title: Early chemotherapy intensification with BEACOPP in advanced-stage Hodgkin lymphoma patients with a interim-PET positive after two ABVD courses.
abstract: Interim 2-[18F]Fluoro-2-deoxy-D-glucose Positron Emission Tomography performed after two chemotherapy cycles (PET-2) is the most reliable predictor of treatment outcome in ABVD-treated Hodgkin Lymphoma (HL) patients. We retrospectively analysed the treatment outcome of a therapeutic strategy based on PET-2 results: positive patients switched to BEACOPP, while negative patients continued with ABVD. Between January 2006 and December 2007, 219 newly diagnosed HL patients admitted to nine centres were enrolled; 54 patients, unfit to receive this treatment were excluded from the analysis. PET-2 scans were reviewed by a central panel of nuclear medicine experts, according to the Deauville score (Meignan, 2009). After a median follow up of 34 months (12-52) the 2-year failure free survival (FFS) and overall survival for the entire cohort of 165 patients were 88% and 98%; the FFS was 65% for PET-2 positive and 92% for PET-2 negative patients. For 154 patients in which treatment was correctly given according to PET-2 review, the 2-year FFS was 91%: 62% for PET-2 positive and 95% for PET-2 negative patients.
  
  
  CONCLUSIONS
  this strategy, with BEACOPP intensification only in PET-2 positive patients, showed better results than ABVD-treated historic controls, sparing BEACOPP toxicity to the majority of patients.
authors.affiliation: Hematology Department and BMT Unit, Azienda Ospedaliera S. Croce e Carle, Via M. Coppino 26, Cuneo, Italy. gallamini.a@ospedale.cuneo.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Gallamini
authors.forename: Caterina
authors.initials: C
authors.lastname: Patti
authors.forename: Simonetta
authors.initials: S
authors.lastname: Viviani
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossi
authors.forename: Francesca
authors.initials: F
authors.lastname: Fiore
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Raimondo
authors.forename: Maria
authors.initials: M
authors.lastname: Cantonetti
authors.forename: Caterina
authors.initials: C
authors.lastname: Stelitano
authors.forename: Tatyana
authors.initials: T
authors.lastname: Feldman
authors.forename: Paolo
authors.initials: P
authors.lastname: Gavarotti
authors.forename: Roberto
authors.initials: R
authors.lastname: Sorasio
authors.forename: Antonino
authors.initials: A
authors.lastname: Mulè
authors.forename: Monica
authors.initials: M
authors.lastname: Leone
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rambaldi
authors.forename: Alberto
authors.initials: A
authors.lastname: Biggi
authors.forename: Sally
authors.initials: S
authors.lastname: Barrington
authors.forename: Federico
authors.initials: F
authors.lastname: Fallanca
authors.forename: Umberto
authors.initials: U
authors.lastname: Ficola
authors.forename: Stéphane
authors.initials: S
authors.lastname: Chauvie
authors.forename: Alessandro Massimo
authors.initials: AM
authors.lastname: Gianni
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D003606:Dacarbazine / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D057915:Drug Substitution; D004812:Epidemiologic Methods; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006689:Hodgkin Disease / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011241:Prednisone / Q000627:therapeutic use; D011344:Procarbazine / Q000627:therapeutic use; D011379:Prognosis; D016896:Treatment Outcome; D014747:Vinblastine / Q000627:therapeutic use; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D001761:Bleomycin; D011344:Procarbazine; D014750:Vincristine; D014747:Vinblastine; D005047:Etoposide; D003606:Dacarbazine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone