Chlvpp is as Effective as Alternating ChlvppAbod in Advanced Stage Hodgkin's Disease

Holte, Harald; Mella, Olav; Wist, Ertk; Telhaug, Ragnar; Hannisdal, Einar; Abrahamsen, Arne Foss

doi:10.3109/02841869609098523

Cited by 12 publications

(4 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The treatment strategies of HL at the RRMC have been described previously (Abrahamsen et al, , 1997Holte et al, 1996;Aurlien et al, 1998;Blystad et al, 2001aBlystad et al, , 2001b and are summarized in Table 1a and b. From 1985 to 1990, primary chemotherapy with MVPP/ChlVPP was gradually replaced by ABOD or EBVP for limited disease.…”

Section: Treatment Principlesmentioning

confidence: 99%

Post-treatment parenthood in Hodgkin's lymphoma survivors

Kiserud

Fosså²,

Holte³

et al. 2007

Br J Cancer

View full text Add to dashboard Cite

Attempted and achieved post-treatment parenthood, with or without use of assisted reproduction techniques (ARTs), was assessed in Hodgkin's lymphoma survivors treated from 1971 -1998, aged below 50 (females) or 65 (males) at diagnosis, aged 18 to 75 at survey. Four treatment groups were constructed: radiotherapy only, low -, medium -and high gonadotoxic chemotherapy (with or without radiotherapy in the three chemotherapy groups). Using Kaplan -Meier estimates, log-rank tests and Cox regression analyses, factors influencing post-treatment parenthood were investigated, with birth of the first child after treatment as the end point. Fortyfive per cent (120/269) of males and 50% (91/184) of females reported attempted post-treatment parenthood. Of these, 76 (63%) males and 68 (75%) females had a child without use of ARTs. In addition 10 males and one female achieved post-treatment parenthood with use of ARTs. Treatment group was significantly associated with post-treatment parenthood, with highest probabilities after radiotherapy only and low gonadotoxic chemotherapy. In univariate analyses, age at diagnosis was a significant factor related to post-treatment parenthood in females.

show abstract

Section: Treatment Principlesmentioning

confidence: 99%

Post-treatment parenthood in Hodgkin's lymphoma survivors

Kiserud

Fosså²,

Holte³

et al. 2007

Br J Cancer

View full text Add to dashboard Cite

show abstract

“…Finally, in a randomised Norwegian study of 100 patients, one group was treated with a MOPP-derived regimen, and another group was treated with this regimen alternating with an ABVD-derived regimen. The results in terms of relapse-free and overall survival were almost identical (73). Taken together, some studies indicate that there is a slightly higher activity in alternating regimens than in conventional 4-drug regimens, but rm evidence is lacking.…”

Section: Recommended Chemotherapy Regimensmentioning

confidence: 84%

A Systematic Overview of Chemotherapy Effects in Hodgkin's Disease

Brandt

2001

Acta Oncologica

View full text Add to dashboard Cite

A systematic review of chemotherapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for the evaluation of the scienti c literature are described separately (Acta Oncol 2001; 40: 155-65). This synthesis of the literature on chemotherapy for Hodgkin's disease (HD) is based on 113 scienti c reports including four meta-analyses, 44 randomised studies, 18 prospective studies and 40 retrospective studies. These studies involve 69 196 patients. The conclusions reached can be summarised into the following points: Chemotherapy is of utmost importance for the cure of HD. At early stages, extended eld radiotherapy cures most patients. For the majority of patients with relapse after radiotherapy, chemotherapy is curative and the total proportion of cured early stage patients is 75-90%. Chemotherapy in addition to extended eld radiotherapy reduces recurrences but does not improve long-term survival. In early stage HD with a large mediastinal mass and:or with systemic symptoms, combined treatment with chemotherapy and radiotherapy is recommended. It is likely that chemotherapy will play a greater role in the future in the treatment also of early stage patients in order to reduce late consequences from extended eld radiotherapy. However, this conclusion remains to be better documented in the literature. At advanced stages, chemotherapy or a combination of chemotherapy and limited eld radiotherapy are effective treatment options and, using the regimens available 10-20 years ago, 40-50% of the patients are cured. Based upon more favourable short-term (three to eight years) results of more recently developed regimens, it can be expected that today a higher proportion of the patients will become long-term survivors. Several chemotherapy regimens containing four to eight drugs are effective in HD. The best regimen considering both antitumour activity and acute and late side-effects is not known. The choice of regimen is probably best done after considering various pre-treatment factors such as the number of poor prognostic signs, concomitant diseases and individual preferences. The results of chemotherapy are more favourable in young than in elderly patients. The development of less toxic but still effective treatment programmes is therefore particularly important for the elderly. High dose chemotherapy with stem cell support is presently often used in patients who are chemotherapy induction failures, who relapse after a short initial remission or after a longer initial remission and treated initially with seven or eight drugs, or who have had multiple relapses. However, this use is based on data from uncontrolled or small controlled studies, not being fully convincing with respect to effect on survival. Persistent side-effects of treatment are common among long-term survivors, although most patients have an apparently normal life. The relative contributions of chemotherapy and radiotherapy to the persistent effects are not well documented.

show abstract

“…Other alternative regimes have been trialed in the elderly population. These include CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) [33] VEPEMB (vinblastine, cyclophosphadmide, procarbazine, prednisolone, etoposide, mitoxantrone, bleomycin) [34] PVAG (prednisolone, vinblastine, doxorubicin, gemcitabine) [35] and ChlVPP (chlorambucil, vinblastine, procarbazine and prednisolone) [36]. However, all were associated with disappointing progression free survival rates, when compared with ABVD, although this may partially reflect the frailty of the study populations.…”

Section: Advanced Stage Hl In the Elderlymentioning

confidence: 99%

Treatment of advanced stage classical Hodgkin lymphoma: a pathway through the maze

At¹,

Vora²,

Collins³

2018

Hematol Med Oncol

View full text Add to dashboard Cite

The wealth of trial data, complex trial design, and variation in treatment standards in advanced stage classical Hodgkin lymphoma can be difficult to navigate when deciding on the best treatment for patients. In this review, we appraise and synthesise this evidence, in order to explain our suggested treatment approach.Since the 1960s, cures have been achieved in advanced stage classical Hodgkin lymphoma (cHL) through the use of multi-agent chemotherapy regimens often with addition of radiotherapy. Since then, treatment has been improved through a process of rigorous testing in clinical trials, such that progression free survival (PFS) and overall survival rates (OS) are now excellent, especially in younger patients. More recently there has been a shift in focus towards minimizing toxicity (both short and long term) without compromising efficacy. Recent trials have tried to achieve this by risk-stratifying patients, both at baseline and according to response to treatment, so as to guide escalation or de-escalation of therapy. Uncertainty as to where this equipoise between efficacy and toxicity lies has also led to two international standards for treatment of cHL: ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) and escalated BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisolone). It has also influenced decisions on combined modality treatment with radiotherapy.The wealth of trial data, complex trial design, and variation in treatment standards can be difficult to navigate when deciding on the best treatment for our patients. In this article, we aim to provide a possible pathway through this maze.

show abstract

Chlvpp is as Effective as Alternating ChlvppAbod in Advanced Stage Hodgkin's Disease

Cited by 12 publications

References 38 publications

Post-treatment parenthood in Hodgkin's lymphoma survivors

Post-treatment parenthood in Hodgkin's lymphoma survivors

A Systematic Overview of Chemotherapy Effects in Hodgkin's Disease

Treatment of advanced stage classical Hodgkin lymphoma: a pathway through the maze

Contact Info

Product

Resources

About