الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
Hodgkin’s lymphoma is a malignancy of the lymphoid system that accounts for approximately 30% of all malignant lymphoma and belongs to the most curable malignancy in adults; about 80% of patients in all anatomical stages and of different histological subtypes can be cured with modern treatment strategies. It represents about 30.3% of all lymphoma cases presenting to the NCI of Egypt cancer pathology registry. For patients with advanced stage disease, ABVD has become the standard
chemotherapy because of a number of advantages; it is all-intravenous
(providing better compliance), has less cumulative myelotoxicity, a lower
risk of secondary malignancies (AML or solid tumors), and a lower rate
of infertility compared with previous regimens (eg,mechlorethamine,
vincristine procarbazine and prednisone).
The aim of this retrospective study is to determine the efficacy, treatment outcome and toxicity of ABVD regimen in stage III and stage IV of Hodgkin’s lymphoma as a first line treatment using the International prognostic factors as a predictor for the outcome of treatment.
The study includes fifty-seven adult patients with stage III and stage
IV HL who are treated with median 6 cycles of ABVD regimen during the period between January 2003 and December 2004. Twenty-five
patients (43.9%) achieved CR with ABVD regimen after an observation period of 57 months.
The OS for the whole study group was 94.5% with mean 54.9 months while the DFS cannot be computed due to too little uncensored data.
Regarding the prognostic factors for response to treatment the response rate was significantly affected by the pathological type clinical stage and extranodal involvement.
The CR rate was 5.6%, 42.1% and 50% with Nodular sclerosis Mixed cellularity and lymphoid rich
respectively (P value 0.01). As regard the clinical stage, the CR rate was
40.9%% and 10.5%% with stage III and stage IV respectively (P value
0.03). Regarding extranodal involvement, the CR rate was 5.3% and
45.5% with extranodal involvement and without extranodal involvement
respectively (P value 0.004).
The OS rate wasn’t significantly affected by any of the prognostic
factors.
As regard the toxicity of ABVD regimen reported in our study, it was
found that ABVD was well-tolerated by the patients where only 40.4%
developed toxicity distributed between; neutropenia 29.8%, neuropathy,
infection 1.8%, mucositis 1.8%, neutropenia and infection 1.8% and1.8%
for neutropenia and mucositis.
We conclude that ABVD regimen is still feasible and well-tolerated in
treatment of patients with advanced stage HL, given the survival results
and toxicity profile.
The treatment outcome is influenced by the pathological type, clinical stage and extranodal involvement.