Outcome of Classic Hodgkin Lymphoma Treated with ABVD Regimen- A Single Center Experience

Classic Hodgkin lymphoma (cHL) treatment has evolved over recent years, driven by advances in novel agents. In low-income countries with resource constraints, ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy is the cheapest and most curative option. Here we highlight the outcome of the ABVD regimen in adults with classic Hodgkin lymphoma (cHL) and associated factors.

A retrospective cohort study conducted at Aga Khan University Hospital, Karachi, Pakistan, from 1st January 2013 to 31st December 2023, included 246 patients (aged 18 years or older at cHL diagnosis) who received ABVD as their first chemotherapy regimen. Median OS and PFS were estimated using the Kaplan-Meier method, and the association between variables was assessed using the log-rank test. Univariate and multivariate analyses were used to identify significant factors using Cox regression.

The median age of our cohort was 35 years, with a male predominance (1.6 male-to-female ratio). Out of 246 patients, 78 (31.7%) had early-stage disease, while 168 (68.3%) had advanced-stage disease. The median overall survival and progression-free survival (PFS) were not reached. Median follow-up duration was 35 months. Two hundred and five (83.3%) patients remained alive at the end of the study. OS and PFS at 2 years were 85.6% and 74.7%, respectively. Factors that significantly affected OS were age, stage, bulky disease, and ECOG.

Our findings show that ABVD is still an effective and economical regimen in developing parts of the world and signifies the importance of age, bulky disease, ECOG, stage, and the risk stratification approach.