[Chemotherapy of BOVAPEC in the primary treatment of Hodgkin's lymphoma intermediate stages].

DESIGN

Chemotherapy of BOVAPEC is the modification of temporary intensified Stanford V protocol, an effective primary treatment of advanced Hodgkin's lymphoma (HL) in spite of limited toxicity. Nitrogen mustard was substituted by less myelotoxic cyclophosphamide and the protocol has been used in the treatment of patients with an intermediate stage of HL.

METHODS

The primary treatment with BOVAPEC was started in 62 patients. Complete chemotherapy schedule was administered to 60 patients (97%) and the median of its overall duration was 13 (12-18) weeks. 31 patients (50 %) underwent adjuvant "involved field" radiotherapy (RT). The median of posttherapeutic follow-up was 37 (range 8-85) months.

RESULTS

During the treatment, a neutropenia of grade 3 and 4 was observed in 14 patients (23%) but without the development of any serious infectious complications. The manifestation of early non-hematological toxicity did not overcome grade 2.58 patients (94%) achieved the complete remission of HL. A relapse was observed in 11 cases (19%) and estimated five years disease-free survival (DFS) is 72%. The combination of BOVAPEC and RT in primary treatment was associated with higher probability of five years DFS but actually without statistical significance (88% vs. 58%; p = 0.08).

CONCLUSION

The BOVAPEC regimen with its acceptable toxicity may represent effective primary therapeutic approach to the patients with the intermediate stage of HL. Adjuvant RT is essential in all patients diagnosed with nodal bulk and/or residual lymphadenomegaly.