scholarly journals Neutropenia and Neutropenic Complications in ABVD Chemotherapy for Hodgkin Lymphoma

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Bhanu Vakkalanka ◽  
Brian K. Link
Keyword(s):  
Effective Treatment ◽  
Hodgkin Lymphoma ◽  
Significant Risk ◽  
Therapeutic Use ◽  
Colony Stimulating Factors ◽  
Definitive Evidence ◽  
Dose Modification ◽  
Chemotherapy Regime ◽  
Highly Effective ◽  
Abvd Chemotherapy

A combination of Adriamycin (a.k.a. Doxorubicin), Bleomycin, Vinblastine, and Dacarbazine (ABVD) is the most commonly used chemotherapy regime for Hodgkin lymphoma. This highly effective treatment is associated with a significant risk of neutropenia. Various strategies are adopted to counter this commonly encountered problem, including dose modification, use of colony stimulating factors, and prophylactic or therapeutic use of antibiotics. Data to support these approaches is somewhat controversial, and in keeping with the paucity of definitive evidence, there is a wide disparity in the management of neutropenia in patients receiving ABVD chemotherapy. This paper summarizes the evidence for managing ABVD-related neutropenia during the treatment of Hodgkin lymphoma.

Antibiotic Resistance

2017 ◽  
Author(s):  
Jessica Litman
Keyword(s):  
Antibiotic Resistance ◽  
Content Distribution ◽  
Significant Risk ◽  
Copyright Infringement ◽  
Online Content ◽  
30Th Anniversary ◽  
Secure Control ◽  
Highly Effective ◽  
New Entrants ◽  
War Stories

In this essay, written for the 30th Anniversary of Cardozo’s Arts and Entertainment Law Journal, I revisit the ruinous litigation strategy copyright owners pursued after Napster to secure control of the market for personal uses of copyrighted works, which I wrote about ten years ago in War Stories, 20 Cardozo Arts & Ent. L.J. 337 (2002). The litigation campaign had effects that copyright owners now have reason to regret. Medical experts tell us that powerful antibiotics are highly effective in killing off both good and bad bacteria, but at a significant risk. Bugs that survive the treatment grow bigger, stronger, and resistant to antibiotics. They become much more dangerous because they are harder to kill. Copyright owners’ indiscriminate litigation against new entrants into the entertainment and information marketplace killed off a broad swath of potential competitors and partners. The ones who were left faced a less crowded field because old media had helpfully cleared it for them. The scorched-earth litigation strategy temporarily cleared the field, and made room both for tepid, content-industry-controlled efforts to distribute music, books, and video online, and for new entrants with the stamina and resources to survive copyright infringement suits. Apple, Amazon, and Google took advantage of that environment to grow into dominant distributors who are obligatory partners for any serious online content distribution plan, and who insist on calling the shots on price, format, and other matters that content owners believe should rightfully be under their own control.

Nivolumab as a safe and effective treatment in an HIV patient with refractory Hodgkin lymphoma

2018 ◽  
Vol 98 (6) ◽  
pp. 1505-1506 ◽  
Author(s):  
Alessandra Serrao ◽  
Martina Canichella ◽  
Maria Lucia De Luca ◽  
Germana Tartaglia ◽  
Giorgia Annechini ◽  
...  
Keyword(s):  
Effective Treatment ◽  
Hodgkin Lymphoma ◽  
Refractory Hodgkin Lymphoma

scholarly journals Report on the Treatment of Hodgkin Lymphoma With ABVD Chemotherapy at Two Rural District Hospitals in Rwanda

2016 ◽  
Vol 2 (3_suppl) ◽  
pp. 67s-67s ◽  
Author(s):  
Rebecca J. DeBoer ◽  
Caitlin D. Driscoll ◽  
Yvan Butera ◽  
Jean Bosco Bigirimana ◽  
Clemence Muhayimana ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Conflicts Of Interest ◽  
Treatment Protocol ◽  
Rural District ◽  
Standard Chemotherapy ◽  
International Partnership ◽  
Low Resource ◽  
High Resource ◽  
District Hospitals ◽  
Abvd Chemotherapy

Abstract 34 Background: While Hodgkin lymphoma (HL) is highly curable with standard chemotherapy in high resource settings, there are few reports of HL treatment in low resource settings. In Rwanda, a treatment protocol using six cycles of ABVD chemotherapy (doxorubicin, bleomycin, vinblastine, dacarbazine) without radiotherapy has been implemented at two rural district hospitals. Here we report on the feasibility of this approach, our patient characteristics, and preliminary outcomes. Methods: We conducted a retrospective cohort study of all patients with biopsy confirmed HL seen at Butaro and Rwinkwavu hospitals between June 2012 and August 2015. Data was extracted from clinical charts and analyzed using descriptive statistics. Results: 43 HL patients were seen at Butaro (n=38) and Rwinkwavu (n=5); 58% male, median age 17 (range 4-54). Five (12%) were HIV positive. Of 22 patients with biopsy specimens evaluated for EBV, 12 (55%) were positive, 9 (41%) negative, and one indeterminate. Most patients were staged with chest x-ray (79%); fewer had liver ultrasound (33%) or CT (9%). With that, Ann Arbor stages were I (28%), II (23%), III (21%), IV (21%), and undetermined (7%). Of 39 patients who started ABVD, 25 (64%) completed all 6 cycles. Median time to completion of the 24 week ABVD regimen was 26.1 weeks (IQR 25-27); 26 patients (67%) experienced at least one treatment delay. Dose reductions were rare. At the time of data extraction, 5 (12%) were still on treatment, 18 (43%) in remission, 2 (5%) alive with relapse, 15 (35%) deceased, and 2 (5%) lost to follow up. Conclusions: Here we demonstrate the feasibility of treating HL with standard chemotherapy in a low resource setting through international partnership. Our preliminary results suggest that a majority of patients who complete treatment may experience a clinically significant remission with this approach. Further data analysis will identify areas for improvement with the hope of increasing sustained remissions. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.

Trends in use of primary prophylactic colony stimulating factors and neutropenia-related hospitalization in commercially insured patients receiving myelosuppressive chemotherapy in the United States: 2005–2017

2020 ◽  
pp. 107815522091577 ◽  
Author(s):  
Jennifer R Schenfeld ◽  
Corina W Bennett ◽  
Shuling Li ◽  
Lucy J DeCosta ◽  
Renee R Jaramillo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
High Risk ◽  
Febrile Neutropenia ◽  
Hodgkin Lymphoma ◽  
Colony Stimulating Factor ◽  
Myelosuppressive Chemotherapy ◽  
Colony Stimulating Factors ◽  
Non Hodgkin Lymphoma ◽  
Insured Patients ◽  
Stimulating Factor

Purpose Describe temporal changes in use of myelosuppressive chemotherapy, primary prophylactic colony-stimulating factor, and neutropenia-related hospitalization, in commercially insured patients. Methods Using a large commercial administrative database, we identified annual cohorts of adult patients diagnosed with breast or lung cancer, or non-Hodgkin lymphoma and initiating myelosuppressive chemotherapy during 2005–2017. We described yearly changes in proportions of myelosuppressive chemotherapy by febrile neutropenia risk category (high, intermediate, unclassified) and proportion of prophylactic colony-stimulating factor use and unadjusted incidence of neutropenia-related hospitalization in the first cycle of myelosuppressive chemotherapy. Results Annual cohorts included 4383–5888 eligible patients during 2005–2017. The proportion of eligible patients aged ≥ 65 years increased from 26.0% in 2005 to 58.2% in 2017. Myelosuppressive chemotherapy use with regimens with high risk for febrile neutropenia increased from 15.1% in 2005 to 31.0% in 2017; and regimens with intermediate risk for febrile neutropenia decreased from 63.7% to 48.1% in 2017. Prophylactic colony-stimulating factor use increased from 41.6% in 2005 to 54.3% in 2017. Crude incidence of neutropenia-related hospitalization for all cancers increased from 2.0% to 3.1%, with a substantial increase in neutropenia-related hospitalization observed among non-Hodgkin lymphoma patients (2.8% to 8.5%) during 2005–2017. Conclusion Among adult patients with breast and lung cancer, and non-Hodgkin lymphoma receiving myelosuppressive chemotherapy, use of regimens with high risk for febrile neutropenia increased, as did the use of prophylactic colony-stimulating factors after 2005. Incidence of neutropenia-related hospitalization increased slightly, particularly among non-Hodgkin lymphoma patients. Further studies are required to understand this increasing trend of neutropenia-related hospitalization, changing patient-level risk factors, and febrile neutropenia management.

Sign in / Sign up

Export Citation Format

Share Document