Vnitr Lek 2007, 53(1):31-37

Chemotherapy of BOVAPEC in the primary treatment of Hodgkin's lymphoma intermediate stages

L. Raida1,*, T. Papajík1, K. Indrák1, M. Heřman2, B. Pauček2, J. Zapletalová3
1 Hemato-onkologická klinika Lékařské fakulty UP a FN Olomouc, přednosta prof. MUDr. Karel Indrák, DrSc.
2 Radiologická klinika Lékařské fakulty UP a FN Olomouc, přednosta doc. MUDr. Miroslav Heřman, Ph.D.
3 Ústav lékařské biofyziky Lékařské fakulty UP Olomouc, přednosta prof. Ing. Jan Hálek, CSc.

Design:
Chemotherapy of BOVAPEC is the modification of temporary intensified Stanford V protocol, an effective primary treatment of advanced Hodgkin's lymphoma (HL) in spite of limited toxicity. Nitrogen mustard was substituted by less myelotoxic cyclophosphamide and the protocol has been used in the treatment of patients with an intermediate stage of HL.

Methods:
The primary treatment with BOVAPEC was started in 62 patients. Complete chemotherapy schedule was administered to 60 patients (97 %) and the median of its overall duration was 13 (12-18) weeks. 31 patients (50 %) underwent adjuvant "involved field" radiotherapy (RT). The median of posttherapeutic follow-up was 37 (range 8-85) months.

Results:
During the treatment, a neutropenia of grade 3 and 4 was observed in 14 patients (23 %) but without the development of any serious infectious complications. The manifestation of early non-hematological toxicity did not overcome grade 2. 58 patients (94 %) achieved the complete remission of HL. A relapse was observed in 11 cases (19 %) and estimated five years disease-free survival (DFS) is 72 %. The combination of BOVAPEC and RT in primary treatment was associated with higher probability of five years DFS but actually without statistical significance (88 % vs 58 %; p = 0.08).

Conclusion:
The BOVAPEC regimen with its acceptable toxicity may represent effective primary therapeutic approach to the patients with the intermediate stage of HL. Adjuvant RT is essential in all patients diagnosed with nodal bulk and/or residual lymphadenomegaly.

Keywords: Hodgkin's lymphoma; intermediate stage; chemotherapy; Stanford V; radiotherapy; toxicity

Received: May 11, 2006; Accepted: September 15, 2006; Published: January 1, 2007  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Raida L, Papajík T, Indrák K, Heřman M, Pauček B, Zapletalová J. Chemotherapy of BOVAPEC in the primary treatment of Hodgkin's lymphoma intermediate stages. Vnitr Lek. 2007;53(1):31-37.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Loeffler M, Hasenclever D, Diehl V. Model based development of the BEACOPP regimen for advanced stage Hodgkin's disease. Ann Oncol 1998; 9(Suppl 5): S73-S78. Go to original source... Go to PubMed...
    2. Aisenberg AC, Finkelstein DM, Doppke KP et al. High risk of breast carcinoma after irradiation of young women with Hodgkin's disease. Cancer 1997; 79: 1203-1210. Go to original source...
    3. Andrieu JM, Ifrah N, Payen C et al. Increased risk of secondary acute nonlymphocytic leukemia after extended-field radiation combined with MOPP chemotherapy for Hodgkin's disease. J Clin Oncol 1990; 8: 1148-1154. Go to original source... Go to PubMed...
    4. Boivin JF, Hutchison G, Lubin JH et al. Coronary artery disease mortality in patients treated for Hodgkin's disease. Cancer 1992; 69: 1241-1247. Go to original source... Go to PubMed...
    5. Foss Abrahamsen A, Andersen A, Nome O et al. Long-term risk of second malignancy after treatment of Hodgkin's disease: the influence of treatment, age and follow-up time. Ann Oncol 2002; 13: 1786-1791. Go to original source... Go to PubMed...
    6. Hancock SL, Cox RS, McDougall IR Thyroid disease after treatment of Hodgkin's disease. N Engl J Med 1991; 325: 599-605. Go to original source... Go to PubMed...
    7. Henry-Amar M. Second cancer after the treatment for Hodgkin's disease: A report from the International Database on Hodgkin's Disease. Ann Oncol 1992; 3(Suppl 4): 117-128. Go to original source... Go to PubMed...
    8. Lund MB, Kongerud J, Nome O et al. Lung function impairment in long-term survivors in Hodgkin's disease. Ann Oncol 1995; 6: 495-501. Go to original source... Go to PubMed...
    9. Melinová L, Heřmanská Z, Halíková J et al. Plicní komplikace a jejich prevence v léčbě Hodgkinovy choroby. Vnitř Lék 1995; 41: 313-319. Go to PubMed...
    10. Sears JD, Greven KM, Ferree CR et al. Definitive Irradiation in the Treatment of Hodgkin's Disease. Analysis of outcome, prognostic factors, and long-term complications. Cancer 1997; 79: 145-151. Go to original source...
    11. Viviani S, Santoro A, Ragni G et al. Gonadal toxicity after combination chemotherapy for Hodgkin's disease. Comparative results of MOPP vs ABVD. Eur J Cancer 1985; 21: 601-605. Go to original source... Go to PubMed...
    12. Horning SJ, Hoppe RT, Breslin S et al. Stanford V and radiotherapy for locally extensive and advanced Hodgkin's disease: Mature results of a prospective clinical trial. J Clin Oncol 2002; 20: 630-637. Go to original source...
    13. Aleman BMP, van den Belt-Dusebout AW, Klokman WJ et al. Long-Term Cause-Specific Mortality of Patients Treated for Hodgkin's Disease. J Clin Oncol 2003; 21: 3431-3439. Go to original source... Go to PubMed...
    14. Sieber M, Tesch H, Pfistner B et al. Rapidly alternating COPP/ABV/IMEP is not superior to conventional alternating COPP/ABVD in combination with extended-field radiotherapy in intermediate-stage Hodgkin's lymphoma: final results of the German Hodgkin's Lymphoma Study Group Trial HD5. J Clin Oncol 2002; 20: 476-484. Go to original source...
    15. Engert A, Schiller P, Josting A et al. Involved-field radiotherapy is equally effective and less toxic compared with extended-field radiotherapy after four cycles of chemotherapy in patients with early-stage unfavourable Hodgkin's lymphoma: results of the HD8 trial of the German Hodgkin's Lymphoma Study Group. J Clin Oncol 2003; 21: 3601-3608. Go to original source... Go to PubMed...
    16. Devizzi L, Maffioli L, Bonfante V et al. Comparison of gallium scan, computed tomography, and magnetic resonance in patients with mediastinal Hodgkin's disease. Ann Oncol 1997; 8(Suppl 1): 53-56. Go to original source...
    17. Jerusalem G, Beguin Y, Fassotte MF et al. Early detection of relapse by whole-body positron emission tomography in the follow-up of patients with Hodgkin's disease. Ann Oncol 2003; 14: 123-130. Go to original source... Go to PubMed...
    18. Maisey NR, Hill ME, Webb A et al. Are 18fluorodeoxyglucose positron emission tomography and magnetic resonance imaging useful in the prediction of relapse in lymphoma residual masses? Eur J Cancer 2000; 36: 200-206. Go to original source... Go to PubMed...
    19. Salloum E, Brandt DS, Caride VJ et al. Gallium scans in the management of patients with Hodgkin's disease: a study of 101 patients. J Clin Oncol 1997; 15: 518-527. Go to original source... Go to PubMed...
    20. Marková J, Feltl D, Kozák T Léčba Hodgkinovy choroby v roce 2002. Klinická onkologie 2002; 15: 198-200.
    21. Feltl D Potřebujeme radioterapii v léčbě Hodgkinovy choroby? Klinická onkologie 2003; 16: 184-187.
    22. Connors JM. Evolving Approaches to primary Treatment of Hodgkin's Lymphoma. ASH Educational Book 2005. Go to original source...
    23. Diehl V, Stein H, Hummel M et al. Intensification of chemotherapy and concomitant dosis reduction of radiotherapy in intermediate stage Hodgkin's lymphoma: interim results of the HD11 trial of the GHSG. ASH Educational Book 2003. Go to original source...
    24. Dienstbier Z, Heřmanská Z, Zámečník J et al. Děti rodičů léčených pro Hodgkinovu chorobu ozařováním a chemoterapií. Vnitř Lék 1994; 40: 163-166. Go to PubMed...

    Return to the content


    Vnitřní lékařství

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.