title: ABVD in older patients with early-stage Hodgkin lymphoma treated within the German Hodgkin Study Group HD10 and HD11 trials.
abstract: OBJECTIVE
  Older patients with Hodgkin lymphoma (HL) account for approximately 20% of all HL patients. ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy is regarded as standard of care in these patients. However, little is known on feasibility and efficacy of ABVD in this age group.
  
  
  METHODS
  We analyzed the feasibility and efficacy of four cycles of ABVD in older patients age 60 to 75 years with early-stage HL who were treated within the German Hodgkin Study Group (GHSG) HD10 and HD11 trials; results were compared with those of younger patients treated within these trials.
  
  
  RESULTS
  In total, 1,299 patients received four cycles of ABVD, and 117 of those patients were older than age 60 years (median, 65 years). In 14% of older patients, treatment was not administered according to protocol, mainly because of excessive toxicity. The mean delay of treatment was twice as high in the older patients (2.2 v 1.2 weeks). Fifty-nine percent of older patients achieved a relative dose-intensity of at least 80% compared with 85% of younger patients. Major toxicity (WHO grade 3 and 4), including leucopenia, nausea, infection, and others, was documented in 68% of older patients with a treatment-related mortality of 5%. Complete response was achieved in 89% of older patients, 3% had progressive disease, and 11% relapsed. At a median observation time of 92 months, 28% of the patients had died, and the 5-year progression-free survival estimate was 75% (95% CI, 66% to 82%).
  
  
  CONCLUSIONS
  In patients age ≥ 60 years with HL, four cycles of ABVD is associated with substantial dose reduction, treatment delay, toxicity, and treatment-related mortality.
authors.affiliation: German Hodgkin Study Group, Cologne, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Böll
authors.forename: Helen
authors.initials: H
authors.lastname: Görgen
authors.forename: Michael
authors.initials: M
authors.lastname: Fuchs
authors.forename: Annette
authors.initials: A
authors.lastname: Pluetschow
authors.forename: Hans Theodor
authors.initials: HT
authors.lastname: Eich
authors.forename: Mario J
authors.initials: MJ
authors.lastname: Bargetzi
authors.forename: Eckhart
authors.initials: E
authors.lastname: Weidmann
authors.forename: Christian
authors.initials: C
authors.lastname: Junghanß
authors.forename: Richard
authors.initials: R
authors.lastname: Greil
authors.forename: Alexander
authors.initials: A
authors.lastname: Scherpe
authors.forename: Oliver
authors.initials: O
authors.lastname: Schmalz
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Eichenauer
authors.forename: Bastian
authors.initials: B
authors.lastname: von Tresckow
authors.forename: Achim
authors.initials: A
authors.lastname: Rothe
authors.forename: Volker
authors.initials: V
authors.lastname: Diehl
authors.forename: Andreas
authors.initials: A
authors.lastname: Engert
authors.forename: Peter
authors.initials: P
authors.lastname: Borchmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use; D003606:Dacarbazine / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012074:Remission Induction; D015996:Survival Rate; D014747:Vinblastine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D001761:Bleomycin; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin