PMID- 21926399
OWN - NLM
STAT- MEDLINE
DCOM- 20120907
LR  - 20240229
IS  - 1569-8041 (Electronic)
IS  - 0923-7534 (Linking)
VI  - 23
IP  - 5
DP  - 2012 May
TI  - Two escalated followed by six standard BEACOPP in advanced-stage high-risk 
      classical Hodgkin lymphoma: high cure rates but increased risk of aseptic 
      osteonecrosis.
PG  - 1254-1259
LID - S0923-7534(19)34680-0 [pii]
LID - 10.1093/annonc/mdr385 [doi]
AB  - BACKGROUND: From 1999, Norwegian guidelines recommend two escalated (esc) BEACOPP 
      (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, 
      prednisolone) followed by six standard (s) BEACOPP for patients with 
      advanced-stage classical Hodgkin lymphoma (HL) with an international prognostic 
      score (IPS) >/= 4. We evaluated retrospectively the experience with this 
      recommendation at the Norwegian Radium Hospital, also including all IPS 3 
      patients treated with the same regimen. PATIENTS AND METHODS: Forty-seven 
      patients were treated between June 1999 and December 2008. IPS was 3 in 10 
      patients and >/= 4 in 37. RESULTS: Thirty-five patients received eight cycles of 
      BEACOPP, 12 patients received one to six cycles only, mainly due to toxicity. 
      Sixty percent of patients had dose reductions. With median follow-up of survivors 
      of 89 months, 5-year progression-free and overall survival are 84% [95% 
      confidence interval (CI) 73% to 95%] and 91% (95% CI 82% to 100%), respectively. 
      Toxicity was considerable with grade 3 or more infections/febrile neutropenia in 
      66% of patients, including one death and three cases of Pneumocystis jiroveci 
      pneumonia. Of note, 10 patients (21%) experienced symptomatic aseptic 
      osteonecrosis, of whom 3 have had hip replacement surgery after treatment. 
      CONCLUSION: Two escBEACOPP plus six sBEACOPP is efficacious in advanced-stage 
      high-risk HL. We document a high incidence of aseptic bone necrosis, possibly 
      related to prednisolone.
FAU - Fossa, A
AU  - Fossa A
AD  - Department of Oncology, Division of Surgery and Cancer Medicine. Electronic 
      address: AFF@ous-hf.no.
FAU - Fiskvik, I H
AU  - Fiskvik IH
AD  - Department of Oncology, Division of Surgery and Cancer Medicine.
FAU - Kolstad, A
AU  - Kolstad A
AD  - Department of Oncology, Division of Surgery and Cancer Medicine.
FAU - Lauritzsen, G F
AU  - Lauritzsen GF
AD  - Department of Oncology, Division of Surgery and Cancer Medicine.
FAU - Aurlien, E
AU  - Aurlien E
AD  - Department of Oncology, Division of Surgery and Cancer Medicine.
FAU - Blystad, A K
AU  - Blystad AK
AD  - Department of Oncology, Division of Surgery and Cancer Medicine.
FAU - Hole, K H
AU  - Hole KH
AD  - Department of Radiology.
FAU - Ikonomou, I M
AU  - Ikonomou IM
AD  - Department of Pathology, Oslo University Hospital, The Norwegian Radium Hospital, 
      Oslo, Norway.
FAU - Holte, H
AU  - Holte H
AD  - Department of Oncology, Division of Surgery and Cancer Medicine.
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
DEP - 20110916
PL  - England
TA  - Ann Oncol
JT  - Annals of oncology : official journal of the European Society for Medical 
      Oncology
JID - 9007735
RN  - 11056-06-7 (Bleomycin)
RN  - 35S93Y190K (Procarbazine)
RN  - 5J49Q6B70F (Vincristine)
RN  - 6PLQ3CP4P3 (Etoposide)
RN  - 80168379AG (Doxorubicin)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - VB0R961HZT (Prednisone)
RN  - BEACOPP protocol
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antineoplastic Combined Chemotherapy Protocols/*administration & dosage/*adverse 
      effects
MH  - Bleomycin/administration & dosage/adverse effects
MH  - Chemotherapy, Adjuvant
MH  - Cyclophosphamide/administration & dosage/adverse effects
MH  - Disease Progression
MH  - Dose-Response Relationship, Drug
MH  - Doxorubicin/administration & dosage/adverse effects
MH  - Drug Administration Schedule
MH  - Etoposide/administration & dosage/adverse effects
MH  - Female
MH  - Follow-Up Studies
MH  - Hodgkin Disease/diagnosis/*drug therapy/mortality/pathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Osteonecrosis/*chemically induced/diagnosis/etiology/mortality
MH  - Practice Guidelines as Topic/standards
MH  - Prednisone/administration & dosage/adverse effects
MH  - Procarbazine/administration & dosage/adverse effects
MH  - Retrospective Studies
MH  - Risk
MH  - Survival Analysis
MH  - Vincristine/administration & dosage/adverse effects
MH  - Young Adult
EDAT- 2011/09/20 06:00
MHDA- 2012/09/08 06:00
CRDT- 2011/09/20 06:00
PHST- 2011/09/20 06:00 [entrez]
PHST- 2011/09/20 06:00 [pubmed]
PHST- 2012/09/08 06:00 [medline]
AID - S0923-7534(19)34680-0 [pii]
AID - 10.1093/annonc/mdr385 [doi]
PST - ppublish
SO  - Ann Oncol. 2012 May;23(5):1254-1259. doi: 10.1093/annonc/mdr385. Epub 2011 Sep 
      16.