TY - JOUR
T1 - Bleomycin use in the treatment of Hodgkin lymphoma (HL)
T2 - toxicity and outcomes in the modern era
AU - Taparra, Kekoa
AU - Liu, Heshan
AU - Polley, Mei Yin
AU - Ristow, Kay
AU - Habermann, Thomas M.
AU - Ansell, Stephen M.
N1 - Publisher Copyright:
© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2020/1/28
Y1 - 2020/1/28
N2 - One-in-five Hodgkin Lymphoma (HL) patients treated with bleomycin develop bleomycin pulmonary toxicity (BPT). Given bleomycin-omission data with negative interim-PET, we assessed changes in BPT statistics. We retrospectively evaluated 126 ABVD-treated HL patients for overall survival (OS), progression-free survival (PFS), BPT factors, and management. Forty-seven patients developed BPT with 17% BPT-mortality. In univariable analysis, OS was negatively impacted by BPT (HR = 3.6, 95%CI = 1.2–10.6), but not bleomycin-omission (HR = 1.3, 95%CI = 0.5–3.7). In multivariable analysis, BPT was not associated with OS (HR = 3.0, 95%CI = 0.9–9.9). BPT patients were older (46 y vs 33 years) and received less bleomycin (107 vs 215 units) compared to non-BPT patients. BPT was managed primarily with bleomycin-omission. “Recent Era” patients had lower BPT rates (28% vs 48%), mortality (10% vs 21%), and bleomycin doses (7 vs 12 doses), yet higher bleomycin-omission in the absence of the BPT (59% vs 8%) compared to “Early Era”. Our data suggest BPT continually impacts OS in ABVD-treated HL patients, however management is changing.
AB - One-in-five Hodgkin Lymphoma (HL) patients treated with bleomycin develop bleomycin pulmonary toxicity (BPT). Given bleomycin-omission data with negative interim-PET, we assessed changes in BPT statistics. We retrospectively evaluated 126 ABVD-treated HL patients for overall survival (OS), progression-free survival (PFS), BPT factors, and management. Forty-seven patients developed BPT with 17% BPT-mortality. In univariable analysis, OS was negatively impacted by BPT (HR = 3.6, 95%CI = 1.2–10.6), but not bleomycin-omission (HR = 1.3, 95%CI = 0.5–3.7). In multivariable analysis, BPT was not associated with OS (HR = 3.0, 95%CI = 0.9–9.9). BPT patients were older (46 y vs 33 years) and received less bleomycin (107 vs 215 units) compared to non-BPT patients. BPT was managed primarily with bleomycin-omission. “Recent Era” patients had lower BPT rates (28% vs 48%), mortality (10% vs 21%), and bleomycin doses (7 vs 12 doses), yet higher bleomycin-omission in the absence of the BPT (59% vs 8%) compared to “Early Era”. Our data suggest BPT continually impacts OS in ABVD-treated HL patients, however management is changing.
KW - ABVD
KW - Hodgkin lymphoma
KW - bleomycin
KW - chemotherapy toxicity
KW - lung toxicity
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U2 - 10.1080/10428194.2019.1663419
DO - 10.1080/10428194.2019.1663419
M3 - Article
C2 - 31517559
AN - SCOPUS:85073823948
SN - 1042-8194
VL - 61
SP - 298
EP - 308
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 2
ER -