Page 81 - Haematologica May 2022

Analysis of older cHL patients in ECHELON-1
A
B
Figure 1. Progression-free survival in patients aged ≥60 years. (A) Modified progression-free survival (PFS) per independent review facility after a median follow-up of 25 months. (B) PFS per investigator after a median follow-up of 60.9 months. A+AVD: brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine; ABVD: doxorubicin, bleomycin, vinblastine, and dacarbazine; CI: confidence interval; HR: hazard ratio; INV: investigator; IRF: independent review facility.
was higher in the A+AVD arm than in the ABVD arm in both older patients (37% vs. 17%) and younger patients (17% vs. 6%) (Table 3). In the A+AVD arm, the use of granulocyte colony-stimulating factor (G-CSF) primary prophylaxis, given per institutional guidelines, was associ- ated with a lower incidence of neutropenia (40% with vs. 78% without primary prophylaxis) and febrile neutrope- nia (30% with vs. 38% without primary prophylaxis) in older patients (Table 4). The incidence of any-grade peripheral neuropathy was higher in the A+AVD arm than in the ABVD arm in both older (65% vs. 43%) and younger patients (67% vs. 43%) (Table 5). Furthermore, the rate of severe grade 3/4 peripheral neuropathy was higher in older patients who received A+AVD than in
those who received ABVD (18% vs. 3%). Rates of resolu- tion or improvement in peripheral neuropathy appeared similar in older cHL patients treated with A+AVD and ABVD (80% vs. 83%; respectively). In older patients, 24 and 12 patients had residual peripheral neuropathy, which was grade 1 (n=14 and n=6), grade 2 (n=7 and n=4), and grade 3 (n=3 and n=2) in severity in the A+AVD and ABVD arms, respectively.
Discussion
Outcomes for older patients with cHL, particularly those with advanced disease, have historically been poor
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