Mid- and post-ABVD gallium scanning predicts for recurrence in early-stage Hodgkin's disease.
OBJECTIVE
To determine the efficacy of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) for patients with Hodgkin's disease and to identify predictors of outcome with this regimen.


METHODS
Between 1987 and 1998, 175 patients with Stage I-IV Hodgkin's disease received ABVD as part of initial treatment. Overall survival (OS), freedom-from-treatment-failure (FFTF), and progression-free survival (PFS) were calculated using the Kaplan-Meier technique. Log-rank tests were used to identify univariate predictors of OS, FFTF, and PFS. Specifically, restaging gallium scan results and clinical response after chemotherapy were separately evaluated.


RESULTS
The median follow-up time was 64 months. The 5-year OS, FFTF, and PFS rates were 90%, 85%, and 82%, respectively. For Stage I-II patients, restaging gallium scan results and clinical response after chemotherapy were highly predictive of OS, FFTF, and PFS (p < 0.0001). Other significant predictors for higher OS included age <50 (p = 0.002), female gender (p = 0.047), and absence of B symptoms (p = 0.043). Of the 20 patients with a positive restaging gallium scan, 4 received high-dose therapy and 16 continued with conventional-dose therapy or received no further treatment. Of these 16 patients, 11 (69%) were disease-free at last follow-up.


CONCLUSIONS
Although a positive mid- or postchemotherapy gallium scan was an adverse prognostic factor for OS, FFTF, and PFS, continued treatment with conventional-dose therapy may be adequate in selected patients with positive scans.
Ng
Andrea K
AK
Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA.
Bernardo
M V Patricia
MV
Silver
Barbara
B
Van Den Abbeele
Annick
A
Stevenson
Mary Ann
MA
Fisher
David C
DC
Mauch
Peter M
PM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D002423:Cause of Death; D002648:Child; D003606:Dacarbazine / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005710:Gallium Radioisotopes; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011877:Radionuclide Imaging; D012008:Recurrence; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects
D005710:Gallium Radioisotopes; D001761:Bleomycin; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin