Rueda Antonio, Olmos David, Viciana Ruth, Alba Emilio
Oncology Department, Hospital Clinico Universitario, Malaga, Spain.
Clin Lymphoma Myeloma. 2006 Mar;6(5):389-92. doi: 10.3816/CLM.2006.n.015.
Doxorubicin/bleomycin/vinblastine/dacarbazine (ABVD) chemotherapy alone is a viable option for the treatment of stage I/II Hodgkin's lymphoma. Among the main drawbacks for widespread acceptance of this therapy is the absence of available data on the post-salvage therapy course in patients with limited-stage disease who relapse after ABVD. This article focuses on the outcome of 11 limited-stage patients who relapsed after ABVD alone.
After a clinical restaging, the patients received mantle-type radiation therapy (only if patients met these criteria: supradiaphragmatic disease in a single-node area, erythrocyte sedimentation rate < 30 mm per hour, and absence of B symptoms) or conventional salvage chemotherapy followed by high-dose chemotherapy and autologous hematopoietic stem cell transplantation.
After a median follow-up of 64 months, 10 patients showed complete response and are still alive without disease progression. One patient showed refractory disease and died 9 months after relapse. This experiment entails the series with the longest follow-up in patients with limited-stage Hodgkin's lymphoma who relapsed after ABVD alone.
The data seem to indicate that salvage therapy is capable of providing cure in most cases and lend further support for the use of ABVD alone as first-line therapy.
单纯多柔比星/博来霉素/长春碱/达卡巴嗪（ABVD）化疗是治疗Ⅰ/Ⅱ期霍奇金淋巴瘤的一种可行选择。该疗法广泛应用的主要缺点之一是，对于局限期疾病患者在接受ABVD治疗后复发的挽救治疗过程，缺乏可用数据。本文重点关注11例仅接受ABVD治疗后复发的局限期患者的治疗结果。
经过临床重新分期后，患者接受斗篷式放射治疗（仅在患者符合以下标准时：单个淋巴结区域的膈上疾病、红细胞沉降率<每小时30毫米且无B症状）或常规挽救化疗，随后进行大剂量化疗和自体造血干细胞移植。
中位随访64个月后，10例患者显示完全缓解，且仍存活，无疾病进展。1例患者出现难治性疾病，复发后9个月死亡。该实验是对仅接受ABVD治疗后复发的局限期霍奇金淋巴瘤患者进行随访时间最长的系列研究。
数据似乎表明，挽救治疗在大多数情况下能够实现治愈，并为单独使用ABVD作为一线治疗提供了进一步支持。
