The Impact of Bleomycin Deficit on Survival in Hodgkin's Lymphoma Patients: A Retrospective Study

Luiz Ricardo Soldi , Diogo Henrique Rabelo , Paulo Henrique Rosa da Silva , Victor Luigi Costa Silva , Marcelo José Barbosa Silva
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Abstract

Purpose

Hodgkin's lymphoma is currently treated with a chemotherapy protocol consisting of doxorubicin, bleomycin, vinblastine, and dacarbazine. Due to Brazil facing a bleomycin shortage in 2017, and this drug's high toxicity, this retrospective study evaluates the effect that the absence of bleomycin had on treatment response and overall survival of Hodgkin's lymphoma patients.

Methods

The medical records of 126 HL patients treated between 2007 and 2021 were reviewed and their data collected, followed by grouping into ABVD and AVD groups according to bleomycin use. Data concerning the patient's characteristics, cancer type, and treatment plan were analyzed with proportion tests, Kaplan-Meier curves. univariate Cox regression, and χ2 tests.

Results

No discernible differences were found in this study between the overall survival and recurrence rate of patients treated with bleomycin compared to those without. Additionally, there was an increased risk of death in each subsequent cycle of chemotherapy of the complete ABVD protocol, demonstrating a risk of toxicity. Among the variables analyzed, hypertension and the presence of B symptoms were also associated with an increased risk of death, while the use of radiotherapy significantly improved survival.

Conclusion

The results of this study suggest that bleomycin did not impact the outcome of Hodgkin's lymphoma treatment. Moreover, the increased risk of death associated with its toxicity during each cycle of treatment raises concerns about its role as an essential component of the gold standard for Hodgkin's lymphoma treatment. Therefore, further research and consideration are needed to reassess the use of bleomycin in Hodgkin's lymphoma treatment protocols.

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博莱霉素缺乏对霍奇金淋巴瘤患者生存期的影响:一项回顾性研究
目的霍奇金淋巴瘤目前采用由多柔比星、博来霉素、长春新碱和达卡巴嗪组成的化疗方案进行治疗。由于2017年巴西面临博莱霉素短缺,且该药毒性较高,本回顾性研究评估了缺乏博莱霉素对霍奇金淋巴瘤患者治疗反应和总生存期的影响。方法回顾2007年至2021年间接受治疗的126名霍奇金淋巴瘤患者的病历并收集其数据,然后根据博莱霉素的使用情况将其分为ABVD组和AVD组。采用比例检验、卡普兰-梅耶曲线、单变量考克斯回归和χ2检验对患者特征、癌症类型和治疗方案等相关数据进行了分析。结果本研究未发现使用博莱霉素治疗的患者与未使用博莱霉素治疗的患者在总生存率和复发率方面存在明显差异。此外,在整个ABVD方案中,每个后续化疗周期的死亡风险都有所增加,这表明存在毒性风险。在分析的变量中,高血压和出现B症状也与死亡风险增加有关,而使用放疗则能显著提高生存率。此外,博来霉素在每个治疗周期中的毒性导致死亡风险增加,这让人们对其作为霍奇金淋巴瘤治疗金标准的重要组成部分产生了担忧。因此,需要进一步研究和考虑,重新评估博来霉素在霍奇金淋巴瘤治疗方案中的应用。
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来源期刊
CiteScore
4.30
自引率
0.00%
发文量
148
审稿时长
56 days
期刊介绍: Cancer Treatment and Research Communications is an international peer-reviewed publication dedicated to providing comprehensive basic, translational, and clinical oncology research. The journal is devoted to articles on detection, diagnosis, prevention, policy, and treatment of cancer and provides a global forum for the nurturing and development of future generations of oncology scientists. Cancer Treatment and Research Communications publishes comprehensive reviews and original studies describing various aspects of basic through clinical research of all tumor types. The journal also accepts clinical studies in oncology, with an emphasis on prospective early phase clinical trials. Specific areas of interest include basic, translational, and clinical research and mechanistic approaches; cancer biology; molecular carcinogenesis; genetics and genomics; stem cell and developmental biology; immunology; molecular and cellular oncology; systems biology; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; cancer policy; and integration of various approaches. Our mission is to be the premier source of relevant information through promoting excellence in research and facilitating the timely translation of that science to health care and clinical practice.
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