Two escalated followed by six standard BEACOPP in advanced-stage high-risk classical Hodgkin lymphoma: high cure rates but increased risk of aseptic osteonecrosis

Abstract

Two escBEACOPP plus six sBEACOPP is efficacious in advanced-stage high-risk HL. We document a high incidence of aseptic bone necrosis, possibly related to prednisolone.

Treatment of classical Hodgkin lymphoma in young adults aged 18–30 years with a modified paediatric Hodgkin lymphoma protocol. Results of a multicentre phase II clinical trial (CRUK/08/012)

“…In a retrospective review of adult cHL patients treated in German Hodgkin Study Group trials, the cumulative incidence of osteonecrosis was 0·93% and was more frequent in male patients. Osteonecrosis was not specifically assessed in these studies and the true rate may be higher as indicated by a small series reporting a rate of 21% (Fosså et al , , Borchmann et al , ). Osteonecrosis has not been specifically reported in the GPOH paediatric trials.…”

Whole‐body MRI reveals high incidence of osteonecrosis in children treated for Hodgkin lymphoma

“…However, in addition to the fact that only 7 Hodgkin lymphoma patients were included, MRI of the lower extremities only was undertakenin that study (Niinimäki et al , ). Fosså et al () evaluated the effects of 2 cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisolone (BEACOPP) followed by 6 standard BEACOPP cycles in 47 adult patients with advanced‐stage Hodgkin lymphoma with an international prognostic score ≥4; symptomatic osteonecrosis was diagnosed in 10 (21%) patients. Three of these 10 patients underwent hip replacement surgery after treatment (Fosså et al , ).…”

“…Fosså et al () evaluated the effects of 2 cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisolone (BEACOPP) followed by 6 standard BEACOPP cycles in 47 adult patients with advanced‐stage Hodgkin lymphoma with an international prognostic score ≥4; symptomatic osteonecrosis was diagnosed in 10 (21%) patients. Three of these 10 patients underwent hip replacement surgery after treatment (Fosså et al , ). However, that study did not include any children, and only performed MRI directed to the site of complaints in symptomatic patients (Fosså et al , ).…”

A xanthogranulomatous process resembling residual disease on endof- treatment 18f-FDG-PET/CT and Whole Body Magnetic Resonance performed on a primary breast lymphoma treated by ibrutinib plus rituximab-chop

“…The role of WB-MR, especially fused with PET in FDG-PET/MR, in breast cancer imaging is being investigated over the last few years, with promising preliminary results (29); instead, WB-MR has already a well-established role in lymphoma imaging. Its high contrast resolution enables an excellent evaluation of bone marrow, allowing a reliable evaluation marrow lymphomatous involvement (30) and the early identification of osteonecrotic lesions, which are @ C I C E d i z i o n i I n t e r n a z i o n a l i very common in the follow-up of patients who receive chemotherapies and high doses of corticosteroids (31)(32)(33)(34)(35). Furthermore, it provides functional information regarding tissue cellularity through DWI, which is a sequence probing the motion of water molecules in intra-cellular and inter-cellular spaces.…”