Gemcitabine added to doxorubicin, bleomycin, and vinblastine for the treatment of de novo Hodgkin disease

被引:39
作者
Friedberg, JW
Neuberg, D
Kim, H
Miyata, S
McCauley, M
Fisher, DC
Takvorian, T
Canellos, GP
机构
[1] Univ Rochester, James P Wilmont Canc Ctr, Rochester, NY USA
[2] Dana Farber Canc Inst, Dept Biostat Sci, Boston, MA USA
[3] Dana Farber Canc Inst, Dept Med Oncol, Boston, MA USA
[4] Massachusetts Gen Hosp, Dept Hematol Oncol, Boston, MA USA
关键词
gemcitabine; Hodgkin disease; pneumonitis; bleomycin;
D O I
10.1002/cncr.11582
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND. Gemcitabine is an effective treatment for recurrent Hodgkin disease (HD), with relatively minimal associated toxicity. The authors conducted a trial substituting this drug for dacarbazine in the standard regimen to form ABVG (doxorubicin, bleomycin, vinblastine, gemcitabine) for patients with newly diagnosed, high-risk HD. METHODS. Twelve patients (median age, 34 years) with advanced-stage de novo HD were enrolled. Standard doses of doxorubicin, bleomycin, and vinblastine were given for six cycles. Cohorts of three patients were enrolled and the dose of gemcitabine was escalated to identify the maximally tolerated dose in this combination. RESULTS. The maximally tolerated dose of gemcitabine was determined to be 800 mg/m(2) in this combination. Five patients developed clinically significant pulmonary toxicity. Three required hospitalization during the final two cycles of treatment. pneumonitis could not be predicted with serial diffusion capacity for carbon monoxide (DECO) evaluations, and reversed after discontinuation of bleomycin in three patients and steroid therapy in two patients. All 12 patients are alive to date, and 4 patients have experienced disease progression. CONCLUSIONS. The bleomycin/gemcitabine combination should not be pursued for de novo HD due to significant pulmonary toxicity. (C) 2003 American Cancer Society.
引用
收藏
页码:978 / 982
页数:5
相关论文
共 29 条
[1]  
ANDERSSON BS, 1990, CANCER, V65, P1079, DOI 10.1002/1097-0142(19900301)65:5<1079::AID-CNCR2820650506>3.0.CO
[2]  
2-K
[3]  
Bredenfeld H, 2002, BLOOD, V100, p295B
[4]   CHEMOTHERAPY OF ADVANCED HODGKINS-DISEASE WITH MOPP, ABVD, OR MOPP ALTERNATING WITH ABVD [J].
CANELLOS, GP ;
ANDERSON, JR ;
PROPERT, KJ ;
NISSEN, N ;
COOPER, MR ;
HENDERSON, ES ;
GREEN, MR ;
GOTTLIEB, A ;
PETERSON, BA .
NEW ENGLAND JOURNAL OF MEDICINE, 1992, 327 (21) :1478-1484
[5]   Long-term follow-up of Hodgkin's disease trial [J].
Canellos, GP ;
Niedzwiecki, D .
NEW ENGLAND JOURNAL OF MEDICINE, 2002, 346 (18) :1417-1418
[6]  
Comis R L, 1992, Semin Oncol, V19, P64
[7]   BEACOPP, a new dose-escalated and accelerated regimen, is at least as effective as COPP/ABVD in patients with advanced-stage Hodgkin's lymphoma: Interim report from a trial of the German Hodgkin's Lymphoma Study Group [J].
Diehl, V ;
Franklin, J ;
Hasenclever, D ;
Tesch, H ;
Pfreundschuh, M ;
Lathan, B ;
Paulus, U ;
Sieber, M ;
Rueffer, JU ;
Sextro, M ;
Engert, A ;
Wolf, J ;
Hermann, R ;
Holmer, L ;
Stappert-Jahn, U ;
Winnerlein-Trump, E ;
Wulf, G ;
Krause, S ;
Glunz, A ;
von Kalle, K ;
Bischoff, H ;
Haedicke, C ;
Duehmke, E ;
Georgii, A ;
Loeffler, M .
JOURNAL OF CLINICAL ONCOLOGY, 1998, 16 (12) :3810-3821
[8]   Advanced Hodgkin's disease: ABVD is better, yet is not good enough! [J].
Diehl, V .
JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (04) :583-585
[9]   Randomized comparison of ABVD and MOPP/ABV hybrid for the treatment of advanced Hodgkin's disease: Report of an intergroup trial [J].
Duggan, DB ;
Petroni, GR ;
Johnson, JL ;
Glick, JH ;
Fisher, RI ;
Connors, JM ;
Canellos, GP ;
Peterson, BA .
JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (04) :607-614
[10]  
FREI E, 1972, CANCER CHEMOTH REP 1, V56, P667