Treatment approaches in ongoing US Cooperative Group protocols for advanced Hodgkin lymphoma
| Component . | AHOD0831 (COG) . | S0816 (SWOG) . |
|---|---|---|
| Initial therapy | ABVE-PC × 2 (21-day cycles) Doxorubicin 25 mg/m2 D1,2 Bleomycin 5 U/m2 D1, 10 U/m2 D8 Vincristine 1.4 mg/m2 D1,8 Etoposide 125 mg/m2 D1-3 Prednisone 20 mg/m2 BID D1-7 Cyclophosphamide 600 mg/m2 D1,2 G-CSF 5 μg/kg daily (starting D4) | ABVD × 2 (28-day cycles) Doxorubicin 25 mg/m2 D1,15 Bleomycin 10 U/m2 D1,15 Vinblastine 6 mg/m2 D1,15 Dacarbazine 375 mg/m2 D1,15 |
| Interim assessment | PET/CT | PET/CT |
| Consolidation | Rapid early responders: ABVE-PC × 2 Slow early responders: Ifos/vino × 2 (below), then ABVE-PC × 2 Ifosfamide 3000 mg/m2 D1-4 Mesna 3000 mg/m2 D1-4, to 12 h after ifos Vinorelbine 25 mg/m2 D1,5 G-CSF 5 μg/kg daily (starting D6) | PET-negative: ABVD × 4 PET-positive: BEACOPP(escalated) × 6 Bleomycin 10 U/m2 D8 Etoposide 200 mg/m2 D1-3 Doxorubicin 35 mg/m2 D1 Cyclophosphamide 1250 mg/m2 D1 Vincristine 1.4 mg/m2 D8 Procarbazine 100 mg/m2 D1-7 Prednisone 40 mg/m2 D1-14 G-CSF 300 μg D8→count recovery |
| Radiation therapy | Risk-adapted radiation therapy (21 Gy) targeting regions of initial bulk disease or nonbulk disease with slow response | No |
| Component . | AHOD0831 (COG) . | S0816 (SWOG) . |
|---|---|---|
| Initial therapy | ABVE-PC × 2 (21-day cycles) Doxorubicin 25 mg/m2 D1,2 Bleomycin 5 U/m2 D1, 10 U/m2 D8 Vincristine 1.4 mg/m2 D1,8 Etoposide 125 mg/m2 D1-3 Prednisone 20 mg/m2 BID D1-7 Cyclophosphamide 600 mg/m2 D1,2 G-CSF 5 μg/kg daily (starting D4) | ABVD × 2 (28-day cycles) Doxorubicin 25 mg/m2 D1,15 Bleomycin 10 U/m2 D1,15 Vinblastine 6 mg/m2 D1,15 Dacarbazine 375 mg/m2 D1,15 |
| Interim assessment | PET/CT | PET/CT |
| Consolidation | Rapid early responders: ABVE-PC × 2 Slow early responders: Ifos/vino × 2 (below), then ABVE-PC × 2 Ifosfamide 3000 mg/m2 D1-4 Mesna 3000 mg/m2 D1-4, to 12 h after ifos Vinorelbine 25 mg/m2 D1,5 G-CSF 5 μg/kg daily (starting D6) | PET-negative: ABVD × 4 PET-positive: BEACOPP(escalated) × 6 Bleomycin 10 U/m2 D8 Etoposide 200 mg/m2 D1-3 Doxorubicin 35 mg/m2 D1 Cyclophosphamide 1250 mg/m2 D1 Vincristine 1.4 mg/m2 D8 Procarbazine 100 mg/m2 D1-7 Prednisone 40 mg/m2 D1-14 G-CSF 300 μg D8→count recovery |
| Radiation therapy | Risk-adapted radiation therapy (21 Gy) targeting regions of initial bulk disease or nonbulk disease with slow response | No |
COG indicates Children's Oncology Group; SWOG, Southwest Oncology Group; D, day; BID, twice daily; PET-CT, positron emission tomography–computed tomography; G-CSF, granulocyte colony-stimulating factor.