Efficacy of the BEACOPP regimen in refractory and relapsed Hodgkinlymphoma

• Published in: Leukemia & lymphoma Vol. 50; no. 11; pp. 1803 - 1808
• Main Authors: Cavalieri, Elena, Matturro, Angela, Annechini, Giorgia, De Angelis, Federico, Frattarelli, Natalia, Gentilini, Fabiana, Grapulin, Lavinia, Sacco, Mikael, Torelli, Fabio, Vignetti, Marco, Mandelli, Franco, Foà, Robin, Pulsoni, Alessandro
• Format: Journal Article
• Language: English
• Published: Informa UK Ltd 01.11.2009; Taylor & Francis
• Subjects: BEACOPP regimen; Hodgkin lymphoma; refractory Hodgkin lymphoma; relapsed Hodgkin lymphoma
• ISSN: 1042-8194; 1029-2403
• DOI: 10.3109/10428190903254383

The BEACOPP regimen is a consolidated first-line treatment regimen for advanced stage Hodgkin lymphoma (HL), while few data are available on the efficacy of this regimen in advanced disease. About 50% of patients with HL relapsed after or refractory to first-line therapy achieve a durable response after peripheral blood stem cell transplantation (PBSCT). Patients relapsing after a PBSCT (performed as second line therapy) have a very poor prognosis. We evaluated the efficacy of BEACOPP in two settings: patients refractory or in relapse after first-line therapy (Group A) and patients relapsing after a PBSCT (Group B). Twenty-three patients with HL, admitted between February 2003 and April 2007, were retrospectively studied: 10 patients in Group A and 13 in Group B. Group A: Nine complete remissions (CR) and one partial remission (PR) were achieved following BEACOPP treatment. After a median follow-up of 32 months, one patient has died due to secondary leukemia, while the other eight are alive, five (50%) in second CR, three in third CR after PBSCT and one with disease. Group B: Eight of the 13 patients (62%) obtained a CR, one patient a PR, two were refractory and two have died of toxicity. To date, eight patients (62%) are alive, four (31%) still in CR. All patients experienced hematologic toxicity (WHO 3-4) with two deaths due to septic shock. These results show that BEACOPP is an effective regimen for both refractory/relapsed patients with HL after first-line treatment (Group A) and for patients relapsing after a PBSCT (Group B) with a 3-year probability of overall survival, progression-free survival, and cumulative incidence of relapse of 90, 50, and 33.3% in Group A, and 61, 31, and 37.5% in Group B, respectively.