Doxorubicin, vinblastine, and gemcitabine (CALGB 50203) for stage I/II nonbulky Hodgkin lymphoma: Pretreatment prognostic factors and interim PET

David J. Straus, Jeffrey L. Johnson, Ann S. Lacasce, Nancy L. Bartlett, Lale Kostakoglu, Eric D. Hsi, Heiko Schöder, Nathan C. Hall, Sin Ho Jung, George P. Canellos, Lawrence H. Schwartz, Ronald W. Takvorian, Malik E. Juweid, Bruce D. Cheson

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Abstract

To reduce doxorubicin, bleomycin, vinblastine and dacarbazine toxicity, the Cancer and Leukemia Group B conducted a phase 2 trial of doxorubicin, vinblastine, and gemcitabine for newly diagnosed, nonbulky stages I and II Hodgkin lymphoma. Ninety-nine assessable patients received 6 cycles of doxorubicin 25 mg/m2, vinblastine 6 mg/m2, and gemcitabine 800 mg/m2 (1000 mg/m2 in first 6) on days 1 and 15 every 28 days. Computed tomography (CT) and positron emission tomography (PET) were performed before and after 2 and 6 cycles. Complete remission (CR)/CR unconfirmed was achieved in 72 of 99 patients (72.7%) and partial remission in 24 of 99 patients (24.2%). The CR rate was 81% when using PET criteria. Two patients have died of Hodgkin lymphoma progression. Median follow-up for nonprogressing patients is 3.3 years. The progression-free survival (PFS) at 3 years was 77% (95% confidence interval, 68%-84%). The relapse rate was less than 10% for patients with favorable prognostic factors. The 2-year PFS for cycle 2 PET-negative and-positive patients was 88% and 54%, respectively (P =.0009), compared with 89% and 27% for cycle 6 PET-negative and-positive patients (P =.0001). Although the CR rate and PFS were lower than anticipated, patients with favorable prognostic features had a low rate of relapse. Cycle 2 PET and cycle 6 PET were predictive of PFS. This clinical trial is registered at www.clinicaltrials.gov as #NCT00086801.

Original languageEnglish
Pages (from-to)5314-5320
Number of pages7
JournalBlood
Volume117
Issue number20
DOIs
StatePublished - May 19 2011

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