Real-world evidence of ABVD-like regimens compared with ABVD in classical Hodgkin lymphoma: a 10-year study from China

Wen, Qing; Ge, Jingjing; Lei, Yaxin; Zhang, Yue; Kong, Xiaoshuang; Wang, Wenhua; Hou, Huting; Wang, Zeyuan; Qian, Siyu; Ding, Mengjie; Meng, Di; Zhu, Linan; Zhang, Mingzhi; Zhang, Xudong; Chen, Qingjiang

doi:10.1007/s00432-022-04321-6

Cited by 6 publications

(5 citation statements)

References 44 publications

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“…The role of sβ 2 m as a prognostic factor in HL has been evaluated in several smallor medium-sized studies in the past, with partially conflicting results, probably owing to the sample sizes and the variable treatment approaches (Table 5) ( [48][49][50][51]53,55,56,[64][65][66][67][68][69], present study). Briefly, considering both the MD Anderson studies together [48,51], sβ 2 m appears to correlate with FFS in advanced stages (overall survival not reported), while it was associated with inferior overall survival in early stages, with only a borderline effect on FFS.…”

Section: Discussionmentioning

confidence: 96%

Prognostic Impact of Serum β2-Microglobulin Levels in Hodgkin Lymphoma Treated with ABVD or Equivalent Regimens: A Comprehensive Analysis of 915 Patients

Vassilakopoulos,

Arapaki,

Diamantopoulos

et al. 2024

Cancers

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The significance of serum beta-2 microglobulin (sβ2m) in Hodgkin lymphoma (HL) is controversial. We analyzed 915 patients with HL, who were treated with ABVD or equivalent regimens with or without radiotherapy. Sβ2m levels were measured by a radioimmunoassay (upper normal limit 2.4 mg/L). Sequential cutoffs (1.8–3.0 by 0.1 mg/L increments, 3.5 and 4.0 mg/L) were tested along with ROC analysis. The median sβ2m levels were 2.20 mg/L and were elevated (>2.4 mg/L) in 383/915 patients (41.9%). Higher sβ2m was associated with inferior freedom from progression (FFP) at all tested cutoffs. The best cutoff was 2.0 mg/L (10-year FFP 83% vs. 70%, p = 0.001), which performed better than the 2.4 mg/L cutoff (“normal versus high”). In multivariate analysis, sβ2m > 2.0 mg/L was an independent adverse prognostic factor in the whole patient population. In multivariate overall survival analysis, sβ2m levels were predictive at 2.0 mg/L cutoff in the whole patient population and in advanced stages. Similarly, sβ2m > 2.0 mg/L independently predicted inferior HL-specific survival in the whole patient population. Our data suggest that higher sβ2m is an independent predictor of outcome in HL but the optimal cutoff lies within the normal limits (i.e., at 2.0 mg/L) in this predominantly young patient population, performing much better than a “normal versus high” cutoff set at 2.4 mg/L.

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Section: Discussionmentioning

confidence: 96%

Prognostic Impact of Serum β2-Microglobulin Levels in Hodgkin Lymphoma Treated with ABVD or Equivalent Regimens: A Comprehensive Analysis of 915 Patients

Vassilakopoulos,

Arapaki,

Diamantopoulos

et al. 2024

Cancers

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“…Although HL is highly curable in high-income countries, many patients worldwide do not have access to the standard ABVD regimen. ABVD-like regimens have recently emerged as first-line chemotherapy in China ( Wen et al, 2022 ). In this study, we report the use of the combination of dacarbazine, vindesine, bleomycin, and doxorubicin/epirubicin/liposomal doxorubicin on days 1 and 15 of each cycle as first-line therapy for patients with newly-diagnosed HL.…”

Section: Discussionmentioning

confidence: 99%

“…First, the studies involve different racial and ethnic groups. Second, the cause of the discrepancy may be multi-fold, involving interaction between a specific drug type, dose, and pharmacokinetics ( Matos et al, 2016 ; Wen et al, 2022 ). Third, differences in the level of therapeutic exposure in obese versus normal weight individuals might confound the observed effects ( Aminian et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

“…Although the ABVD-like regimen is widely used to treat HL patients, patients’ responses are unclear, especially when compared with the standard ABVD regimen. Moreover, different populations exhibit different clinical responses to ABVD-like chemotherapy regimens ( Wen et al, 2022 ). Among them, obese people have implications for chemotherapy administration and dosing ( Khouri et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

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Body mass index-associated responses to an ABVD-like regimen in newly-diagnosed patients with Hodgkin lymphoma

Hu,

Ding,

Zhang

et al. 2023

Front. Pharmacol.

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Background: The role of body mass index (BMI) in the treatment outcomes of lymphoma patients is controversial. While investigating the efficacy of ABVD-like regimen in Hodgkin lymphoma (HL) patients, we observed that obese patients had poor responses. To better understand this clinical phenomenon, we evaluated the effect of BMI on responses to ABVD-like chemotherapy in HL patients.Methods: This retrospective cohort study evaluated the clinical outcomes of all 67 patients with confirmed HL who were treated at the First Affiliated Hospital of Soochow University from November 2016 to March 2023 with an ABVD-like regimen as first-line chemotherapy. Baseline patient characteristics and clinical outcomes were compared across different BMI categories. The primary end-point was the overall response rate defined as the proportion of the HL patients who achieved complete response or partial response. The additional end-points included progression-free survival and overall survival.Results: The median age of the HL patients was 31 years old. Of the patients, 10.4% were obese, and 17.9% patients were overweight. Interim and end-term response evaluations revealed overall response rates of 98.5% and 83.6%, respectively. The proportion of patients with potential poor prognostic factors (IPS risk factors) did not differ significantly in the responders versus non-responders. However, non-responders had a higher average BMI when compared with responders (p = 0.002). Poor overall response rates in higher BMI patients indeed manifested with shorter progression free survival (p = 0.013). The minimum relative dose of the ABVD-like regimen in the overweight and obese groups was significantly lower than in the normal weight group (p < 0.001).Conclusion: Our analyses show that >80% of newly-diagnosed HL patients responded to the ABVD-like regimen. We find that being obese or overweight at the time of diagnosis correlated with a poorer overall response rate and that BMI was an independent risk factor in HL patients treated with the ABVD-like regimen. Lower doses of ABVD-like regimen contributed to the discrepant findings of responses in the high BMI groups. These findings indicate that newly-diagnosed, obese HL patients receiving an ABVD-like regimen require personalized treatment.

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“…[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35].Another possible factor contributing to the development of secondary DLBCL to AITL in patients is TET2 mutations. Nguyen, et al showed that TET2 mutations were found in programmed death 1 positive cells as well as CD20 + cells in 15/16 cases[36].…”

mentioning

confidence: 99%

Born with Two Faces: Sequential development of Diffuse Large B-cell Lymphoma and Angioimmunoblastic T-cell Lymphoma with EBV positive and TET2 mutation

Li,

Dai,

Liu

et al. 2023

Preprint

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There may be significant histopathological and pathogenetic overlap between Epstein–Barr virus (EBV) -positive diffuse large B cell lymphoma (DLBCL) and other lymphomas, including angioimmunoblastic T-cell lymphoma (AITL). Herein, we reported a rare case of an AITL developing two years after the initial diagnosis of EBV-positive DLBCL. Next-generation sequencing (NGS) is used to study genetic mutations in biopsy samples of DLBCL and subsequent AITL. NGS revealed that TET2 mutated in both DLBCL and AITL, while other differential mutations were also detected, reflecting their own characteristics. Since inherent EBV infection plays a role in both AITL and DLBCL, we evaluated the characteristics of lymphoma associated with EBV infection, including morphology and treatment, etc. We deduce that chronic EBV infection and epigenetic TET2 mutations may alter the immune profile or tumor microenvironment of lymphoma cells, resulting in patients presenting with different tumor types at different times. Patients with AITL secondary to DLBCL have a poor prognosis, and the combination of chidamide and chemotherapy is expected to provide new treatment options for these patients, mainly due to the multiplex antitumor mechanism of chidamide in lymphoma.

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Real-world evidence of ABVD-like regimens compared with ABVD in classical Hodgkin lymphoma: a 10-year study from China

Cited by 6 publications

References 44 publications

Prognostic Impact of Serum β2-Microglobulin Levels in Hodgkin Lymphoma Treated with ABVD or Equivalent Regimens: A Comprehensive Analysis of 915 Patients

Prognostic Impact of Serum β2-Microglobulin Levels in Hodgkin Lymphoma Treated with ABVD or Equivalent Regimens: A Comprehensive Analysis of 915 Patients

Body mass index-associated responses to an ABVD-like regimen in newly-diagnosed patients with Hodgkin lymphoma

Born with Two Faces: Sequential development of Diffuse Large B-cell Lymphoma and Angioimmunoblastic T-cell Lymphoma with EBV positive and TET2 mutation

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