Initial dose intensity has limited impact on the outcome of ABVD chemotherapy for advanced Hodgkin lymphoma (HL): data from UKLG LY09 (ISRCTN97144519).
BACKGROUND
This analysis was undertaken to assess the relationship between the dose intensity (DI) of initial chemotherapy and outcome in a large cohort of patients with advanced Hodgkin lymphoma treated in a randomised controlled trial, in which detailed dose data were collected prospectively.


METHODS
Three-hundred and eighty patients randomly assigned to receive standard doxorubicin, bleomycin, vinblastine and dacarbazine who underwent at least two cycles of treatment were studied. With a median follow-up of 6.9 years, progression-free survival (PFS) from the end of cycle 2 was analysed according to DI during those cycles.


RESULTS
During the first two cycles, 25% of patients received >97% of planned DI, 37% received between 86% and 97% and 38% received <86%. DI during the first two cycles was correlated with DI during the remainder of the course, but there was no evidence that early DI influenced PFS (hazard ratio 0.87, 95% confidence interval 0.67-1.11; P = 0.265). Multivariate analysis also failed to confirm the influence of early DI on PFS or overall survival.


CONCLUSIONS
At the range of DI delivered in a multicentre trial using conventional therapy, there is no clear evidence that early DI influences outcome. This should be tested in a prospective study.
Owadally
W S
WS
Cancer Sciences Division, Cancer Research UK Clinical Centre, Southampton.
Sydes
M R
MR
Cancer Division, Medical Research Council Clinical Trials Unit, London.
Radford
J A
JA
Department of Medical Oncology, Christie Hospital, Manchester.
Hancock
B W
BW
Department of Medical Oncology, Weston Park Hospital, Sheffield.
Cullen
M H
MH
Cancer Centre, Birmingham University Hospitals, Birmingham, UK.
Stenning
S P
SP
Cancer Division, Medical Research Council Clinical Trials Unit, London.
Johnson
P W M
PWM
Cancer Sciences Division, Cancer Research UK Clinical Centre, Southampton. Electronic address: johnsonp@soton.ac.uk.
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use; D003606:Dacarbazine / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000627:therapeutic use; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014747:Vinblastine / Q000627:therapeutic use
D001761:Bleomycin; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin