Risk Adapted Beacopp Regimen for Standard and High Risk Hodgkin Lymphoma
Risk Adapted Beacopp Regimen for Standard and High Risk Hodgkin Lymphoma
.This study is trying to address change of chemotherapy dosage according to individual
 patient response to initial cycles of chemotherapy in order to reduce cumulative dose of
 chemotherapy.The study includes patients with early unfavorable and advanced hodgkin
 lymphoma. Patients with low risk were started with standard beacopp and only high risk
 patients were started with escalated beacopp.Following 2 cycles of therapy the patients were
 reassessed.Based on scintigraphy results decision was made regarding further therapylative
 chemotherapy for early responders and maximize dose intensity for late responders.
Patients were eligible if they had early unfavorable disease or patients who presented with
 stage III or IV disease .Pt assigned to receive 6 cycles of Bleomycin Etoposide, Doxorubicin,
 Cyclophosphamide Procarbazine, Prednisone (BEACOPP) or increased dose BEACOPP. (IDB). Patient
 with Stage I or II with ³4 sites of disease, age ³50, ESR³50 "B" symptoms lymphocyte depleted
 histology "E" site, or bulky disease were defined as early unfavorable disease and were given
 standard BEACOPP (SB). Those with I, II B or bulky disease or Stage III, IV were defined
 according the IPS. Increased dose BEACOPP (IDB) cycles of therapy was initiated only to
 patients with IPS of 3 or more risk factors (high risk) Standard BEACOPP (SB) cycles were
 initiated to those with a score of 0-2 (standard risk). All patients had baseline GA67 or
 hybrid PET\CT scan at diagnosis and post first cycle for gallium scan or second cycle for
 hybrid PET\CT. Upon the scan results therapy was planned and given for addition of 4 cycles.
 Those with negative scan received cycles of SB as of the third cycle. Dose was reduced to
 level I to III if patient was hospitalized due to fever and neutropenia of 5 days or longer
 or pt had an episode of sepsis with unstable vital signs.

 Patient with residual uptake interpreted as positive scan had additional cycles of IDB for a
 total of 6 cycles
Inclusion Criteria:

 -  stage I-IIA/B with adverse prognostic or III-IV disease

 -  Age 18 and Over

 -  Performance status ECOG 0-3

 -  Hematopoietic WBC at least 4000/mm3(unless documented bone marrow involvement)

 -  Hepatic bilirubin no greater then 5 mg/dL

 -  RENAL:Creatinine no greater than 2.0mg/dL

 -  not pregnant or nursing

 -  Fertile patients must use effective contraception

 -  HIV negative

 -  No other malignancy within the past 5 years

 Exclusion Criteria:

 -