Prognostic relevance of DHAP dose-density in relapsed Hodgkin lymphoma: an analysis of the German Hodgkin-Study Group
Language English Country United States Media print-electronic
Document type Clinical Trial, Phase III, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
- Keywords
- DHAP, dose density, hematotoxicity, outcome, relapsed Hodgkin lymphoma,
- MeSH
- Radiotherapy, Adjuvant MeSH
- Cisplatin adverse effects therapeutic use MeSH
- Cytarabine adverse effects therapeutic use MeSH
- Dexamethasone adverse effects therapeutic use MeSH
- Adult MeSH
- Hodgkin Disease drug therapy mortality pathology MeSH
- Combined Modality Therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Retreatment MeSH
- Prognosis MeSH
- Proportional Hazards Models MeSH
- Antineoplastic Combined Chemotherapy Protocols adverse effects therapeutic use MeSH
- Recurrence MeSH
- Neoplasm Staging MeSH
- Hematopoietic Stem Cell Transplantation MeSH
- Treatment Outcome MeSH
- Salvage Therapy MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial, Phase III MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Randomized Controlled Trial MeSH
- Geographicals
- Germany MeSH
- Names of Substances
- Cisplatin MeSH
- Cytarabine MeSH
- Dexamethasone MeSH
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.
b University Hospital Brno and Faculty of Medicine Masaryk University Brno Czech Republic ;
c Department of Hematology and Oncology Hospital of Oldenburg Oldenburg Germany ;
Clinic 3 for Internal Medicine University Hospital of Ulm Ulm Germany ;
e Department of Hematology and Oncology University Hospital of Magdeburg Magdeburg Germany ;
f Department of Hematology and Oncology University Hospital of Leipzig Leipzig Germany ;
g Department of Hematology Oncology Asklepios Clinic St Georg Hamburg Germany ;
h Department of Oncology Hematology Klinikum Nuernberg Nord Nuernberg Germany ;
i Department of Hematology Radboud University Medical Center Nijmegen Netherlands ;
Internal Medicine 1 German Hodgkin Study Group University Hospital of Cologne Cologne Germany ;
j Clinic 1 for Internal Medicine Helios Clinic Wuppertal Wuppertal Germany
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