Hodgkin lymphoma treatment with ABVD in the US and the EU: neutropenia occurrence and impaired chemotherapy delivery.

dc.contributor.author

Schwenkglenks, Matthias

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Pettengell, Ruth

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Szucs, Thomas D

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Culakova, Eva

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Lyman, Gary H

dc.coverage.spatial

England

dc.date.accessioned

2011-06-21T17:30:26Z

dc.date.issued

2010-08-19

dc.description.abstract

BACKGROUND: In newly diagnosed patients with Hodgkin lymphoma (HL) the effect of doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD)-related neutropenia on chemotherapy delivery is poorly documented. The aim of this analysis was to assess the impact of chemotherapy-induced neutropenia (CIN) on ABVD chemotherapy delivery in HL patients. STUDY DESIGN: Data from two similarly designed, prospective, observational studies conducted in the US and the EU were analysed. One hundred and fifteen HL patients who started a new course of ABVD during 2002-2005 were included. The primary objective was to document the effect of neutropenic complications on delivery of ABVD chemotherapy in HL patients. Secondary objectives were to investigate the incidence of CIN and febrile neutropenia (FN) and to compare US and EU practice with ABVD therapy in HL. Pooled data were analysed to explore univariate associations with neutropenic events. RESULTS: Chemotherapy delivery was suboptimal (with a relative dose intensity < or = 85%) in 18-22% of patients. The incidence of grade 4 CIN in cycles 1-4 was lower in US patients (US 24% vs. EU 32%). Patients in both the US and the EU experienced similar rates of FN across cycles 1-4 (US 12% vs. EU 11%). Use of primary colony-stimulating factor (CSF) prophylaxis and of any CSF was more common in the US than the EU (37% vs. 4% and 78% vs. 38%, respectively). The relative risk (RR) of dose delays was 1.54 (95% confidence interval [CI] 1.08-2.23, p = 0.036) for patients with vs. without grade 4 CIN and the RR of grade 4 CIN was 0.35 (95% CI 0.12-1.06, p = 0.046) for patients with vs. without primary CSF prophylaxis. CONCLUSIONS: In this population of HL patients, CIN was frequent and FN occurrence clinically relevant. Chemotherapy delivery was suboptimal. CSF prophylaxis appeared to reduce CIN rates.

dc.description.version

Version of Record

dc.identifier

http://www.ncbi.nlm.nih.gov/pubmed/20723212

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1756-8722-3-27

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1756-8722

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https://hdl.handle.net/10161/4389

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eng

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en_US

dc.publisher

Springer Science and Business Media LLC

dc.relation.ispartof

J Hematol Oncol

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10.1186/1756-8722-3-27

dc.relation.journal

Journal of Hematology & Oncology

dc.subject

Adult

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Aged

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Aged, 80 and over

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Antineoplastic Combined Chemotherapy Protocols

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Bleomycin

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Colony-Stimulating Factors

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Dacarbazine

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Doxorubicin

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Female

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Hodgkin Disease

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Humans

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Male

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Middle Aged

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Neutropenia

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Prospective Studies

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Vinblastine

dc.title

Hodgkin lymphoma treatment with ABVD in the US and the EU: neutropenia occurrence and impaired chemotherapy delivery.

dc.title.alternative
dc.type

Journal article

duke.date.pubdate

2010-8-19

duke.description.issue
duke.description.volume

3

pubs.author-url

http://www.ncbi.nlm.nih.gov/pubmed/20723212

pubs.begin-page

27

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Duke

pubs.organisational-group

Medicine

pubs.organisational-group

Medicine, Medical Oncology

pubs.organisational-group

School of Medicine

pubs.publication-status

Published online

pubs.volume

3

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