AIAVD'(BRENTUXIMAB'VEDOTIN,'ADRIAMYCIN,'VINBLASTINE,'DACARBAZINE)'
EFFICACY'AND'TOLERANCE'AS'FIRST'LINE'TREATMENT'IN'ADVANCED'STAGES'
POSTER'14'
OF'HODGKIN'S'LYMPHOMA'(HL):'A'REAL'LIFE'EXPERIENCE'
'
Alessandra! Comai1,! Maria! Belen! Navarro! Matilla2,! Maria! Alejandra! Blum! Domínguez3,! Estévez!
Fernández!Mónica4,!Aránzazu!Alonso!Alonso5,!José!Manuel!Sánchez!Ramírez6,!Carlos!Grande!García7,!
Agustín!Hernández!Sánchez8,!Gabriela!Bastidas!Mora9and!Ramón!Salinas!Argente1!
!
(1)Hospital! Universitario! General! de! Cataluña,! Barcelona,! Spain,! (2)Hospital! Puerta! de! Hierro,!
Majadahonda,!Spain,!(3)Hospital!Recoletas!Campo!Grande,!Valladolid,!Spain,!(4)MD!Anderson!Cancer!
Center,! Madrid,! Spain,! (5)Complejo! Hospitalario! Ruber! Juan! Bravo,! Madrid,! Spain,! (6)Hospital!
Universitario! Quirón! Salud,! Madrid,! Spain,! (7)Clínica! Universidad! de! Navarra,! Madrid,! Spain,!
(8)Hospital!Quirón!Salud,!Malaga,!Spain,!(9)Hospital!Universitario!Sagrat!Cor,!Barcelona,!Spain!
!
INTRODUCTION'AND'OBJECTIVES:!
The! ECHELONJ1! study! has! shown! that! AJAVD,! administered! as! firstJline! treatment! in!
advancedJstage! classical! HL,! is! more! effective! than! ABVD! (adriamycin,! bleomycin,!
vinblastine,! dacarbazine)! in! terms! of! progressionJfree! survival! at! 2! years! (82.1%! versus!
77.2%).!Despite!this,!the!Spanish!experience!outside!clinical!trials!is!limited!because!the!AJ
AVD!combination!doesn't!have!a!reimbursement!price!in!our!country.!Our!study!aims!to!pool!
the! real! life! national! experience! and! compare! the! AJAVD! efficacy! and! tolerance! with! data!
from!the!clinical!trial.!
MATERIALS'AND'METHODS:!
A! multicenter! observational! retrospective! study! was! proposed! that! included! all! HL's! cases!
treated! with! AJAVD! as! first! line,! according! to! ECHELONJ1! clinical! trial! regimen,! between!
March!2019!and!June!2020.!
RESULTS:!
Eight!patients!from!five!different!Spanish!hospitals!were!included,!whose!characteristics!are!
detailed! in!Table) 1.! All! patients! received! AJAVD! as! firstJline! treatment.! The! vast! majority!
(7/8,!87.5%)!received!prophylaxis!with!filgrastim,!from!day!+5,!6!or!7!of!chemotherapy!and!
for!a!median!of!2!days!(2J4).!
Patients!were!evaluated!according!to!Cheson's!criteria.!In!PET2!(after!2!cycles!of!AJAVD),!a!
complete! response! (CR)! was! achieved! in! 75%! (6/8)! of! the! cases,! a! partial! response! (PR,!
Deauville! 4)! in! 12.5%! (1/8)! and! progression! (Deauville! 5)! in! 12.5%! (1/8).! Currently,! we!
reviewed!PET!at!the!end!of!treatment!in!5!of!8!patients,!showing!4!sustained!CR!(4/5,!80%)!
and! 1! progression! after! PR! (1/5,! 20%).! The! eldest! patient,! achieving! CR! in! PET2,! switched!
treatment!to!brentuximab!vedotin!monotherapy!due!to!his!frailty.!
Hematological!toxicity!with!G3!neutropenia!was!observed!in!12.5%!(1/8)!of!the!cases!and!G4!
in! 62.5%! (5/8).! Only! 20%! (1/5)! of! the! G4! group! were! feverish.! Neutropenia! required! a!
treatment! delay! of! 6! days! on! average! (5J7),! without! requiring! chemotherapy! dose!
adjustment.!Sensory!and/or!motor!neuropathy!was!frequent!(7/8,!87.5%),!although!mild!and!
reversible:! G1! in! 71.5%! (5/7)! and! G2! in! 28.5%! (2/7),! and! required! a! BV! dose! reduction! by!
30%.!Pulmonary!toxicity!was!not!observed.!
CONCLUSIONS:!
In!our!clinical!practice,!both!response!and!toxicity!rates!are!close!to!the!percentages!in!the!
ECHELONJ1!clinical!trial!(see!Table)2).!The!greatest!difference!is!observed!in!the!frequency!of!
G≥3! neutropenia,! higher! in! our! group,! although! it! must! be! taken! into! account! that! there!