PET-adapted treatment for newly diagnosed advanced Hodgkin lymphoma (AHL2011): a randomised, multicentre, non-inferiority, phase 3 study

Response‐adapted therapy for the treatment of children with newly diagnosed high risk Hodgkin lymphoma (AHOD0831): a report from the Children’s Oncology Group

“…HD12 (Borchmann et al , ) trials found a significant benefit to the use of RT as part of initial therapy, and the indication for RT in this trial was similar to that in the Stanford V arm of the Eastern Cooperative Oncology Group (E2496) (Gordon et al , ) trial. More recently, the Gruppo Italiano Terapie innovative nel Linfomi/Italian Lymphoma Foundation HD 0607 trial found no significant benefit to RT among patients with nodal masses ≥5 cm who had a negative PET scan after two and four cycles of ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) (Casasnovas et al , ) and adult HL protocols that incorporate escalated dose BEACOPP chemotherapy have reported 5‐year progression‐free survival (PFS) rates >85% with limited or no routine use of RT. (Borchmann et al , ) These findings suggest that PET may be utilized to avoid RT for the majority of advanced stage patients who achieve a rapid metabolic response, provided chemotherapy is sufficiently intensive.…”

Australian and New Zealand consensus statement on the management of lymphoma, chronic lymphocytic leukaemia and myeloma during the COVID‐19 pandemic

“…However, when using escalated BEACOPP, we suggest abbreviating to four cycles rather than delivering six in patients with a negative PET after two cycles (II) For patients experiencing significant toxicity or infection during the first two cycles of escalated BEACOPP, we suggest considering descalation to ABVD if an interim PET after cycle 2 is negative as described in the AHL2011 trial (II) For patients treated with six cycles of ABVD, we recommend the omission of bleomycin after cycle 2 in patients with advanced‐stage disease treated with ABVD having a negative interim PET, in line with the RATHL study (II) …”

Resources-Stratified Guidelines for Classical Hodgkin Lymphoma

“…Bleomycin can be omitted in ePET-negative patients after two cycles of ABVD chemotherapy thereby reducing rates of treatment related pulmonary toxicity, without significantly impacting treatment outcome [50]. Patients treated frontline with two cycles of escalated BEACOPP who become PET negative can also be safely treated to a total of only four cycles of escalated BEACOPP chemotherapy or four additional cycles of ABVD without impacting on the treatment outcome [51,52]. Such treatment approaches should only be considered in the maximal resource setting.…”