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Fifteen‐year secondary leukaemia risk observed in 761 patients with Hodgkin's disease prospectively treated by MOPP or ABVD chemotherapy plus high‐dose irradiation
Author(s) -
Delwail Vincent,
Jais JeanPhilippe,
Colonna Pierre,
Andrieu JeanMarie
Publication year - 2002
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2002.03564.x
Subject(s) - abvd , medicine , procarbazine , dacarbazine , vinblastine , vincristine , regimen , prednisone , chemotherapy , gastroenterology , oncology , cyclophosphamide
Summary. Between 1972 and 1988, 869 adult patients received MOPP (mechlorethamine, vincristine, procarbazine and prednisone; 462 patients) or ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine; 373 patients) and subsequent high‐dose irradiation for Hodgkin's disease. Nine patients developed a leukaemia after MOPP and four after ABVD; 11 patients were diagnosed as acute non‐lymphoblastic leukaemia (ANLL) and two as acute lymphoblastic leukaemia (ALL). Both cases of ALL were observed after ABVD and were associated with a 11q23 translocation. The 15‐year actuarial risk of secondary leukaemia was 2·4% for the whole group of patients, 3·4% after MOPP and 1·3% after ABVD. For the MOPP subgroup, the risk of leukaemia was significantly associated with the extent of irradiation: 2·4% for limited irradiation and 13·9% for extended irradiation ( P < 0·001). For the ABVD subgroup, this risk remained low (1·3%) whatever the type of irradiation. Concerning ANLL, the MOPP regimen was significantly associated with a higher risk: 3·4% versus 0·7% for ABVD ( P ≤0·05). The 15‐year risk of ALL was 0·6 after ABVD regimen. This study demonstrated that ABVD induced less ANLL than MOPP. However, a low risk of ALL with a 11q23 translocation related to topoisomerase II inhibitors was observed.