Adapted Treatment Guided by Interim PET-CT Scan in Advanced Hodgkin’s Lymphoma

A randomized trial suggests that patients with negative PET-CT findings after two cycles of ABVD may have the bleomycin dropped from the regimen for the final four cycles. The omission of bleomycin reduced pulmonary toxic effects without reducing overall survival. The treatment of advanced-stage Hodgkin’s lymphoma with chemotherapy has produced high survival rates. A series of randomized trials has confirmed that doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD), first described more than 40 years ago, 1 yields cure rates of 70 to 80%, similar to the rates observed with more complex multidrug regimens. 2 – 7 The possible exception is escalated therapy with bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP), with higher-than-standard doses of etoposide, doxorubicin, and cyclophosphamide. 8 This escalated regimen has been shown to yield higher progression-free survival rates than ABVD among previously untreated patients. 9 , 10 Trials in which ABVD and . . .