De-escalation chemotherapy and hematological profiles in patients with advanced Hodgkin’s lymphoma

Background There is a need to develop treatment strategies that are less toxic than BEACOPPescalated x6 cycles, the standard-of-care in advanced Hodgkin’s lymphoma patients. Objective To compare short-term hematological toxicity in advanced Hodgkin’s lymphoma patients treated with either BEACOPPescalated x6 cycles (standard group) or BEACOPPescalated x2 followed by ABVD x4 cycles (experimental group). Method In 27 patients, we compared injections of erythropoiesis stimulating agent and granulocyte colony-stimulating factor, transfusions, hospitalization days, as well as hemoglobin, platelet, leukocyte levels. Method In 27 patients, we compared injections of erythropoiesis stimulating agent and granulocyte colony-stimulating factor, transfusions, hospitalization days, as well as hemoglobin, platelet, leukocyte levels. Results The mean number of erythropoiesis stimulating agent and granulocyte colony-stimulating factor injections, platelet transfusions and hospitalization days was significantly lower in the experimental group (erythropoiesis stimulating agents: mean difference −6.6 ± 2.4, p = 0.005; granulocyte colony-stimulating factors: mean difference −8.3 ± 3.6, p = 0.020, platelet transfusions: mean difference −0.6 ± 0.3, p = 0.035; hospitalization days: mean difference: −8.5 ± 1.7 days, p < 10⁻³). There were no differences in terms of red cell transfusions, platelet counts or leukocyte levels between the two groups. From the 3rd chemotherapy cycle, hemoglobin levels decreased to a significantly lesser extent in the experimental group. Conclusion We demonstrated an overall better short-term hematological profile in advanced Hodgkin’s lymphoma patients who received a de-escalation chemotherapy regimen with significant differences mainly in terms of hemoglobin levels, erythropoiesis stimulating agent injections, and hospitalization days.