Limited, But Not Eliminated, Excess Long-Term Morbidity in Stage I-IIA Hodgkin Lymphoma Treated With Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine and Limited-Field Radiotherapy

• DOI: 10.1200/jco.21.02407
• Publication Date: 2022-01-25T20:59:30Z
• Authors: Ingemar Lagerlöf; Helena Fohlin; Gunilla Enblad; Bengt Glimelius; Christina Goldkuhl; Marzia Palma; Lisa Åkesson; Ingrid Glimelius; Daniel Molin
• Keywords: ABVD; Dacarbazine

Balancing disease control and toxicity from chemotherapy radiotherapy (RT) when treating early-stage classical Hodgkin lymphoma (cHL) is important. Available data on long-term after RT for cHL mostly refer to techniques no longer in use. We aimed describe modern limited-field (LF)-RT two or four cycles of doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD).This study included all patients with treated ABVD 30 Gy LF-RT during 1999-2005 Sweden. Patients (n = 215) comparators 860), matched age, gender, region residence, were cross-checked against national health registries malignancies, diseases the circulatory system (DCS), respiratory (DRS) day diagnosis cHL.The risk a malignancy was higher than comparators, hazard ratio (HR) 1.5 (95% CI, 1.0 2.4), as DCS 1.1 2.0) DRS 2.6 1.6 4.3). The median follow-up 16 years (range, 12-19 years). Of individual diagnoses DCS, only venous thromboembolism statistically significantly elevated. If first 6 months (ie, time active treatment cHL) excluded censoring at relapse any malignancy, increased HR diminished. Most excess consisted asthma, 3.5 1.8 6.8). diagnosed younger comparators.Compared earlier techniques, morbidity not eliminated, but lower previously reported. elevated driven by which could part be explained misdiagnosis persisting pulmonary toxicity.