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PET-adapted therapy after three cycles of ABVD for all stages of Hodgkin lymphoma: results of the GATLA LH-05 trial.
Pavlovsky, Astrid; Fernandez, Isolda; Kurgansky, Nicolas; Prates, Virginia; Zoppegno, Lucia; Negri, Pedro; Milone, Gustavo; Cerutti, Ider; Zabaljauregui, Soledad; Mariano, Romina; Grecco, Horacio F; Basquiera, Ana L; Saba, Silvia; Rudoy, Silvia; Sackmann, Federico; Castano, Vanesa; Remaggi, Guillermina; Cabrejo, Maria; Roveri, Eriberto; Casale, Maria F; Cabane, Vanina; Taus, Rossana; Venturini, Claudia; Sakamoto, Francisco; Varela, Ana I; Riddick, Maximiliano; Pavlovsky, Santiago.
Afiliación
  • Pavlovsky A; Haematology, Fundaleu, Buenos Aires, Argentina.
  • Fernandez I; Haematology, Centro de Hematologia Pavlovsky, Buenos Aires, Argentina.
  • Kurgansky N; Haematology, Fundaleu, Buenos Aires, Argentina.
  • Prates V; Haematology, Centro de Hematologia Pavlovsky, Buenos Aires, Argentina.
  • Zoppegno L; Haematology, Doctus, Santa Fe, Argentina.
  • Negri P; Haematology, Hospital Italiano de la Plata, La Plata, Argentina.
  • Milone G; Haematology, Hospital san Martin de la Plata, La Plata, Argentina.
  • Cerutti I; Haematology, Instituto Privado de Hematologia y Hemoterapia, Paraná, Entre Rios, Argentina.
  • Zabaljauregui S; Haematology, Fundaleu, Buenos Aires, Argentina.
  • Mariano R; Haematology, IDHeA, Rosario, Santa Fe, Argentina.
  • Grecco HF; Haematology, Academia Nacional de Medicina, Buenos Aires, Argentina.
  • Basquiera AL; Haematology, Hospital San Martin, Paraná, Entre Rios, Argentina.
  • Saba S; Haematology, Sanatorio Mendez, Buenos Aires, Argentina.
  • Rudoy S; Haematology, Hospital Privado de Cordoba, Cordoba, Argentina.
  • Sackmann F; Bone Marrow Transplantation Unit, Hospital Rossi, La Plata, Argentina.
  • Castano V; Haematology, Clinica Modelo Moron, Buenos Aires, Argentina.
  • Remaggi G; Haematology, Fundaleu, Buenos Aires, Argentina.
  • Cabrejo M; Haematology, Centro de Hematologia Pavlovsky, Buenos Aires, Argentina.
  • Roveri E; Haematology, IDHeA, Rosario, Santa Fe, Argentina.
  • Casale MF; Haematology, Centro de Hematologia Pavlovsky, Buenos Aires, Argentina.
  • Cabane V; Transplantation Program, Fundaleu, Buenos Aires, Argentina.
  • Taus R; Haematology, Sanatorio Julio Mendez, Buenos Aires, Argentina.
  • Venturini C; Haematology, IDHeA, Rosario, Santa Fe, Argentina.
  • Sakamoto F; Haematology, Hospital General Centeno, Gral Pico, La Pampa, Argentina.
  • Varela AI; Haematology, Clínica Dr. Roberto Raña, Neuquen, Argentina.
  • Riddick M; Bone Marrow Transplantation Unit, Hospital Rossi, La Plata, Argentina.
  • Pavlovsky S; Haematology, Instituto Privado de Hematologia y Hemoterapia, Paraná, Entre Rios, Argentina.
Br J Haematol ; 185(5): 865-873, 2019 06.
Article en En | MEDLINE | ID: mdl-30864146
The role of Ann Arbor staging in determining treatment intensity after achieving a negative positron emission tomography (PET) has not been established in classical Hodgkin lymphoma (cHL). Patients with stage I-IV cHL, received three cycles of ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) and an interim PET scan (PET3). PET3-negative patients received no further therapy. PET3-positive patients received three additional cycles of ABVD plus involved-field radiation therapy or salvage chemotherapy, if refractory to ABVD, and were re-evaluated by PET scan (PET6). Study endpoints were 3-year progression-free survival (PFS) and overall survival (OS) rates. Two hundred and thirty-nine patients with early-stage and 138 with advanced-stage were evaluable. Overall, 260 patients (70%) were PET3-negative and had higher 3-year PFS (90% vs. 65%; P < 0·0001) and OS (98% vs. 92%; P = 0·007) rates than PET3-positive patients. All PET3-negative patients, regardless of disease stage at diagnosis, achieved similarly good PFS (90-91%; P = 0·76) and OS (97-99%). The only independent prognostic factor for PFS was PET3-negativity (Hazard ratio 3·8; 95% confidence interval 2·4-6·3; P < 0·0001). This study suggests that cHL patients who achieve a negative PET3 following ABVD have an excellent outcome, regardless of stage at diagnosis. An appropriately powered, phase III trial will be necessary to confirm these findings.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de Hodgkin / Protocolos de Quimioterapia Combinada Antineoplásica / Tomografía de Emisión de Positrones Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Br J Haematol Año: 2019 Tipo del documento: Article País de afiliación: Argentina Pais de publicación: Reino Unido
Texto completo
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XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de Hodgkin / Protocolos de Quimioterapia Combinada Antineoplásica / Tomografía de Emisión de Positrones Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Br J Haematol Año: 2019 Tipo del documento: Article País de afiliación: Argentina Pais de publicación: Reino Unido