De-escalation chemotherapy and hematological profiles in patients with advanced Hodgkin's lymphoma

Int J Clin Pharm. 2015 Dec;37(6):1033-7. doi: 10.1007/s11096-015-0201-5. Epub 2015 Sep 25.

Abstract

Background: There is a need to develop treatment strategies that are less toxic than BEACOPPescalated x6 cycles, the standard-of-care in advanced Hodgkin's lymphoma patients.

Objective: To compare short-term hematological toxicity in advanced Hodgkin's lymphoma patients treated with either BEACOPPescalated x6 cycles (standard group) or BEACOPPescalated x2 followed by ABVD x4 cycles (experimental group).

Method: In 27 patients, we compared injections of erythropoiesis stimulating agent and granulocyte colony-stimulating factor, transfusions, hospitalization days, as well as hemoglobin, platelet, leukocyte levels. Method In 27 patients, we compared injections of erythropoiesis stimulating agent and granulocyte colony-stimulating factor, transfusions, hospitalization days, as well as hemoglobin, platelet, leukocyte levels.

Results: The mean number of erythropoiesis stimulating agent and granulocyte colony-stimulating factor injections, platelet transfusions and hospitalization days was significantly lower in the experimental group (erythropoiesis stimulating agents: mean difference -6.6 ± 2.4, p = 0.005; granulocyte colony-stimulating factors: mean difference -8.3 ± 3.6, p = 0.020, platelet transfusions: mean difference -0.6 ± 0.3, p = 0.035; hospitalization days: mean difference: -8.5 ± 1.7 days, p < 10(-3)). There were no differences in terms of red cell transfusions, platelet counts or leukocyte levels between the two groups. From the 3rd chemotherapy cycle, hemoglobin levels decreased to a significantly lesser extent in the experimental group.

Conclusion: We demonstrated an overall better short-term hematological profile in advanced Hodgkin's lymphoma patients who received a de-escalation chemotherapy regimen with significant differences mainly in terms of hemoglobin levels, erythropoiesis stimulating agent injections, and hospitalization days.

Keywords: ABVD; Advanced Hodgkin’s lymphoma; BEACOPPescalated; Chemotherapy; Hematological toxicity.

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Blood Transfusion / statistics & numerical data
  • Erythropoiesis / drug effects
  • Female
  • Granulocyte Colony-Stimulating Factor / metabolism
  • Hematologic Diseases / chemically induced*
  • Hemoglobins / analysis
  • Hodgkin Disease / blood*
  • Hodgkin Disease / drug therapy*
  • Humans
  • Length of Stay
  • Leukocyte Count
  • Male
  • Middle Aged
  • Neutrophils
  • Platelet Count
  • Treatment Outcome
  • Young Adult

Substances

  • Antineoplastic Agents
  • Hemoglobins
  • Granulocyte Colony-Stimulating Factor