Frontline ABVD Remains an Effective Option in Advanced-Stage Classical Hodgkin Lymphoma: Real-World Data from Turkey

Objectives: Novel agents such as brentuximab vedotin and anti-PD-1 antibodies, together with PET-adapted intensified strategies, have improved outcomes in advanced-stage classical Hodgkin lymphoma (cHL). However, their applicability remains limited in many middle-income countries because of restricted drug availability, reimbursement barriers, and toxicity concerns. Therefore, real-world data on the effectiveness of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) remains essential. Methods: We conducted a retrospective two-center study including 95 patients with newly diagnosed cHL treated with first-line ABVD. Baseline characteristics, treatment response, progression-free survival (PFS), overall survival (OS), and mortality were compared between early-stage (I-II, n = 33) and advanced-stage (III-IV, n = 62) disease. Results: The median age was 38 years (range, 18-73), and 69.5% were male; 65% had advanced-stage. Complete response rates were high in both early-stage (97%) and advanced-stage (95.2%) patients. Median PFS (21 vs. 23 months; p = 0.994) and OS (23 vs. 25 months; p = 0.848) were similar. Five-year OS was 84.3% for early-stage and 98% for advanced-stage patients (p = 0.292), while five-year PFS was 55.3% and 29.6% (p = 0.526). Mortality rates were comparable. Conclusions: In this real-world cohort, first-line ABVD achieved high response rates and favorable long-term survival in advanced-stage cHL, supporting its continued use as a frontline treatment option, particularly in settings where access to novel therapies may be limited.