Back to Search Start Over

Liposomal Doxorubicin, Vinblastine and Dacarbazine Plus Consolidation Radiotherapy of Residual Nodal Masses for Frontline Treatment in Older Adults With Advanced Stage Classic Hodgkin Lymphoma: Improved Outcome in a Multi-Center Real-Life Study.

Authors :
Picardi M
Vincenzi A
Giordano C
Fazio L
Pugliese N
Scarpa A
Vigliar E
Troncone G
Russo D
Mascolo M
Esposito G
Prastaro M
Santoro C
Esposito R
Tocchetti CG
Mainolfi C
Fonti R
Vecchio SD
Carchia M
Quagliano C
Salemme A
Damiano V
Bianco R
Trastulli F
Ronconi F
Annunziata M
Pane F
Source :
Hematological oncology [Hematol Oncol] 2024 Nov; Vol. 42 (6), pp. e70003.
Publication Year :
2024

Abstract

In elderly patients with high-risk classic Hodgkin lymphoma (c-HL), we evaluated the impact of a new modality treatment without bleomycin, that is, liposomal doxorubicin (NPLD)-based regimen plus consolidation radiotherapy of residual nodal masses (RNMs), on overall survival (OS) and progression free survival (PFS). In this retrospective study (2013-2023) conducted in tertiary hospitals in the bay of Naples (Italy), 50 older adults (median age, 69 years; range, 60-89) with advanced stage c-HL received frontline treatment with MVD ± irradiation. MVD consisted of 25 mg/m <superscript>2</superscript> of NPLD along with standard Vinblastine and Dacarbazine for a total of 6 cycles (twelve iv administrations, every 2 weeks) followed by radiation of RNMs with size ≥ 2.5 cm at computed tomography. Patients underwent MVD with a median dose intensity of 92%. At 2-deoxy-2[F-18] fluoro-D-glucose positron emission tomography (FDG-PET), 90% of patients (45/50 patients; one failed to perform final FDG-PET due to early death) reached complete responses. Altogether, 17 patients (34%) received consolidation radiotherapy of RNMs with Deauville score ≥ 3. At 5-year median follow-up, the OS and PFS of the entire population were 87.5% (95% confidence interval [CI], 78.7-97.4) and 81.6% (95% CI, 71.4-93.2), respectively. Eleven patients (22%) experienced grade ≥ 3 adverse events, and 4 of them required hospitalization. Our data suggest that in older adults with high-risk c-HL NPLD-driven strategy (without bleomycin) plus consolidation radiotherapy (if needed) may be a promising up-front option, to test in phase II clinical trials for improving survival incidence.<br /> (© 2024 The Author(s). Hematological Oncology published by John Wiley & Sons Ltd.)

Details

Language :
English
ISSN :
1099-1069
Volume :
42
Issue :
6
Database :
MEDLINE
Journal :
Hematological oncology
Publication Type :
Academic Journal
Accession number :
39552192
Full Text :
https://doi.org/10.1002/hon.70003