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AVD is an effective chemotherapy backbone in first-line treatment of older patients with classical Hodgkin lymphoma
Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden; Department of Clinical Pathology, Akademiska University Hospital, Uppsala, Sweden.
Medical Department, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Oncology, Oslo University Hospital, Oslo, Norway.
Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden; Department of Oncology, Akademiska University Hospital, Uppsala, Sweden.
Department of Hematology, Aarhus University Hospital, Aarhus, Denmark.
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2026 (English)In: Blood Advances, ISSN 2473-9529, E-ISSN 2473-9537, Vol. 10, no 14, p. 4889-4897Article in journal (Refereed) Published
Abstract [en]

No universal gold standard chemotherapy exists for the treatment of older (≥60 years) patients with classical Hodgkin lymphoma (cHL). To evaluate the current curative treatment strategies used in the Nordic countries, we collected data from patients diagnosed in Sweden, Denmark and Norway during the years 2000 to 2021. We included 1569 patients: 704 (45%) Swedish, 671 (43%) Danish, and 194 (12%) Norwegian. Of these, 671 (43%) received doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD), 123 (8%) received doxorubicin, vinblastine, and dacarbazine (AVD), 465 (31%) received cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), and 212 (13%) received other chemotherapy (single agent or combination). Eighty-two (5%) patients lacked information on first-line regimen. In multivariable analyses of overall survival (OS), treatment with AVD was associated with improved survival compared to ABVD, whereas there was a trend toward inferior survival among patients receiving CHOP or other regimens. For progression-free survival (PFS), multivariable analysis likewise demonstrated significantly improved outcome with AVD relative to ABVD, whereas outcomes for the CHOP group were comparable to ABVD. Outcome for patients receiving other regimens tended to be poorer. Collectively, outcome for AVD with respect to both OS and PFS was at least equal to ABVD and often superior to CHOP. By omitting bleomycin, treatment-related toxicity is known to be reduced in AVD compared to ABVD. Based on our findings, AVD is a preferable chemotherapy option in older patients with cHL and should rightly be considered as backbone in treatment with novel drugs.

Place, publisher, year, edition, pages
American Society of Hematology, 2026. Vol. 10, no 14, p. 4889-4897
Keywords [en]
Clinical Trials and Observations, Lymphoid Neoplasia
National Category
Hematology Cancer and Oncology
Identifiers
URN: urn:nbn:se:umu:diva-256835DOI: 10.1182/bloodadvances.2025018954PubMedID: 41921203Scopus ID: 2-s2.0-105044327171OAI: oai:DiVA.org:umu-256835DiVA, id: diva2:2087280
Funder
Swedish Cancer SocietySwedish Society for Medical Research (SSMF)Stiftelsen Onkologiska Klinikens i Uppsala ForskningsfondAvailable from: 2026-07-20 Created: 2026-07-20 Last updated: 2026-07-20Bibliographically approved

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CiteExportLink to record
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