Long‐term follow‐up of
PET
/
CT
‐adapted therapy after three cycles of
ABVD
for all stages of cla
Astrid Pavlovsky, Lorena Fiad, Isolda Fernández, Virginia Prates, Nicolas Kurgansky, Amalia Cerutti, Federico Sackmann, Florencia Negri, Pedro Negri, Guillermina Remaggi, Luciana Ferrari, Luciana Guanchiale, Romina Mariano, Franco Giuliani, Juan Maradei, Gonzalo Bentolila, Fernando Warley, Maximiliano Riddick, Santiago Pavlovsky Summary
The Grupo Argentino de Tratamiento de la Leucemia Aguda (GATLA) LH‐05 trial evaluated positron emission tomography‐computed tomography (PET‐CT)‐guided ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) in patients with stage I–IV classic Hodgkin lymphoma (cHL). A total of 563 patients with cHL stages I–IV were included in the prospective, non‐randomized GATLA LH‐05 trial. Patients received three cycles of ABVD followed by PET‐CT (PET3). Patients with PET3 Deauville score (DS) 1–2 discontinued treatment, DS 3–4 completed six ABVD with involved‐field radiotherapy (IFRT) and DS 5 received salvage chemotherapy. Progression‐free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Prognostic factors for PFS were assessed using Cox regression. After a median follow‐up of 93.5 months Interquartile Range (IQR) 54–139, 5‐ and 10‐year PFS for the whole cohort were 78.9% 95% Confidence Interval (CI) 75.5–82.6 and 76.2% (95% CI 72.4–80.2) respectively. Five‐ and 10‐year OS were 95.2% (95% CI 93.3–97.0) and 93.7% (95% CI 91.5–96.0). All PET3‐negative patients achieved 10‐year PFS of 84.4%. PET3 was the strongest predictor of PFS, while disease stage had no independent prognostic significance. With extended follow‐up, PET‐CT‐adapted therapy after three cycles of ABVD provides durable disease control while reducing exposure to chemotherapy and radiotherapy. These results support PET‐CT‐guided treatment discontinuation in PET3‐negative patients across all stages of cHL.