Mahuad Carolina, Victoria Otero, Laura Korin, Enriqueta Martinez, Fernando Warley, Hernán García Rivello, Nancy Cristaldo, Dana Kohan, Marta Zerga, Gonzalo Garate, de Los Ángeles Vicente Repáraz María, Florencia Aizpurua, Erica Rojas Bilbao, Susana Cerana, Eugenia Funes Maria, Iliana Plaza, Cecilia Foncuberta, Anahí Vijnovich Baron, Santiago Cranco, Adriana Vitriu, Mariela Gomez, Justina Lavalle, Claudia Casali, Manuela Clavijo, Luciana Melillo, Cecilia Cabral Lorenzo Maria, Augusto Miroli, Laura Fischman, Maximiliano Pavlove, Marcela Miodosky, Silvana Cugliari
Servicio de Hematología, Hospital Alemán, CABA, Pueyrredón 1640, CP 1118 Buenos Aires, Argentina.
Servicio de Hematología, Hospital Italiano, Buenos Aires, Argentina.
Clin Hematol Int. 2022 Jun 22;4(1-2):44-51. doi: 10.1007/s44228-022-00008-4. eCollection 2022 Jun.
There are no data in Argentina on the response rates to first-line treatment of classical Hodgkin Lymphoma (cHL) outside clinical trials. A total of 498 patients from 7 public and private hospitals in Argentina were retrospectively examined. The median follow-up was 37.4 months (CI 95% 17.7-63.5). The median time from diagnosis to treatment was 22 days (IQR 14-42), which was significantly longer in public hospitals (49.3 (IC 95% 38.5-60.2) versus 32.5 (IC 95% 27-38); = 0.0027). A total of 96.8% of patients were treated with ABVD.:84.3% achieved complete remission (CR) and 6.02% partial remission (PR), being the CR rate higher in private hospitals. End-of-treatment metabolic CR was achieved in 85.4% ( = 373). The interim PET scan was widely used in our cohort (70.5%; = 351), but in only 23.3% ( = 116) was the treatment strategy response-adapted. The 5-year progression-free survival (PFS) was 76% (CI 95% 70-81). The 2 and 5-years-OS rates were 91% (CI 95% 88-94%) and 85% (CI 95% 80-89%), respectively. No differences in OS were found between public and private institutions ( = 0.27). This is one of the largest retrospective cHL cohorts reported. In Argentina ABVD is the chemotherapy regimen of choice and, although it is well tolerated, it is not exempt from toxicity. We showed that early initiation of treatment impacts the induction results. Although the use of PET scan is widespread, only a minority of patients was treated with respons- adapted strategies. The use of PET-guided treatment is strongly encouraged.
在阿根廷，尚无关于临床试验之外经典霍奇金淋巴瘤（cHL）一线治疗缓解率的数据。对来自阿根廷7家公立和私立医院的498例患者进行了回顾性研究。中位随访时间为37.4个月（95%置信区间17.7 - 63.5）。从诊断到治疗的中位时间为22天（四分位间距14 - 42），在公立医院显著更长（49.3（95%置信区间38.5 - 60.2）对32.5（95%置信区间27 - 38）；P = 0.0027）。共有96.8%的患者接受了ABVD治疗：84.3%达到完全缓解（CR），6.02%达到部分缓解（PR），私立医院的CR率更高。85.4%（n = 373）的患者实现了治疗结束时的代谢CR。中期PET扫描在我们的队列中广泛使用（70.5%；n = 351），但只有23.3%（n = 116）的患者采用了根据治疗反应调整的策略。5年无进展生存率（PFS）为76%（95%置信区间70 - 81）。2年和5年总生存率（OS）分别为91%（95%置信区间88 - 94%）和85%（95%置信区间80 - 89%）。公立和私立机构之间在OS方面未发现差异（P = 0.27）。这是所报道的最大规模的回顾性cHL队列之一。在阿根廷，ABVD是首选的化疗方案，尽管耐受性良好，但仍有一定毒性。我们表明早期开始治疗会影响诱导结果。虽然PET扫描的使用很广泛，但只有少数患者采用了根据反应调整的策略。强烈鼓励使用PET引导的治疗。
