Comparison between hybrid MOPPABV and ABVD chemotherapy protocols for Hodgkin's lymphoma in public hospitals of the largest South American city: a retrospective 14-year study.
The behavior of Hodgkin's lymphoma (HL) is different in developing countries, perhaps due to differences in epidemiology and population access to health care. We performed a retrospective study comparing the efficacy of mechlorethamine, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, and vinblastine (MOPPABV) versus adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy protocols as first-line therapy for HL in a Brazilian population. A hundred and eighty-six HL patients were retrospectively analyzed regarding their first-line treatment with MOPPABV and ABVD at two public hospitals in São Paulo, Brazil. Eligible patients were either previously untreated or at first relapse after being treated with only radiotherapy with confirmed HL diagnosis. At a median follow-up of 9 years, complete remission is 89.5 and 85.9 (P = 0.3), overall survival 93.8% and 89.6% (P = 0.68), disease-free survival 85.6% and 81.6% (P = 0.41), and relapse ratios 20.9% and 26.4% (P = 0.17) for ABVD and MOPPABV, respectively. Extended-field radiation therapy postchemotherapy was mostly used in the MOPPABV group. There were three cases of secondary neoplasm (colon adenocarcinoma, myeloid chronic leukemia, and non-Hodgkin's lymphoma), all associated with MOPPABV. ABVD and MOPPABV protocols as first-line treatment for HL resulted in similar therapeutic outcomes and did not influence overall survival, disease-free survival, and relapse ratio. MOPPABV was related to a higher risk of secondary malignancy and, therefore, ABVD should be considered a better option for HL therapy. These findings corroborate recent data in literature.
Souza
E M
EM
Departamento de Oncologia Clínica e Experimental, Federal University of São Paulo (UNIFESP), Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Baiocchi
O C G
OC
Zanichelli
M A
MA
Alves
A C
AC
Oliveira
J S R
JS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use* / Q000633:toxicity; D001761:Bleomycin / Q000008:administration & dosage; D001938:Brazil; D003606:Dacarbazine / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004341:Drug Evaluation; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008466:Mechlorethamine / Q000008:administration & dosage; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000139:chemically induced; D011241:Prednisone / Q000008:administration & dosage; D011344:Procarbazine / Q000008:administration & dosage; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D016019:Survival Analysis; D014747:Vinblastine / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
D001761:Bleomycin; D011344:Procarbazine; D008466:Mechlorethamine; D014750:Vincristine; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin; D011241:Prednisone