ABVD regimen in the treatment of Hodgkin's lymphoma

March. 09,2021


The Polish Gdansk Medical University Zaucha et al. reported an observational study by the Polish Lymphoma Research Group (PLRG) that after 2 cycles of ABVD chemotherapy, PET examination (iPET2) can identify effective treatment, which is an evaluation of classic Hodgkin The best way to treat lymphoma (cHL) ABVD. In addition, PET examination (iPET1) after one cycle of ABVD treatment can identify the rapid onset of the best curative effect, and can be used to guide the early de-escalation treatment of patients with early and advanced HL. (Ann Oncol. Online version September 18, 2017)

 

iPET2 can be used to predict the treatment outcome of cHL. In order to verify whether earlier chemotherapy evaluation can improve the accuracy of prediction, evaluate the predictive value (PV) of iPET1 and the response kinetics of subsequent PET scan evaluations. This is a prospective, multi-center, An observational study enrolled patients with newly treated cHL, improved the iPET1 examination, and divided the PET test results into negative (DS 1~3 points) and positive (DS 4~5 points) based on the Deauville score (DS). Patients with iPET1 DS 3~5 should complete iPET2.

 

The results showed that a total of 106 early (Ⅰ~ⅡA) patients and 204 advanced (ⅡB~IV) patients were enrolled. Among early patients, 87 (82%) were iPET1 negative and 19 were iPET1 positive; among advanced patients, 133 (65%) were iPET1 negative and 71 (35%) were iPET1 positive. 24 patients were excluded from the efficacy analysis due to treatment upgrades.

 

With a median follow-up of 38.2 months (3.2-90.2 months), 9 (9%) early patients and 43 (23%) advanced patients had progression-free survival events. At the 36th month, the negative predictive value and positive predictive value of iPET1 were 94% and 41% in early patients, and 84% and 43% in advanced patients, respectively.

 

198 patients received iPET1 and iPET2, which can be used to assess the kinetics of PET response. 116 cases of iPET1 and iPET2 negative patients were rapid onset; of 82 iPET1 positive patients, 41 cases became iPET2 negative, which was slow onset; 41 iPET2 positive cases were ineffective; three types of patients were 36 months old The progression-free survival rates were 88%, 79%, and 34%, respectively.