Survival rates of adult patients with Hodgkin lymphoma who underwent ABVD versus escalated BEACOPP in a resource-limited country: An observational study

Cancer Rep (Hoboken). 2023 Aug;6(8):e1839. doi: 10.1002/cnr2.1839. Epub 2023 May 31.

Abstract

Background: The survival rate of adult patients with Hodgkin lymphoma (HL) depends on the responses to standard chemotherapy, radiotherapy, or combined therapy. Resource-limited countries face numerous obstacles in supporting patients with HL who undergo chemotherapy, especially in advanced stages.

Aim: To analyze the survival outcomes of adult patients with HL after combined-modality treatment (CMT) with involved-field or non-involved-field radiotherapy.

Methods and results: We retrospectively reviewed the medical records of 90 adult patients with HL who received CMT at Rajavithi Hospital, Bangkok between 2007 and 2021. Patients with stage I-IV disease received different therapies depending on their risk group. The risk groups were evaluated according to initial response, bulky disease, and B symptoms. Patients (n = 90) who underwent CMT were followed up for 34.7 months (range, 1-141 months). The median follow-up periods of early and advanced-stage patients were 53.1 months and 23.5 months, respectively. The estimated 5-year overall survival (OS) and progression-free survival (PFS) rates of patients with advanced-stage diseases were 85% and 62%, respectively. There was a difference in the 3-year overall survival among advance-stage patients who underwent ABVD (94%) compared to those administered BEACOPPesc (50%), and the 3-year PFS (84%) among patients who underwent ABVD was higher than that among those administered BEACOPPesc (66%). Radiotherapy increased toxicity but did not improve the survival rate.

Conclusion: Chemotherapy administered to patients with advanced-stage adult HL was more effective than BEACOPPesc when ABVD was administered. Our findings are relevant for hospitals with limited resources.

Keywords: Hodgkin disease; adult; advance-stage cancer; chemotherapy; life expectancy; limited resource country.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Bleomycin / adverse effects
  • Cyclophosphamide
  • Dacarbazine / adverse effects
  • Doxorubicin
  • Etoposide
  • Hodgkin Disease* / drug therapy
  • Hodgkin Disease* / pathology
  • Humans
  • Prednisone
  • Retrospective Studies
  • Survival Rate
  • Thailand
  • Vinblastine
  • Vincristine

Substances

  • Bleomycin
  • Doxorubicin
  • Dacarbazine
  • Vinblastine
  • Cyclophosphamide
  • Vincristine
  • Prednisone
  • Etoposide