Does discontinuing bleomycin due to toxicity increase the risk of lymphoma progression? Real-life data from a homogeneous population of advanced stage Hodgkin lymphoma


Yılmaz U., Zulfaliyeva G., Güzelli A. N., Özmen D., Elverdi T., Salihoğlu A., ...More

JOURNAL OF CHEMOTHERAPY, vol.36, no.5, pp.403-410, 2024 (SCI-Expanded, Scopus) identifier identifier identifier

  • Publication Type: Article / Review
  • Volume: 36 Issue: 5
  • Publication Date: 2024
  • Doi Number: 10.1080/1120009x.2023.2281089
  • Journal Name: JOURNAL OF CHEMOTHERAPY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, PASCAL, BIOSIS, CAB Abstracts, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.403-410
  • Keywords: adverse events, bleomycin toxicity, Hodgkin lymphoma, pneumonitis, risk of progression, supportive care
  • Istanbul University-Cerrahpasa Affiliated: Yes

Abstract

Hodgkin Lymphoma (HL) is often curable with ABVD therapy and improving outcomes is a main goal of ongoing research. Bleomycin-associated pneumonitis (BAPT) is a potentially life-threatening complication that necessitates bleomycin discontinuation. We conducted this study on a homogenous cohort of advanced stage HL treated only with ABVD for frontline therapy to assess if bleomycin discontinuation increases the risk of lymphoma progression. After the exclusion of patients who received radiotherapy or other drugs, 106 and 28 patients in the six-cycle ABVD and BAPT groups respectively had similar survival curves for progression and death with a 49-month median follow-up. PFS rates were also very similar at two and four years from diagnosis with 2-year PFS rates of 83.9% and 82.1% (RR = 1.1 95%CI = 0.45-2.2). Outcome comparisons were also similar between the two groups when stratified according to early response assessment with PET/CT. Patients who discontinued bleomycin due to toxicity did not experience an increased risk of progression compared to patients who completed six ABVD cycles.