Results
224 patients with HL were screened for inclusion. Of the total charts
examined 93 patients were found to be eligible; 46 patients had received
ABVD and 47 patients had received ABVE-PC chemotherapy as initial
chemotherapy. 129 patients were not included due to either receiving
either a different therapy or a variation of the two therapies in
question, and 2 patients were excluded due to having received initial
therapy at a different institution. There were no significant
differences in the two groups regarding gender, ethnicity, and race
(Table 1). Of note, the ABVE-PC group contained statistically
significantly older patients on average compared to the ABVD group (14.5
vs 12.7 years, p =0.03).
Known prognostic factors are summarized in Table 2. As risk
classification has changed multiple times during the time period
examined, patients were stratified retrospectively and uniformly into
comparable risk groups utilizing the criteria employed by the COG
AHOD0031 study.9 There were no statistically
significant differences found in risk stratification (Table 2,p =0.56). There were also no differences in splenic involvement,
extra-nodal extension, erythrocyte sedimentation rate, leukocyte count,
or hemoglobin concentration.
Patients were followed for a median of 3.9 years from diagnosis (range
0.3-18.1 years, interquartile range 1.5-5.8 years). There was no
difference found in EFS and OS between patients who received ABVE-PC and
those who received ABVD (Figures 1A and 1B, p =0.46 andp =0.37, respectively). There was no difference in the proportion
of patients requiring more than four cycles of chemotherapy or requiring
a chemotherapy regimen change (Table 3). Notably, more patients in the
ABVE-PC group received external beam radiation when compared to the ABVD
group in intention-to-treat analysis (59.6% vs 32.6%, Table 3,p =0.01), although 6 patients achieved complete response but were
randomized to receive radiation on the AHOD0031 study. When the 6
patients were analyzed as not having radiation, the difference was not
statistically significant (46.8% vs 32.6%, Table 3, p =0.21).
Response by PET-CT was only available for a subset of the cohort
(n =34). 90% of patients receiving ABVD (n =9 of 10 total)
and 58.3% of patients receiving ABVE-PC (n =14 of 24 total) had
rapidly-responsive lesions on PET-CT following 2 cycles of therapy
(i.e., Deauville score of 1, 2, or 3) (p =0.11).
Late effects are summarized in Table 4; statistics are not available due
to extremely low event rates. There were no apparent differences seen in
reduced cardiac shortening fractions (SF, reduced SF defined as
<29%), reduced diffusing capacity of the lung for carbon
monoxide (DLCO), second malignancies or evidence of early gonadal
dysfunction (as measured by follicle stimulating hormone above
gender-defined norms).