Neutropenia and Neutropenic Complications in ABVD Chemotherapy for Hodgkin Lymphoma

Vakkalanka, Bhanu; Link, Brian K.

doi:10.1155/2011/656013

Cited by 9 publications

(10 citation statements)

References 44 publications

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“…For HL, retrospective data suggest that the incidence of FN, neutropenic sepsis, and death in patients receiving ABVD chemotherapy is low ( < 1%) so it can be said that there is no role for routine administration of prophylactic antibiotics. 14 The current study results support this belief for HL patients. However, for all NHL patients even if it is an aggressive type such as DLBCL, TCL and MCL, the current study results conflict with previous findings and recommendations since it can be considered that antimicrobial prophylaxis is not routinely used for these patients.…”

Section: Discussionsupporting

confidence: 82%

Is antimicrobial prophylaxis necessary for lymphoma patients? A single centre, real-life experience

Yıldız

Öztürk

Albayrak

et al. 2018

J Oncol Pharm Pract

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Background Prophylaxis is strongly recommended in patients with hematological malignancy who are usually at higher risk for infection and neutropenic fever. It is still unclear whether or not there is a definite need for antimicrobial prophylaxis in intermediate-risk hematology patients such as those with lymphoma. Methods A retrospective analysis was made of patients admitted from January 2009 to December 2017 to the Hematology Department of Diskapi Yildirim Beyazit Training and Research Hospital, a tertiary referral hospital in Ankara, Turkey. The study included patients who were diagnosed with any type of lymphoma and given chemotherapy. Routine antimicrobial prophylaxis was administered to 127 lymphoma patients, and not to 65 lymphoma patients. These two groups were compared in respect of the incidence of total infection episodes (IE), febrile neutropenia episodes, and nonneutropenic clinically documented infection episodes. Results For all patients with lymphoma and subtypes of non-Hodgkin lymphoma or Hodgkin lymphoma, no significant difference was determined between the groups in respect of the total incidence of IE, febrile neutropenia and nonneutropenic clinically documented infection both during the first-line chemotherapy and throughout the total follow-up period ( p > 0.05). Patients with prophylaxis had a higher incidence of IE, which was treated with parenteral antibiotics both during the first-line chemotherapy and throughout the total follow-up period ( p < 0.05). Conclusion Antimicrobial prophylaxis was seen to have no effect on the total incidence of infection episode and febrile neutropenia. Therefore, the routine use of antimicrobial prophylaxis should not be recommended for patients with lymphoma.

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Section: Discussionsupporting

confidence: 82%

Is antimicrobial prophylaxis necessary for lymphoma patients? A single centre, real-life experience

Yıldız

Öztürk

Albayrak

et al. 2018

J Oncol Pharm Pract

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“…This was a significantly lower rate than that of the NHL cases as was expected from current knowledge. It has been previously reported that neutropenia is a common complication of ABVD chemotherapy, but related complications including febrile neutropenia (FN), neutropenic sepsis, and death are much less frequent [20].…”

Section: Discussionmentioning

confidence: 99%

Infections in patients with lymphoma: An analysis of incidence, relationship and risk factors

Yıldız

Albayrak

Pala

et al. 2018

J Infect Dev Ctries

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Introduction: Bacterial infections and febrile neutropenia (FN) are major causes of morbidity and mortality in patients with hematological malignancy. The aim of this study was to investigate the incidence and risk factors of infections in lymphoma patients. Methodology: This retrospective study was conducted on 200 lymphoma patients diagnosed and treated between January 2009 and December 2017 in Diskapi Yildirim Beyazit Training and Research Hospital, a tertiary referral hospital in Ankara, Turkey. Results: The mean follow-up period was 20.09 ± 19.81 months. The incidence of infection episode (IE) was 32.5% (65/200) and FN was 18.5% (37/200). Analysis of the data revealed that patients with IE had significantly higher rates of diagnosis of primary central nervous system lymphoma (PCNSL), lower baseline hemoglobin, lower baseline hematocrit, higher baseline lactate dehydrogenase levels, higher usage of central cathater, and a higher number of chemotherapy lines compared to patients with no IE. In logistic regression analysis, disease subtype of PCNSL, usage of central catheter and lactate deyhydrogenase (LDH) were found to increase the risk of infection. The odds ratio for PCNSL was 37.866 (p = 0.003), 2.679 for central catheter (p = 0.008) and 1.001 for LDH (p = 0.011). Conclusions: The risk of infection in patients with lymphoma was associated with central catheter usage, higher LDH levels and a diagnosis of PCNSL. Baseline hematological parameters were not determined to have any impact on the occurrence of infection. Patients with these risk factors should be monitored more carefully and the maximum level of infection prevention should be taken.

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“…Mounier et al, 2014 showed higher rates of anemia and leukopenia in the BEACOPP 4+4 treatment group vs ABVD [46]. Chemotherapyinduced neutropenia is another common side-effect of HL treatment, and can result in dose-modifications or treatment delays [35,128]. One study reported neutropenia in 90% of patients treated with BEACOPP 4+4 [84].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of front-line treatments for advanced Hodgkin lymphoma: a systematic literature review

Dalal

Gupta²,

Price³

et al. 2020

Expert Review of Hematology

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Objective: To assess evidence on the safety and efficacy of ABVD (doxorubicin [Adriamycin®], bleomycin, vinblastine, and dacarbazine), BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone), and A+AVD (brentuximab vedotin, with doxorubicin, vinblastine, and dacarbazine) for advanced-stage Hodgkin lymphoma (HL). Methods: A systematic literature review (SLR) was conducted on 29 July 2016 (updated 26 July 2018) to identify randomized controlled trials (RCTs) and non-RCTs assessing the treatment of newly-diagnosed advanced-stage HL with ABVD and BEACOPP (and their variants), and A+AVD. Results: The SLR identified 62 RCTs and 42 non-RCTs. Five-year overall survival rates for ABVD and BEACOPP were 60-97% and 84-99%, and 5-year progression-free survival rates were 58-81% and 83-96%, respectively. Both regimens were associated with tolerability issues and side effects. Discontinuation or dose reduction of bleomycin resulted in fewer adverse events, without significantly affecting efficacy. A head-to-head trial demonstrated improved efficacy for A+AVD vs ABVD, with an acceptable tolerability profile. No data from head-to-head trials comparing A+AVD with BEACOPP were available, and an indirect treatment comparison was not feasible. Conclusion: New therapies, such as A+AVD, maintain the efficacy observed with current treatments, and may provide a more tolerable treatment option for patients with advanced-stage HL.

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Neutropenia and Neutropenic Complications in ABVD Chemotherapy for Hodgkin Lymphoma

Cited by 9 publications

References 44 publications

Is antimicrobial prophylaxis necessary for lymphoma patients? A single centre, real-life experience

Is antimicrobial prophylaxis necessary for lymphoma patients? A single centre, real-life experience

Infections in patients with lymphoma: An analysis of incidence, relationship and risk factors

Efficacy and safety of front-line treatments for advanced Hodgkin lymphoma: a systematic literature review

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