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Myeloablative therapy for recurrent Hodgkin lymphoma: Good success rates irrespective of previous treatments in the UKLG LY09 trial (ISRCTN97144519)4

Myeloablative therapy for recurrent Hodgkin lymphoma: Good success rates irrespective of previous treatments in the UKLG LY09 trial (ISRCTN97144519)4
Myeloablative therapy for recurrent Hodgkin lymphoma: Good success rates irrespective of previous treatments in the UKLG LY09 trial (ISRCTN97144519)4
Introduction: This randomised trial compared ABVD with two multi-drug regimens
(MDR) for initial therapy of advanced Hodgkin Lymphoma (HL). The results of
salvage therapy have been examined.
Methods: Patients (pts) with advanced HL were randomised to standard ABVD or one
of two MDRs: Alternating ChlVPP/PABlOE or Hybrid ChlVPP/EVA. Pts who
developed recurrence, or in whom remission was not achieved, were advised to
undergo high dose therapy (HDT).
Results: 807 pts were randomised; 406 allocated ABVD and 401 MDRs. At 65 months
median follow-up, 220 PFS events were reported. 101 pts were treated with HDT as the
first treatment after initial therapy: 27 after inadequate response and 74 for recurrence.
Median time from diagnosis to HDT was 11 months. At median 48 months follow-up,
87% (95%CI 79%, 93%) pts remain alive at 2 years after HDT and 66% (95%CI 54%,
75%) at 5 years. In univariate analyses, prior use of ABVD or MDR had no influence
upon survival after HDT (Hazard ratio (HR) 0.817 (95% CI 0.398, 1.678) There is
limited evidence that radiotherapy after initial chemotherapy is associated with poorer
survival after HDT (HR 0.56, 95%CI 0.25, 1.28) and a suggestion that pts who receive 6
cycles of chemotherapy do better after HDT than pts who receive more (HR 1.35, 95%
CI 0.62, 2.93) but less well than those who had fewer (HR 0.45, 95%CI 0.15, 1.41).
Results for pts with primary refractory disease (81% alive at 2 years) are similar to those
treated for recurrence (90% alive at 2 years) (HR 0.97, 95%CI 0.44, 2.15).
Conclusion: Results of HDT-based salvage are good for pts with HL, with durable
remissions obtained in a high proportion. In this sample of 101 pts, statistical power is
limited but there is no clear evidence that outcome after HDT is affected by the
complexity of initial therapy or the timing of HDT.
time, trial, lymphoma, therapy
1569-8041
91-91
Johnson, P. W.
3f6068ce-171e-4c2c-aca9-dc9b6a37413f
Sydes, M. R.
74f846e5-4690-452a-b0d8-5ca43c02dfa4
Hancock, B.
682176b1-8dce-4838-8fdb-dfb0b49114c7
Cullen, M.
d3dee1e2-b7bb-4c38-a94a-ae3e5cc0b544
Stenning, S.
55e998a7-e762-4d38-a3d8-288728395aaf
Radford, J.
1a8a0bd5-8ef3-46af-b35c-3a4bba491eee
Johnson, P. W.
3f6068ce-171e-4c2c-aca9-dc9b6a37413f
Sydes, M. R.
74f846e5-4690-452a-b0d8-5ca43c02dfa4
Hancock, B.
682176b1-8dce-4838-8fdb-dfb0b49114c7
Cullen, M.
d3dee1e2-b7bb-4c38-a94a-ae3e5cc0b544
Stenning, S.
55e998a7-e762-4d38-a3d8-288728395aaf
Radford, J.
1a8a0bd5-8ef3-46af-b35c-3a4bba491eee

Johnson, P. W., Sydes, M. R., Hancock, B., Cullen, M., Stenning, S. and Radford, J. (2008) Myeloablative therapy for recurrent Hodgkin lymphoma: Good success rates irrespective of previous treatments in the UKLG LY09 trial (ISRCTN97144519)4. Annals of Oncology, 19, 91-91.

Record type: Article

Abstract

Introduction: This randomised trial compared ABVD with two multi-drug regimens
(MDR) for initial therapy of advanced Hodgkin Lymphoma (HL). The results of
salvage therapy have been examined.
Methods: Patients (pts) with advanced HL were randomised to standard ABVD or one
of two MDRs: Alternating ChlVPP/PABlOE or Hybrid ChlVPP/EVA. Pts who
developed recurrence, or in whom remission was not achieved, were advised to
undergo high dose therapy (HDT).
Results: 807 pts were randomised; 406 allocated ABVD and 401 MDRs. At 65 months
median follow-up, 220 PFS events were reported. 101 pts were treated with HDT as the
first treatment after initial therapy: 27 after inadequate response and 74 for recurrence.
Median time from diagnosis to HDT was 11 months. At median 48 months follow-up,
87% (95%CI 79%, 93%) pts remain alive at 2 years after HDT and 66% (95%CI 54%,
75%) at 5 years. In univariate analyses, prior use of ABVD or MDR had no influence
upon survival after HDT (Hazard ratio (HR) 0.817 (95% CI 0.398, 1.678) There is
limited evidence that radiotherapy after initial chemotherapy is associated with poorer
survival after HDT (HR 0.56, 95%CI 0.25, 1.28) and a suggestion that pts who receive 6
cycles of chemotherapy do better after HDT than pts who receive more (HR 1.35, 95%
CI 0.62, 2.93) but less well than those who had fewer (HR 0.45, 95%CI 0.15, 1.41).
Results for pts with primary refractory disease (81% alive at 2 years) are similar to those
treated for recurrence (90% alive at 2 years) (HR 0.97, 95%CI 0.44, 2.15).
Conclusion: Results of HDT-based salvage are good for pts with HL, with durable
remissions obtained in a high proportion. In this sample of 101 pts, statistical power is
limited but there is no clear evidence that outcome after HDT is affected by the
complexity of initial therapy or the timing of HDT.

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More information

Published date: 2008
Keywords: time, trial, lymphoma, therapy

Identifiers

Local EPrints ID: 62808
URI: http://eprints.soton.ac.uk/id/eprint/62808
ISSN: 1569-8041
PURE UUID: cce6c454-cf63-4cf9-8955-4da3b1de95f3
ORCID for P. W. Johnson: ORCID iD orcid.org/0000-0003-2306-4974

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Date deposited: 01 Sep 2008
Last modified: 12 Dec 2021 03:02

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Contributors

Author: P. W. Johnson ORCID iD
Author: M. R. Sydes
Author: B. Hancock
Author: M. Cullen
Author: S. Stenning
Author: J. Radford

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