Antoine Seignez1,2, Olivier Casasnovas3, Emmanuelle Ferrant3, Jean Noel Bastie2,3, Pauline Mondoloni4, Ludwig Serge Aho5, Mathieu Boulin6,7. 1. Department of Immunology and Internal Medicine, University Hospital, Dijon, France. 2. Inserm U866, University of Burgundy, Dijon, France. 3. Department of Hematology, University Hospital, Dijon, France. 4. Department of Pharmacy, University Hospital, 14 rue Gaffarel, 21000, Dijon, France. 5. Department of Hospital Hygiene and Epidemiology, University Hospital, Dijon, France. 6. Department of Pharmacy, University Hospital, 14 rue Gaffarel, 21000, Dijon, France. mathieuboulin@yahoo.fr. 7. EA4184, University of Burgundy, Dijon, France. mathieuboulin@yahoo.fr.
Abstract
BACKGROUND: There is a need to develop treatment strategies that are less toxic than BEACOPPescalated x6 cycles, the standard-of-care in advanced Hodgkin's lymphoma patients. OBJECTIVE: To compare short-term hematological toxicity in advanced Hodgkin's lymphoma patients treated with either BEACOPPescalated x6 cycles (standard group) or BEACOPPescalated x2 followed by ABVD x4 cycles (experimental group). METHOD: In 27 patients, we compared injections of erythropoiesis stimulating agent and granulocyte colony-stimulating factor, transfusions, hospitalization days, as well as hemoglobin, platelet, leukocyte levels. Method In 27 patients, we compared injections of erythropoiesis stimulating agent and granulocyte colony-stimulating factor, transfusions, hospitalization days, as well as hemoglobin, platelet, leukocyte levels. RESULTS: The mean number of erythropoiesis stimulating agent and granulocyte colony-stimulating factor injections, platelet transfusions and hospitalization days was significantly lower in the experimental group (erythropoiesis stimulating agents: mean difference -6.6 ± 2.4, p = 0.005; granulocyte colony-stimulating factors: mean difference -8.3 ± 3.6, p = 0.020, platelet transfusions: mean difference -0.6 ± 0.3, p = 0.035; hospitalization days: mean difference: -8.5 ± 1.7 days, p < 10(-3)). There were no differences in terms of red cell transfusions, platelet counts or leukocyte levels between the two groups. From the 3rd chemotherapy cycle, hemoglobin levels decreased to a significantly lesser extent in the experimental group. CONCLUSION: We demonstrated an overall better short-term hematological profile in advanced Hodgkin's lymphoma patients who received a de-escalation chemotherapy regimen with significant differences mainly in terms of hemoglobin levels, erythropoiesis stimulating agent injections, and hospitalization days.
BACKGROUND: There is a need to develop treatment strategies that are less toxic than BEACOPPescalated x6 cycles, the standard-of-care in advanced Hodgkin's lymphomapatients. OBJECTIVE: To compare short-term hematological toxicity in advanced Hodgkin's lymphomapatients treated with either BEACOPPescalated x6 cycles (standard group) or BEACOPPescalated x2 followed by ABVD x4 cycles (experimental group). METHOD: In 27 patients, we compared injections of erythropoiesis stimulating agent and granulocyte colony-stimulating factor, transfusions, hospitalization days, as well as hemoglobin, platelet, leukocyte levels. Method In 27 patients, we compared injections of erythropoiesis stimulating agent and granulocyte colony-stimulating factor, transfusions, hospitalization days, as well as hemoglobin, platelet, leukocyte levels. RESULTS: The mean number of erythropoiesis stimulating agent and granulocyte colony-stimulating factor injections, platelet transfusions and hospitalization days was significantly lower in the experimental group (erythropoiesis stimulating agents: mean difference -6.6 ± 2.4, p = 0.005; granulocyte colony-stimulating factors: mean difference -8.3 ± 3.6, p = 0.020, platelet transfusions: mean difference -0.6 ± 0.3, p = 0.035; hospitalization days: mean difference: -8.5 ± 1.7 days, p < 10(-3)). There were no differences in terms of red cell transfusions, platelet counts or leukocyte levels between the two groups. From the 3rd chemotherapy cycle, hemoglobin levels decreased to a significantly lesser extent in the experimental group. CONCLUSION: We demonstrated an overall better short-term hematological profile in advanced Hodgkin's lymphomapatients who received a de-escalation chemotherapy regimen with significant differences mainly in terms of hemoglobin levels, erythropoiesis stimulating agent injections, and hospitalization days.
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