A population-based study of intensive multi-agent chemotherapy with or without autotransplant for the highest risk Hodgkin's disease patients identified by the Scotland and Newcastle Lymphoma Group (SNLG) prognostic index. A Scotland and Newcastle Lymphoma Group study (SNLG HD III)
| Autor: | A Dawson, S. J. Proctor, Graham Jackson, P. R. A. Taylor, Anne Lennard, H. L. Lucraft, Brian Angus, A Hepplestone, M. J. Mackie, Robin J Prescott, J. M. White |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Vincristine Adolescent Population Context (language use) Procarbazine Transplantation Autologous Recurrence Risk Factors Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans education Bone Marrow Transplantation education.field_of_study Chlorambucil business.industry Middle Aged Combined Modality Therapy Hematologic Diseases Hodgkin Disease Survival Analysis Vinblastine Surgery Treatment Outcome Oncology ABVD Population study Female business medicine.drug Follow-Up Studies |
| Zdroj: | European journal of cancer (Oxford, England : 1990). 38(6) |
| ISSN: | 0959-8049 |
| Popis: | The aim of the study was to identify all patients with poor risk Hodgkin’s disease (HD) using a numerical prognostic index in a defined population and to recruit them into a trial of intensive chemotherapy prednisolone, vinblastine, doxorubicin, chlorambucil, etoposide, bleomycin, vincristine, procarbazine (PVACE-BOP)3+autotransplant (Arm A) versus PVACE-BOP5 (Arm B) in first remission. In 10 years, the Scotland and Newcastle Lymphoma Group (SNLG) registered 930 patients with HD of whom 178 (19%) were identified as ‘poor risk’ by the SNLG index and were aged 16–59 years. 126/178 (71%) entered the study. Of the 120 confirmed poor risk HD cases, all completed PVACE-BOP3 with a 93% Complete Response/unconfirmed Complete Response (CR/CRu) rate. Only 65/107 in CR accepted the randomisation. With a median follow-up of 6 years, both arms of the trial have a similar time to treatment failure (TTF) (Arm A 79% 11 versus 85%7 Arm B, P=0.35). Advanced stage ‘good risk’ patients not included in the trial receiving standard therapy with CLVPP or ABVD had a 75% 5-year survival. The study demonstrates that PVACE-BOP therapy in the poorest risk group (58% had an IPI53) produces excellent CR rates (93%) and overall survival with minimal toxicity, and that the substitution of autotransplant in first CR does not improve outcome. The use of the objective SNLG index accurately helped in the selection of the poorest risk group in this population study. The placing of a randomised control trial within the context of a population-based study of HD enhances the validity of the outcome. # 2002 Elsevier Science Ltd. All rights reserved. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect