Treatment for relapse in stage I/II Hodgkin's lymphoma after initial single-modality treatment

Doxorubicin/bleomycin/vinblastine/dacarbazine (ABVD) chemotherapy alone is a viable option for the treatment of stage I/II Hodgkin's lymphoma. Among the main drawbacks for widespread acceptance of this therapy is the absence of available data on the post-salvage therapy course in patients with limited-stage disease who relapse after ABVD. This article focuses on the outcome of 11 limited-stage patients who relapsed after ABVD alone.

After a clinical restaging, the patients received mantle-type radiation therapy (only if patients met these criteria: supradiaphragmatic disease in a single-node area, erythrocyte sedimentation rate < 30 mm per hour, and absence of B symptoms) or conventional salvage chemotherapy followed by high-dose chemotherapy and autologous hematopoietic stem cell transplantation.

After a median follow-up of 64 months, 10 patients showed complete response and are still alive without disease progression. One patient showed refractory disease and died 9 months after relapse. This experiment entails the series with the longest follow-up in patients with limited-stage Hodgkin's lymphoma who relapsed after ABVD alone.

The data seem to indicate that salvage therapy is capable of providing cure in most cases and lend further support for the use of ABVD alone as first-line therapy.