Treatment of Hodgkin's lymphomas in adolescent and young adults

Abstract

Clinical efficacy of DAL-HD-90m protocol in the treatment of adolescent and young patients with Hodgkin's lymphomas was analyzed. From November 1997 to April 2007, 97 patients (38 males and 59 females) aged from 15 to 45 years with first diagnosed Hodgkin's lymphomas were enrolled to trial. Patients with IA, IB and IIA stages (therapeutic group (TG) 1) were treated by 2 cycles of ODPA regimen (vincristine, procarbasine, prednisolone, adriamycin) for females and 2 cycles of OEPA regimen (vincristine, ethoposide, prednisolone, adriamycin) for males. Patients with IIB, IIIA, IE A, IE B, IIE A stages (TG 2) received additional two cycles of multi-agent chemotherapy with COPD regimen (cyclophosphamide, vincristine, prednisolone, adriamycin). Patients of TG 3 (stages IIIB, IVA, IVB, IIE B, IIIE A, IIIE B) were treated with 2 cycles of ODPA and 4 cycles of COPD regimens irrespective of the patient's sex. Radiotherapy was carried out to all patients: targets included regional lymph nodes (total local dose of 30 Gy) and additionally the residual tumor (total dose of 6-10 Gy). Complete response was achieved in 91 % patients from TG 1, 94% patients from TG 2 and 89% from TG 3 group. Six-year overall survival was 0,91±0,09; 0,88±0,08 and 0,76±0,08, respectively. The absence of CR/CRu after 2 courses of OPPA/OEPA (0,60 versus 0,93; p=0,006), initial tumors of larger volumes than 50 cm3 (0,66 versus 0,91, p=0,017) and the International Prognostic Index no lower than 4 points (0,44 versus 0,82; p=0,039) were unfavorable prognostic factors for TG3 patients in this study.

Keywords

• hodgkin's lymphoma
• adolescents
• young patients
• dal-hd-90m protocol