Comparison of the efficiency of ABVD versus BEACOPP for Hodgkin lymphoma treatment: a meta-analysis

To compare the efficiency of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) against that of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) for treating Hodgkin lymphoma (HL). An extensive English-language literature retrieval on clinical outcomes after treatment by ABVD versus BEACOPP was conducted on Medline, PubMed, and Embase through the period ending December 2015. Odds ratio (OR) with corresponding 95 % confidence interval (95 % CI) was pooled based on the heterogeneity across individual studies. In total, seven articles reporting on four trials were included in this meta-analysis. Patients assigned to BEACOPP therapy had a better complete remission (CR) rate (OR = 0.55, 95 % CI 0.35, 0.87), overall survival (OS) greater than 5 years (OR = 0.64, 95 % CI 0.51, 0.81), and progression-free survival (PFS, OR = 0.56, 95 % CI 0.38, 0.81) than patients assigned to ABVD therapy. Subgroup analysis stratified using a different strategy showed no significant difference for OS between short courses of escalated BEACOPP combined with standard BEACOPP and that for ABVD (OR = 0. 72, 95 % CI 0. 45, 1.15). Reduced progression/relapse, better CR, and similar OS were observed with BEACOPP, indicating its superior efficiency of BEACOPP in the treatment of HL. However, more analysis of treatment-related toxicity is needed.