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LYMPHOMA : HODGKIN'S DISEASE
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Regimen/Number Of Patients |
Drug Dose and Route |
Leukopenia/ Neutropenia Toxicity |
Anemia Toxicity |
Other Grade III-IV Toxicities |
Emetogenic Potential |
Consequences of Adverse Event(s) |
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ABVD (Canellos GP, et al. N Engl J. Med. 1992; 327: 1478 -84)
N= 115 |
Doxorubicin 25 mg/m2 IV days 1, 15 Bleomycin 10 units /m2 IV days 1, 15 Vinblastine 6 mg/m2 IV day 1, 15 Repeat cycle every 28 days
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Neutropenia Grade III-IV %
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Grade III-IV 5% |
Infection 2 % Thrombocytopenia (Grade IV) 5% Alpecia (Grade III) 24 % Pulmonary Toxicity 6% Peripheral Neuropathy 1% Nausea / Vomiting 33% |
Days 1, 15- Level 5 |
Death due to pulmonary toxicity 3% More than 80% of Patients received full-dose doxorubicin in each of the first 6 cycles
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ChIVPP (Selby P , et al. Br J Cancer. 1990; 62: 279 – 85)
N= 284
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Chlorambucil 6 mg/m2/d PO days 1-14, max 10 mg/day Vinblastine 6 mg/m2 IV days 1, 8 , max 10 mg/day Procarbazine 100 mg/d PO days 1 – 14, max 150 mg/day Prednisolone 40 mg/d PO days 1 – 14 Repeat cycle every 28 days |
Leukopenia Grade III 7 % Grade IV 2 %
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Infection 3% Thrombocytopenia 5% Nausea/Vomiting 2% Alopecia < 1% |
Days 1 -1 4- Level 4 |
Infection mortality < 1% Dose delayed 1 week in 31 % of patients Dose delayed 2 weeks In 33 % of patients
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MOPP (Canellos GP, et al. N Engl J Med. 1992;327: 1478-84)
N= 123
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Mechlorethamine 6 mg/m2 IV days 1 , 8 Vincristine 1. 4 mg/m2 IV days 1, 8 (maximum 2 mg) Procarbazine 100 mg/m2/d PO days 1 -1 4 Prednisone 40 mg/m2/d PO days 1 - 14 Repeat cycle every 28 days |
Neutropenia Grade III 47% Grade IV 21 % Grade IV 1 %
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Grade III 31 % Grade IV 12 % |
Infection (Grade IV) 12 % Thrombocytopenia 51% Nausea/Vomiting (Grade III) 28 % Peripheral Neuropathy (Grade III) 8% Alopecia (Grade III) 5% Pulmonary Toxicity 4 %
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Days 1, 8 – Level 5 Days 2 – 7- Level 4 Days 9 – 14 – Level 4 |
Over time there was a gradual reduction in the percentage of patients receiving the prescribed dose, from 80 % in cycle 1 to 24% in cycle 6 |
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LYMPHOMA : HODGKIN'S DISEASE (continued ) : Page 2
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Regimen/Number Of Patients |
Drug Dose and Route |
Leukopenia/ Neutropenia Toxicity |
Anemia Toxicity |
Other Grade III-IV Toxicities |
Emetogenic Potential |
Consequences of Adverse Event(s) |
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Stanford V (Horning SJ, et al. J Clin Oncol. 2002; 20: 630-7)
N= 142
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Methclorethamine 6 mg/m2 IV day 1 Doxorubicin 25 mg/m2 IV days 1, 15 Vinblastine * 6 mg/m2 IV days 1,15 Vincristine * 1.4 mg/m2 (maximum 2 mg) IV days 8 , 22 Bleomycin 5 units /m2 IV days 8, 22 Etoposide 60 mg/m2 IV days 15, 16 Prednisone 40 mg/m2 PO QOD, dose tapered by 10 mg QOD starting at the end of week 10 Repeat cycle every 28 days Appropriate premedications listed in Section 2, Commonly Used Premedication Regimens
In patients ≥ 50 years of age, vinblastine dose decreased to 4 mg /m2 , and vincristione dose decreased to 1 mg/m2 durign cycle 3,. Note: Concomitant trimethoprim / sulfa- methoxazolo ; acyclovir. H 2 antagonists. and stool softeners used. |
Neutropenia Grade IV 82%
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Grade III 27% Grade IV 3.5% |
Febrile Neutropenia 14% Thrombocytopenia (Grade III)< 1 % Fatigue ( Grade III) 7 % Constipation ( Grade III) 11% Neuromuscular
(Grade III) 3.5 % (Grade III) 6% pain (Grade III ) 7%
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Day 1 – Level 5 Day 8 - Level 1 Day 15 – Level 4 Day 16 – Level 2 Day 22- Level 1 |
25% of patients hospitalized during or within 2 months of completing therapy with Stanford V Severe constipation 7 % Deep vein thrombosis 1.4 % 1 patient developed a secondary malignancy Fertility preserved in a significant percentage of patients Filgrastim was Incorporated after intial dose reduction or delay in 1991: G-CSF was administered for 5 days on the odd weeks after myelosuppressive therapy, and a total of 94 patients (66%) received G-CSF Erythropoietin therapy was permitted for anemia management at investigator discretion |