ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2023
Positron Emission Tomography-Adapted Therapy in Bulky Stage I/II Classic Hodgkin Lymphoma: CALGB 50801 (Alliance).
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Prognostic role of PET/CT volumetric parameters in paediatric Hodgkin lymphoma: A systematic review and expert recommendations from the International SEARCH for CAYAHL Group.British journal of haematology · 2026Pooled it
- Positron emission tomography-adapted therapy for first-line treatment in adults with Hodgkin lymphoma.The Cochrane database of systematic reviews · 2025Pooled it
- Chemotherapy alone versus chemotherapy plus radiotherapy for adults with early-stage Hodgkin's lymphoma.The Cochrane database of systematic reviews · 2024Pooled it
- Cardiovascular and Oncologic Considerations in Adult Hodgkin Lymphoma: JACC: CardioOncology State-of the-Art Review.JACC. CardioOncology · 2025Review
- Long-term follow-up of bulky classic Hodgkin lymphoma managed with ABVD and PET-guided RT demonstrates excellent outcomes in PET-negative cases.British journal of haematology · 2025Article
- Different Role of PET-CT Evaluation in Newly Diagnosed Follicular Lymphoma Upon Rituximab-Based Chemotherapy and Chemo-Free Immunotherapy.Hematological oncology · 2025Article
- The impact of initial tumor bulk in DLBCL treated with DA-EPOCH-RLeukemia & lymphoma · 2024Article
- Radiotherapy for Advanced Hodgkin Lymphoma with Initial Bulk: A Combined Analysis of Two Randomized Trials.Advances in radiation oncology · 2024Article
- Management of limited-stage Hodgkin lymphoma.Hematology. American Society of Hematology. Education Program · 2023Article
- Application of interim PET-CT in first-line treatment decision-making for lymphoma.Journal of Zhejiang University. Science. B · 2023Review
- Quantitative PET-based biomarkers in lymphoma: getting ready for primetime.Nature reviews. Clinical oncology · 2023Review
- Incorporating novel agents into frontline treatment of Hodgkin lymphoma.Hematology. American Society of Hematology. Education Program · 2022Article
- High-risk stage IIB Hodgkin lymphoma treated in the H10 and AHL2011 trials: total metabolic tumor volume is a useful risk factor to stratify patients at baseline.Haematologica · 2022Article
- A real-world study of combined modality therapy for early-stage Hodgkin lymphoma: too little treatment impacts outcome.Blood advances · 2022Article
- Controversies in the management of early-stage Hodgkin lymphoma.Hematology. American Society of Hematology. Education Program · 2021Article
- American Society of Clinical Oncology 2021 Annual Meeting Highlights for Radiation Oncologists.Advances in radiation oncologyReview
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Authors and funding
13 authors at 11 institutions in 1 country.
Funding
Abstract
purposePatients with bulky stage I/II classic Hodgkin lymphoma (cHL) are typically treated with chemotherapy followed by radiation. Late effects associated with radiotherapy include increased risk of second cancer and cardiovascular disease. We tested a positron emission tomography (PET)-adapted approach in patients with bulky, early-stage cHL, omitting radiotherapy in patients with interim PET-negative (PET-) disease and intensifying treatment in patients with PET-positive (PET+) disease.
methodsEligible patients with bulky disease (mass > 10 cm or 1/3 the maximum intrathoracic diameter on chest x-ray) received two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by interim fluorodeoxyglucose PET (PET2). Patients with PET2-, defined as 1-3 on the 5-point scale, received four additional cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine. Patients with PET2+ received four cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone followed by 30.6 Gy involved-field radiation.
resultsOf 94 evaluable patients, 53% were female with median age 30 years (range, 18-58 years). Eight-five (90%) had stage II disease, including 48 (51%) with stage IIB/IIBE. Seventy-eight (78%) were PET2- and 21 (22%) were PET2+. The predominant toxicity was neutropenia, with 9% of patients developing febrile neutropenia and one developing sepsis. The primary end point of 3-year progression-free survival (PFS) was 93.1% in PET2- and 89.7% in PET2+ patients. Three-year overall survival was 98.6% and 94.4%, respectively. The estimated hazard ratio comparing PFS of patients with PET2+ and patients with PET2- was 1.03 (85% upper bound 2.38) and was significantly less than the null hypothesis of 4.1 (one-sided
conclusionOur study of PET-adapted therapy in bulky stage I/II cHL met its primary goal and was associated with an excellent 3-year PFS rate of 92.3% in all patients, with the majority being spared radiotherapy and exposure to intensified chemotherapy.
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