title: ABVE-PC and modified BEACOPP regimen in Indian children with Hodgkin lymphoma: Feasibility and efficacy.
abstract: OBJECTIVE
  To study the toxicity of ABVE-PC (doxorubicin, bleomycin, vincristine, etoposide, prednisone and cyclophosphamide) and modified-BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) in intermediate-risk and high-risk Hodgkin lymphoma patients.
  
  
  METHODS
  High-risk patients received 4 cycles of modified-BEACOPP (m-BEACOPP) plus 4 cycles of ABVD. Intermediate-risk patients received 4 cycles of ABVE-PC plus 2 cycles of ABVD.
  
  
  RESULTS
  From 2010 to 2014, 17 patients received 66 cycles of m-BEACOPP and 9 patients received 40 cycles of ABVE-PC. In the m-BEACOPP and ABVE-PC courses, respectively, significant thrombocytopenia (<50,000/mm(3)) occurred in 10.6% vs 0% of courses; anemia (Hb. <8 gm/dl) in 27.3% vs 15%; neutropenia (ANC<500/mm(3)) in 46.9% vs 32.5%; and febrile neutropenia in 33.3% vs. 22.5%. Only episode of documented infection (hepatic abscess) occurred in ABVE-PC. There were no episodes of sepsis, typhlitis or pneumonia in either group. All 26 patients are in remission with a median follow-up of 35 months (range, 17-61); and there have been no relapses. Two of 26 (7.7%) patients failed to achieve rapid early response after 2 cycles and complete remission after 4 cycles of chemotherapy; both achieved remission with more intensive regimens followed by radiation. The remaining 24 patients did not receive radiation therapy.
  
  
  CONCLUSIONS
  Both m-BEACOPP and ABVE-PC regimens have acceptable toxicity; and thus can be used in most centres with optimum supportive care facilities. They offer promising response rate and relapse free survival without the need for radiation therapy in most patients; and thus may be considered for children with high-risk and intermediate-risk Hodgkin lymphoma.
authors.affiliation: Department of Pediatric Hematology and Oncology, Meenakshi Mission Hospital and Research Centre, Madurai, Tamil Nadu, India.
authors.forename: Somasundaram
authors.initials: S
authors.lastname: Jayabose
authors.affiliation: Department of Pediatric Hematology and Oncology, Meenakshi Mission Hospital and Research Centre, Madurai, Tamil Nadu, India.
authors.forename: Kasi
authors.initials: K
authors.lastname: Viswanathan
authors.affiliation: Department of Pediatric Hematology and Oncology, Meenakshi Mission Hospital and Research Centre, Madurai, Tamil Nadu, India.
authors.forename: Vignesh
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Department of Pediatric Hematology and Oncology, Meenakshi Mission Hospital and Research Centre, Madurai, Tamil Nadu, India.
authors.forename: Annapoorani
authors.initials: A
authors.lastname: Annamalai
authors.affiliation: Department of Pediatric Oncology, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu, India.
authors.forename: Arathi
authors.initials: A
authors.lastname: Srinivasan
authors.affiliation: Department of Pediatric Oncology, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu, India.
authors.forename: Julius Xavier
authors.initials: JX
authors.lastname: Scott
authors.affiliation: Department of Pediatric Hematology and Oncology, Meenakshi Mission Hospital and Research Centre, Madurai, Tamil Nadu, India.
authors.forename: Krishnakumar
authors.initials: K
authors.lastname: Rathnam
keywords: ABVE-PC; BEACOPP; Hodgkin lymphoma; Indian children