Impact of time from diagnosis to initiation of curative-intent chemotherapy on clinical outcomes in patients with classical Hodgkin lymphoma.
The impact of treatment delays on outcomes in Hodgkin lymphoma (HL) is currently unknown. Time from definitive histologic diagnosis to first ABVD treatment (TDT) was calculated in 810 adults with HL: 365 (45%) TDT ≤4 weeks, 369 (46%) TDT 5-8 weeks, 76 (9%) TDT >8 weeks. The 5-year overall survival (OS) was 92% TDT ≤4 weeks, 92% TDT 5-8 weeks, and 83% TDT >8 weeks (p = 0.007). The 5-year disease-specific survival (DSS) was 93% TDT ≤4 weeks, 95% TDT 5-8 weeks, and 87% TDT >8 weeks (p = 0.094). The 5-year progression-free survival (PFS) was similar between groups (p = 0.139). In the multivariate analysis, TDT >8 weeks was not associated with worse OS, DSS, or PFS. Despite the univariate association between initiation of ABVD >8 weeks and worse OS, these data do not support such cut-off to improve outcomes. Nevertheless, clinicians should make every effort possible to initiate curative-intent chemotherapy as soon as a diagnosis of HL is established.
a Faculty of Medicine , University of British Columbia , Vancouver , BC , Canada .
Edward G
EG
Brooks
b Centre for Lymphoid Cancer, British Columbia Cancer Agency , Vancouver , BC , Canada , and.
Joseph M
JM
Connors
b Centre for Lymphoid Cancer, British Columbia Cancer Agency , Vancouver , BC , Canada , and.
Laurie H
LH
Sehn
b Centre for Lymphoid Cancer, British Columbia Cancer Agency , Vancouver , BC , Canada , and.
Randy D
RD
Gascoyne
b Centre for Lymphoid Cancer, British Columbia Cancer Agency , Vancouver , BC , Canada , and.
Kerry J
KJ
Savage
b Centre for Lymphoid Cancer, British Columbia Cancer Agency , Vancouver , BC , Canada , and.
Tamara N
TN
Shenkier
b Centre for Lymphoid Cancer, British Columbia Cancer Agency , Vancouver , BC , Canada , and.
Richard
R
Klasa
b Centre for Lymphoid Cancer, British Columbia Cancer Agency , Vancouver , BC , Canada , and.|c Leukemia/Bone Marrow Transplant Program of British Columbia , Vancouver , BC , Canada.
Alina S
AS
Gerrie
b Centre for Lymphoid Cancer, British Columbia Cancer Agency , Vancouver , BC , Canada , and.
Brian
B
Skinnider
b Centre for Lymphoid Cancer, British Columbia Cancer Agency , Vancouver , BC , Canada , and.
Graham W
GW
Slack
b Centre for Lymphoid Cancer, British Columbia Cancer Agency , Vancouver , BC , Canada , and.
Diego
D
Villa
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001955:British Columbia; D002423:Cause of Death; D003131:Combined Modality Therapy; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012042:Registries; D012307:Risk Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D055815:Young Adult
ABVD; Hodgkin lymphoma; time to chemotherapy; time to treatment