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Prognostic relevance of DHAP dose-density in relapsed Hodgkin lymphoma: an analysis of the German Hodgkin-Study Group

S. Sasse, M. Alram, H. Müller, L. Smardová, B. Metzner, H. Doehner, T. Fischer, DW. Niederwieser, N. Schmitz, K. Schäfer-Eckart, JM. Raemaekers, O. Schmalz, BV. Tresckow, A. Engert, P. Borchmann,

. 2016 ; 57 (5) : 1067-73. [pub] 20151223

Language English Country England, Great Britain

Document type Clinical Trial, Phase III, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't

Persistent link   https://www.medvik.cz/link/bmc17014187

Only 50% of patients with relapsed Hodgkin lymphoma (HL) can be cured with intensive induction chemotherapy, followed by high-dose chemotherapy (HDCT) and autologous stem cell transplant (ASCT). Based on the results of the HDR2 trial two courses of DHAP and subsequent HDCT/ASCT are the current standard of care in relapsed HL. In order to assess the prognostic relevance of DHAP dose density, we performed a retrospective multivariate analysis of the HDR2 trial (N=266). In addition to four risk factors (early or multiple relapse, stage IV disease or anemia at relapse, and grade IV hematotoxicity during the first cycle of DHAP) a delayed start of the second cycle of DHAP>day 22 predicted a significantly poorer progression-free survival (PFS, p=0.0356) and overall survival (OS, p=0.0025). In conclusion, our analysis strongly suggests that dose density of DHAP has a relevant impact on the outcome of relapsed HL patients.

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$a Only 50% of patients with relapsed Hodgkin lymphoma (HL) can be cured with intensive induction chemotherapy, followed by high-dose chemotherapy (HDCT) and autologous stem cell transplant (ASCT). Based on the results of the HDR2 trial two courses of DHAP and subsequent HDCT/ASCT are the current standard of care in relapsed HL. In order to assess the prognostic relevance of DHAP dose density, we performed a retrospective multivariate analysis of the HDR2 trial (N=266). In addition to four risk factors (early or multiple relapse, stage IV disease or anemia at relapse, and grade IV hematotoxicity during the first cycle of DHAP) a delayed start of the second cycle of DHAP>day 22 predicted a significantly poorer progression-free survival (PFS, p=0.0356) and overall survival (OS, p=0.0025). In conclusion, our analysis strongly suggests that dose density of DHAP has a relevant impact on the outcome of relapsed HL patients.
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$a Alram, Magdalena $u a Internal Medicine I, German Hodgkin Study Group , University Hospital of Cologne , Cologne , Germany ; $7 gn_A_00004798
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$a Müller, Horst $u a Internal Medicine I, German Hodgkin Study Group , University Hospital of Cologne , Cologne , Germany ;
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$a Metzner, Bernd $u c Department of Hematology and Oncology , Hospital of Oldenburg , Oldenburg , Germany ;
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$a Schäfer-Eckart, Kerstin $u h Department of Oncology/Hematology , Klinikum Nuernberg Nord , Nuernberg , Germany ;
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