title: Phase 2 study of rituximab-ABVD in classical Hodgkin lymphoma.
abstract: In classical Hodgkin lymphoma, circulating clonotypic malignant cells express CD20, which potentially explains the observed activity of rituximab. This multicenter phase 2 study investigated the combination of rituximab-ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) for stage II-IV untreated classical Hodgkin lymphoma. A goal was to assess the behavior of circulating clonotypic B cells clinically. Of 49 evaluable patients, 69% had stage IIB-IV disease; 8% had CD20(+) Hodgkin and Reed-Sternberg cells. Rituximab-ABVD was generally well tolerated. Delivered relative dose intensity was 94% for AVD and 79% for bleomycin. After 6 cycles, 81% of patients were in complete remission. Only 8% received radiation therapy. The actuarial 3-year event-free and overall survival rates were 83% and 98%, respectively. EBV copy number in plasma fell dramatically during cycle 1 in patients with EBV(+) tumors. Persistence of detectable circulating clonotypic B cells was associated with a greater relapse frequency (P < .05). Rituximab-ABVD and clonotypic B cells warrant additional study in classical Hodgkin lymphoma.
authors.affiliation: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21287, USA. ykasamon@jhmi.edu
authors.forename: Yvette L
authors.initials: YL
authors.lastname: Kasamon
authors.forename: Heather A
authors.initials: HA
authors.lastname: Jacene
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Gocke
authors.forename: Lode J
authors.initials: LJ
authors.lastname: Swinnen
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Gladstone
authors.forename: Brandy
authors.initials: B
authors.lastname: Perkins
authors.forename: Brian K
authors.initials: BK
authors.lastname: Link
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Popplewell
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Habermann
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Herman
authors.forename: William H
authors.initials: WH
authors.lastname: Matsui
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Jones
authors.forename: Richard F
authors.initials: RF
authors.lastname: Ambinder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016175:B-Lymphocyte Subsets / Q000473:pathology; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D002999:Clone Cells / Q000473:pathology; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D020031:Epstein-Barr Virus Infections; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy / Q000821:virology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008171:Lung Diseases / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D012074:Remission Induction; D000069283:Rituximab; D015996:Survival Rate; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D001761:Bleomycin; D000069283:Rituximab; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin