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Lymphoma and Pets
No Changes to ABVD in Early-Stage Favorable Hodgkins
According to the final analysis of the German Hodgkin Study Group HD13 trial, neither dacarbazine nor bleomycin can be taken out of the combination chemotherapy regimen ABVD without affecting efficacy in early-stage, favorable Hodgkin’s lymphoma.
All participants in this four-armed trial received two cycles of ABVD, ABV (no dacarbazine), AVD (no bleomycin), or AV (no dacarbazine or bleomycin) chemotherapy followed by 30 Gy involved-field radiation therapy.
The trial's primary endpoint was freedom from treatment failure (FFTF) at 5 years.
After ABVD, the FFTF was 93.1 percent. After AVD it was 89.2 percent; after ABV, it was 81.4 percent; after AV it was 77.1 percent.
"Dacarbazine cannot be omitted without considerable loss of efficacy," Dr. Karolin Behringer said at the annual congress of the European Hematology Association. "Bleomycin cannot be omitted with the predefined noninferiority margin of 6 percent," she said.
Another point of this four-armed HD13 trial was to determine whether AVD was equivalent to ABVD.
This was largely due to more late relapses with AVD than with ABVD (37 vs. 20), said Dr. Behringer, of the University Hospital of Cologne, Germany.
Meanwhile, five year overall survival rates for the four arms were, ABVD: 97.6 percent; ABV: 94.1 percent; AVD: 97.6 percent; AV: 98.1 percent.