Classical Hodgkin lymphoma

ABVD (Doxorubicin (Adriamycin), Bleomycin (Blenoxane), Vinblastine (Velban), Dacarbazine (DTIC) (stage I-IV Hodgkin lymphoma)

Regimen

• Doxorubicin (Adriamycin) 25 mg/m2 IV days 1 & 15
• Bleomycin (Blenoxane) 10 units/m2 IV days 1 & 15 (1 unit test dose with cycle 1 doses, 60 minutes prior to remainder of full dose)
• Vinblastine (Velban) 6 mg/m2 IV days 1 & 15
• Dacarbazine (DTIC) 375 mg/m2 IV days 1 & 15

Q28days x 4-6 cycles based on stage, response, and whether radiation therapy is used.

Supportive medications

Antiemetic risk: high

• Acetaminophen 650 mg PO, 30 minutes prior to chemotherapy.
• Aprepitant (Emend) 125 mg PO on days 1 & 15 prior to chemotherapy, 80mg PO on days 2-3, 16-17
• Ondansetron (Zofran) 8 mg PO, 30 minutes prior to chemotherapy on days 1 & 15, daily on days 2-3, 16-17
• Dexamethasone 4 mg PO BID on days 1-3, days 15-17
• Diphendyramine (Benadryl) 25 mg PO on day 1 & 15 prior to chemotherapy

Supportive Hydration

• 500 ml NS at KVO rate. Use as running IV for chemotherapy infusion.

Pretreatment monitoring parameters

• CBC with diff, liver function tests, pulmonary function tests with DLCO

References

• Canellos GP, et al. Chemotherapy of advanced Hodgkin's disease with MOPP, ABVD, or MOPP alternating with ABVD. N Engl J Med. 1992 Nov 19;327(21):1478-84.PubMed
• Gianni AM et al. Comparable 3-year outcome following ABVD or BEACOPP first-line chemotherapy, plus pre-planned high-dose salvage, in advanced Hodgkin's lymphoma (HL): a randomized trial of the Michelangelo, GITIL and IIL cooperative groups. 2008 ASCO annual meeting. Abstract 8506
• Bonadonna G et al. ABVD plus subtotal nodal versus involved-field radiotherapy in early-stage Hodgkin's disease: long-term results. J Clin Oncol 2004; 22:2835
• Carde, P et al. Clinical staging versus laparotomy and combined modality with MOPP versus ABVD in early-stage Hodgkin's disease: The H6 twin randomized trials from the European Organization for Research and Treatment of Cancer Lymphoma Cooperative Group. J Clin Oncol 1993; 11:2258
• Canellos GP et al. Chemotherapy of advanced Hodgkin’s disease with MOPP, ABVD, or MOPP alternating with ABVD. N Eng J Med 1992; 327:1478
• Engert A et al. Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiotherapy is superior to radiotherapy alone in early favorable Hodgkin's lymphoma: Final results of the GHSG HD7 trial. J Clin Oncol 2007; 25:3495