Long-term follow-up of bulky classic Hodgkin lymphoma managed with ABVD and PET-guided RT demonstrates excellent outcomes in PET-negative cases

Br J Haematol. 2025 Jan;206(1):167-171. doi: 10.1111/bjh.19859. Epub 2024 Nov 7.

Abstract

The outcome of 221 patients with bulky (≥10 cm) classic Hodgkin lymphoma (cHL) treated with doxorubicin, bleomycin, vinblastine, dacarbazine and consolidative radiotherapy (RT) only in those with a positive end-of-treatment (EOT) positron emission tomography (PET) scan was evaluated. With a median follow-up of 9.6 years, 5- and 10-year progression-free survival (PFS) in EOT PET-negative cases were 94.0% and 90.4%, respectively, and in PET-positive cases, 5/10-year PFS was 64.6% (p < 0.001), with 15% overall receiving RT. Five-year PFS for Deauville (D) score DX/D1-3 was 93.6%, compared with D4 66.7% (p < 0.001) and D5 33.3% (p < 0.001). Omission of RT in EOT PET-negative cases is associated with excellent long-term outcomes in bulky cHL.

Keywords: ABVD; PET‐adapted RT; bulky Hodgkin lymphoma; consolidative RT.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Bleomycin* / administration & dosage
  • Bleomycin* / therapeutic use
  • Dacarbazine* / administration & dosage
  • Dacarbazine* / therapeutic use
  • Doxorubicin* / administration & dosage
  • Doxorubicin* / therapeutic use
  • Female
  • Follow-Up Studies
  • Hodgkin Disease* / diagnostic imaging
  • Hodgkin Disease* / drug therapy
  • Hodgkin Disease* / mortality
  • Hodgkin Disease* / therapy
  • Humans
  • Male
  • Middle Aged
  • Positron-Emission Tomography*
  • Radiotherapy, Image-Guided / methods
  • Treatment Outcome
  • Vinblastine* / administration & dosage
  • Vinblastine* / therapeutic use
  • Young Adult

Substances

  • Bleomycin
  • Vinblastine
  • Dacarbazine
  • Doxorubicin

Supplementary concepts

  • ABVD protocol