Treatment Outcomes and Toxicities of ABVD Combination Chemotherapy Compared with CVPP in Hodgkin's Disease
Original Article

Korean J Hematol 2007;42(4):335-342.

Published online: 19 January 2007

DOI: https://doi.org/10.5045/kjh.2007.42.4.335

Treatment Outcomes and Toxicities of ABVD Combination Chemotherapy Compared with CVPP in Hodgkin's Disease

Yoon Seok Choi, Byung Soo Kim, Hee Yeon Seo, Hwa Jung Sung, Kyung Hwa Park, In Keun Choi, Seok Jin Kim, Sang Cheul Oh, Jae Hong Seo, Chul Won Choi, Sang Won Shin, Yeul Hong Kim, Jun Suk Kim

Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea

Correspondence to：Byung Soo Kim, M.D., Ph.D. Division of Hematology and Oncology, Department of Internal Medicine, Korea University Medical Center 126-1, Anam-dong 5-ga, Seongbuk-gu, Seoul 136-701, Korea Tel: ＋82-2-920-5980, Fax: ＋82-2-920-6520 E-mail: kbs0309@korea.ac.kr

Received 29 July 2007       Revised 28 September 2007       Accepted 4 October 2007

Copyright © 2007 Korean Society of Hematology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background:

We retrospectively evaluated the treatment outcomes and toxicities of Hodgkin's disease (HD) patients treated by ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine) combination chemotherapy, and compared them with those of a historical group treated with a CVPP (cyclophosphamide, vinblastine, procarbazine, and prednisone) regimen.

Methods:

The medical records of patients who had been diagnosed with HD histologically and treated by either ABVD or CVPP from 1997 to 2006 at the Korea University Medical Center were retrospectively reviewed.

Results:

Thirty patients were eligible. Nineteen patients received ABVD and eleven patients were treated with CVPP. The response rates for ABVD and CVPP were 84.21% and 54.55%, respectively. Median overall survival was 43.17 months for ABVD and 43.27 months for CVPP (P=.570). Median event-free survival was 39.03 months for ABVD and 16.73 months for CVPP (P=.088). There was no significant difference in median survival or in event-free survival between the two regimens. Hematologic toxicities were significantly more common in the CVPP group than in the ABVD group. Grade 3 or 4 neutropenia was observed in 72.72% of the CVPP group and in 36.84% of the ABVD group (P=.050).

Conclusion:

ABVD for HD showed significantly lower hematologic toxicities and moderately better treatment outcomes than did CVPP.

Keywords: Hodgkin’, s disease, Chemotherapy, Toxicity

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Fig. 1
Defined outcomes according to the regimens. Overall survival rate (A) and event free survival rate (B).
kjh-42-335f1.tif
Table 1.
Baseline characteristics of the 30 eligible patients
Characteristics CVPP ABVD P-value
No. % No. %
Sex .61
  Female 2 18.2 5 26.3  
  Male 9 81.8 14 73.7  
Age .56
  60 or older than 4 36.4 5 26.3  
  Younger than 60 7 63.6 14 73.7  
Performance .87
  0∼1 9 81.8 16 84.2  
  ＞1 2 18.2 3 15.8  
Stage .70
  I/II 5 45.4 11 57.9  
  III/IV 6 54.6 8 42.1  
LDH .58
  Normal 7 63.6 12 63.2  
  Elevated 4 36.4 7 38.8  
β2-microglobulin .60
  Normal 6 54.6 13 68.4  
  Elevated 5 45.4 6 31.6  
ESR .63
  Normal 4 36.4 9 47.4  
  Elevated 7 63.6 10 52.6  
Extranodal involve .10
  0∼1 3 27.3 16 84.2  
  2 or more 8 72.7 3 15.8  
B symptoms .14
  Absent 2 18.2 9 47.4  
  Present 9 81.8 10 52.6  
Bulky disease .03
  Absent 11 100.0 12 63.2  
  Present 0 0 7 36.8  
BM involvement .33
  Absent 8 72.7 17 89.5  
  Present 3 27.3 2 10.5  
Subtypes .71
  LP 2 18.2 3 15.8  
  NS 3 27.3 7 36.8  
  MC 5 45.4 9 47.4  
  UC 1 9.1 0 0  
Median follow-up period (months) 42.33 21.10 .07
Total 11 100.0 19 100.0  

Abbreviations: CVPP, cyclophosphamide, vinblastine, procarbazine, and prednisone; ABVD, adriamycin, bleomycin, vinblastine, and dacarbazine; LDH, lactate dehydrogenase; ESR, erythrocyte sedimentation rate; LP, lymphocyte predominance; NS, nodular sclerosis; MC, mixed cellularity; UC, unclassifiable.

Table 2.
Respnse data by treatment group
Response CVPP ABVD
No. % No. %
Complete response 2 18.2 9 47.4
Partial response 4 36.3 7 36.8
Stable disease 3 27.3 1 5.3
Progressive disease 2 18.2 2 10.5

Abbreviations: See Table 1.

Table 3.
Toxicity by treatment group
Type of toxcity CVPP ABVD P-value
No. % No. %
Neutropenia (Grade 3 or 4) 8 72.7 7 36.8 .05
Anemia (Grade 3 or 4) 2 18.2 0 0 .04
Infection (Grade 3 or 4) 2 18.2 2 10.5 .35
Cardiotoxicity (Grade 3 or 4) 1 9.1 0 0 .59
Secondary Malignancy 1 9.1 0 0 .59

Abbreviations: See Table 1.

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