Bleomycin use in the treatment of Hodgkin lymphoma (HL): toxicity and outcomes in the modern era

Kekoa Taparra, Heshan Liu, Mei Yin Polley, Kay Ristow, Thomas M. Habermann, Stephen M. Ansell

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
JournalLeukemia and Lymphoma
DOIs
StateAccepted/In press - Jan 1 2019

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Bleomycin
Hodgkin Disease
Lung
Therapeutics
indium-bleomycin
Survival
Mortality

Keywords

  • ABVD
  • bleomycin
  • chemotherapy toxicity
  • Hodgkin lymphoma
  • lung toxicity

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

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title = "Bleomycin use in the treatment of Hodgkin lymphoma (HL): toxicity and outcomes in the modern era",
abstract = "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.",
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AU - Polley, Mei Yin

AU - Ristow, Kay

AU - Habermann, Thomas M.

AU - Ansell, Stephen M.

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