Suboptimal outcomes of first-line chemotherapeutic regimens for advanced stages of classical Hodgkin lymphoma

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Abstract

Background. Despite high efficacy of chemotherapy in Hodgkin lymphoma (HL), a substantial proportion of patients (about 20 %) still experience relapse or refractory disease. This study was aimed to analyze efficacy and toxicity of most widely-used chemotherapy regimens for advanced-stage HL at a single center.

Materials and methods. The retrospective analysis included adult patients with advanced-stage HL (n = 107) who received treatment at the P. A. Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Center, between 2019 and 2024.

Results. Of the 107 patients, 86 received BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) or a BEACOPP-like regimen, and 21 received ABVD (doxorubicin, bleomycin, vinorelbine, dacarbazine). The overall response rate after completion of therapy was 93.5 %, and the complete metabolic response rate was 92.5 %. With a median follow-up of 26 (10–44) months, overall survival was 98.1 %, and progression-free survival was 78.5 %. Exploratory subgroup analysis showed a negative impact on progression-free survival of a high International Prognostic Score value (hazard ratio 1.13; 95 % confidence interval 2.60–6.02; p = 0.03), presence of extranodal lesions (hazard ratio 5.67; 95 % confidence interval 1.66–19.09; p = 0.006), and bone marrow involvement (hazard ratio 3.19; 95 % confidence interval 1.18–8.61; p = 0.02). Toxicity was comparable between treatment groups, although BEACOPP-like regimens were associated with higher hematologic toxicity.

Conclusion. The most commonly used chemotherapy protocols for advanced-stage HL provide only suboptimal disease control in this setting.

About the authors

M. I. Akhmedov

P.A. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Center, Ministry of Health of Russia; Russian University of Medicine, Ministry of Health of Russia

Author for correspondence.
Email: mobilakhmedov@gmail.com
ORCID iD: 0000-0002-9646-690X
Russian Federation, 3 2nd Botkinskiy Proezd, Moscow, 125284; 4 Dolgorukovskaya St., Moscow, 127006

P. A. Zeynalova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University); Clinical Hospital "Lapino" of the "Mother and Child" Group of Companies

Email: mobilakhmedov@gmail.com
ORCID iD: 0000-0003-1564-424X
Russian Federation, Build. 2, 8 Trubetskaya St., Moscow, 119048; 111 1st Uspenskoe Shosse, Lapino, Moscow Region, 143081

M. A. Vernyuk

P.A. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Center, Ministry of Health of Russia

Email: mobilakhmedov@gmail.com
ORCID iD: 0000-0003-1497-2436
Russian Federation, 3 2nd Botkinskiy Proezd, Moscow, 125284

A. A. Tarasenkova

P.A. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Center, Ministry of Health of Russia; RUDN University

Email: mobilakhmedov@gmail.com
Russian Federation, 3 2nd Botkinskiy Proezd, Moscow, 125284; 6 Miklukho-Maklaya St., Moscow, 117198

S. V. Semochkin

P.A. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Center, Ministry of Health of Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: mobilakhmedov@gmail.com
ORCID iD: 0000-0002-8129-8114
Russian Federation, 3 2nd Botkinskiy Proezd, Moscow, 125284; 1 Ostrovityanova St., Moscow, 117513

L. S. Khayrullina

P.A. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Center, Ministry of Health of Russia

Email: mobilakhmedov@gmail.com
ORCID iD: 0000-0001-8520-0711
Russian Federation, 3 2nd Botkinskiy Proezd, Moscow, 125284

A. M. Chervontseva

P.A. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Center, Ministry of Health of Russia

Email: mobilakhmedov@gmail.com
ORCID iD: 0000-0002-8498-6289
Russian Federation, 3 2nd Botkinskiy Proezd, Moscow, 125284

I. V. Cherkashina

P.A. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Center, Ministry of Health of Russia

Email: mobilakhmedov@gmail.com
ORCID iD: 0000-0001-7096-4700
Russian Federation, 3 2nd Botkinskiy Proezd, Moscow, 125284

V. V. Lunin

P.A. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Center, Ministry of Health of Russia

Email: mobilakhmedov@gmail.com
ORCID iD: 0000-0001-8689-1227
Russian Federation, 3 2nd Botkinskiy Proezd, Moscow, 125284

M. M. Davydov

Clinical Hospital "Lapino" of the "Mother and Child" Group of Companies; Medical University MGIMO-MED

Email: mobilakhmedov@gmail.com
ORCID iD: 0000-0001-5038-9307
Russian Federation, 111 1st Uspenskoe Shosse, Lapino, Moscow Region, 143081; 111 1st Uspenskoe Shosse, Lapino, Moscow Region, 143081

A. A. Fedenko

P.A. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Center, Ministry of Health of Russia

Email: mobilakhmedov@gmail.com
ORCID iD: 0000-0003-4927-5585
Russian Federation, 3 2nd Botkinskiy Proezd, Moscow, 125284

A. D. Kaprin

P.A. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Center, Ministry of Health of Russia; RUDN University

Email: mobilakhmedov@gmail.com
ORCID iD: 0000-0001-8784-8415
Russian Federation, 3 2nd Botkinskiy Proezd, Moscow, 125284; 6 Miklukho-Maklaya St., Moscow, 117198

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