Background: Doxorubicin/bleomycin/vinblastine/dacarbazine (ABVD) chemotherapy alone is a viable option for the treatment of stage I/II Hodgkin's lymphoma. Among the main drawbacks for widespread acceptance of this therapy is the absence of available data on the post-salvage therapy course in patients with limited-stage disease who relapse after ABVD. This article focuses on the outcome of 11 limited-stage patients who relapsed after ABVD alone.
Patients and methods: After a clinical restaging, the patients received mantle-type radiation therapy (only if patients met these criteria: supradiaphragmatic disease in a single-node area, erythrocyte sedimentation rate < 30 mm per hour, and absence of B symptoms) or conventional salvage chemotherapy followed by high-dose chemotherapy and autologous hematopoietic stem cell transplantation.
Results: After a median follow-up of 64 months, 10 patients showed complete response and are still alive without disease progression. One patient showed refractory disease and died 9 months after relapse. This experiment entails the series with the longest follow-up in patients with limited-stage Hodgkin's lymphoma who relapsed after ABVD alone.
Conclusion: The data seem to indicate that salvage therapy is capable of providing cure in most cases and lend further support for the use of ABVD alone as first-line therapy.