Prognostic relevance of DHAP dose-density in relapsed Hodgkin lymphoma: an analysis of the German Hodgkin-Study Group. Issue 5 (3rd May 2016)

• Record Type: Journal Article
• Authors: Sasse, Stephanie; Alram, Magdalena; Müller, Horst; Smardová, Lenka; Metzner, Bernd; Doehner, Hartmut; Fischer, Thomas; Niederwieser, Dietger W.; Schmitz, Norbert; Schäfer-Eckart, Kerstin; Raemaekers, John M. M.; Schmalz, Oliver; Tresckow, Bastian V.; Engert, Andreas; Borchmann, Peter
• Is Part Of: Leukemia & lymphoma. Volume 57:Issue 5(2016:May)
• Page Start: 1067
• Page End: 1073
• Publication Date: 2016-05-03
• Subjects: DHAP -- dose density -- hematotoxicity -- outcome -- relapsed Hodgkin lymphoma; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.3109/10428194.2015.1083561
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: Only 50% of patients with relapsed Hodgkin lymphoma (HL) can be cured with intensive induction chemotherapy, followed by high-dose chemotherapy (HDCT) and autologous stem cell transplant (ASCT). Based on the results of the HDR2 trial two courses of DHAP and subsequent HDCT/ASCT are the current standard of care in relapsed HL. In order to assess the prognostic relevance of DHAP dose density, we performed a retrospective multivariate analysis of the HDR2 trial ( N = 266). In addition to four risk factors (early or multiple relapse, stage IV disease or anemia at relapse, and grade IV hematotoxicity during the first cycle of DHAP) a delayed start of the second cycle of DHAP > day 22 predicted a significantly poorer progression-free survival (PFS, p = 0.0356) and overall survival (OS, p = 0.0025). In conclusion, our analysis strongly suggests that dose density of DHAP has a relevant impact on the outcome of relapsed HL patients.