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Hodgkin lymphoma treatment with ABVD in the US and the EU: neutropenia occurrence and impaired chemotherapy delivery.

Schwenkglenks, M; Pettengell, R; Szucs, TD; Culakova, E; Lyman, GH (2010) Hodgkin lymphoma treatment with ABVD in the US and the EU: neutropenia occurrence and impaired chemotherapy delivery. JOURNAL OF HEMATOLOGY & ONCOLOGY, 3 (27). 1 - 1 (6). ISSN 1756-8722
SGUL Authors: Pettengell, Ruth

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Background: In newly diagnosed patients with Hodgkin lymphoma (HL) the effect of doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD)-related neutropenia on chemotherapy delivery is poorly documented. The aim of this analysis was to assess the impact of chemotherapy-induced neutropenia (CIN) on ABVD chemotherapy delivery in HL patients. Study design: Data from two similarly designed, prospective, observational studies conducted in the US and the EU were analysed. One hundred and fifteen HL patients who started a new course of ABVD during 2002-2005 were included. The primary objective was to document the effect of neutropenic complications on delivery of ABVD chemotherapy in HL patients. Secondary objectives were to investigate the incidence of CIN and febrile neutropenia (FN) and to compare US and EU practice with ABVD therapy in HL. Pooled data were analysed to explore univariate associations with neutropenic events. Results: Chemotherapy delivery was suboptimal (with a relative dose intensity ≤ 85%) in 18-22% of patients. The incidence of grade 4 CIN in cycles 1-4 was lower in US patients (US 24% vs. EU 32%). Patients in both the US and the EU experienced similar rates of FN across cycles 1-4 (US 12% vs. EU 11%). Use of primary colony-stimulating factor (CSF) prophylaxis and of any CSF was more common in the US than the EU (37% vs. 4% and 78% vs. 38%, respectively). The relative risk (RR) of dose delays was 1.54 (95% confidence interval [CI] 1.08-2.23, p = 0.036) for patients with vs. without grade 4 CIN and the RR of grade 4 CIN was 0.35 (95% CI 0.12-1.06, p = 0.046) for patients with vs. without primary CSF prophylaxis. Conclusions: In this population of HL patients, CIN was frequent and FN occurrence clinically relevant. Chemotherapy delivery was suboptimal. CSF prophylaxis appeared to reduce CIN rates.

Item Type: Article
Additional Information: PubMed ID: 20723212. Copyright: © 2010 Schwenkglenks et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Bleomycin, Colony-Stimulating Factors, Dacarbazine, Doxorubicin, Female, Hodgkin Disease, Humans, Male, Middle Aged, Neutropenia, Prospective Studies, Vinblastine, Science & Technology, Life Sciences & Biomedicine, Oncology, Hematology, DOSE-INTENSITY, FEBRILE NEUTROPENIA, CANCER-PATIENTS, BREAST-CANCER, CELL LYMPHOMA, SURVIVAL, OUTCOMES, DISEASE
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Journal or Publication Title: JOURNAL OF HEMATOLOGY & ONCOLOGY
ISSN: 1756-8722
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19 August 2010Published
Web of Science ID: WOS:000282347000001
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