Does discontinuing bleomycin due to toxicity increase the risk of lymphoma progression? Real-life data from a homogeneous population of advanced stage Hodgkin lymphoma

Hodgkin Lymphoma (HL) is often curable with ABVD therapy and improving outcomes is a main goal of ongoing research. Bleomycin-associated pneumonitis (BAPT) is a potentially life-threatening complication that necessitates bleomycin discontinuation. We conducted this study on a homogenous cohort of ad...

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Published in:Journal of chemotherapy (Florence) 2024-09, Vol.36 (5), p.403-410
Main Authors: Yılmaz, Umut, Zulfaliyeva, Güldane, Güzelli, Adnan Nuri, Özmen, Deniz, Elverdi, Tuğrul, Salihoğlu, Ayşe, Eskazan, Ahmet Emre, Öngören, Şeniz, Başlar, Zafer, Ar, Muhlis Cem
Format: Article
Language:English
Subjects:
Adult
Aged
Antibiotics, Antineoplastic - adverse effects
Antibiotics, Antineoplastic - therapeutic use
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Bleomycin - adverse effects
Dacarbazine - administration & dosage
Dacarbazine - adverse effects
Disease Progression
Doxorubicin - adverse effects
Doxorubicin - therapeutic use
Female
Hodgkin Disease - drug therapy
Humans
Male
Middle Aged
Neoplasm Staging
Retrospective Studies
Vinblastine - adverse effects
Vinblastine - therapeutic use
Young Adult
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Summary:Hodgkin Lymphoma (HL) is often curable with ABVD therapy and improving outcomes is a main goal of ongoing research. Bleomycin-associated pneumonitis (BAPT) is a potentially life-threatening complication that necessitates bleomycin discontinuation. We conducted this study on a homogenous cohort of advanced stage HL treated only with ABVD for frontline therapy to assess if bleomycin discontinuation increases the risk of lymphoma progression. After the exclusion of patients who received radiotherapy or other drugs, 106 and 28 patients in the six-cycle ABVD and BAPT groups respectively had similar survival curves for progression and death with a 49-month median follow-up. PFS rates were also very similar at two and four years from diagnosis with 2-year PFS rates of 83.9% and 82.1% (RR = 1.1 95%CI = 0.45-2.2). Outcome comparisons were also similar between the two groups when stratified according to early response assessment with PET/CT. Patients who discontinued bleomycin due to toxicity did not experience an increased risk of progression compared to patients who completed six ABVD cycles.
ISSN:1120-009X
1973-9478
1973-9478
DOI:10.1080/1120009X.2023.2281089