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Chemotherapeutic regimens used for the treatment of Hodgkin lymphoma

Chemotherapeutic regimens used for the treatment of Hodgkin lymphoma
Regimen Dosage and schedule Frequency
ABVD[1]
Doxorubicin 25 mg/m2 IV on days 1 and 15 Repeat cycle every 28 days
Bleomycin 10 units*/m2 IV on days 1 and 15
Vinblastine 6 mg/m2 IV on days 1 and 15
Dacarbazine 375 mg/m2 IV on days 1 and 15
BV+AVD[2]
Brentuximab vedotin 1.2 mg/kg IV on days 1 and 15 Repeat cycle every 28 days
Doxorubicin 25 mg/m2 IV on days 1 and 15
Vinblastine 6 mg/m2 IV on days 1 and 15
Dacarbazine 375 mg/m2 IV on days 1 and 15
Escalated BEACOPP[3,4]
Bleomycin 10 units*/m2 IV on day 8 Repeat cycle every 21 days
Etoposide 200 mg/m2 IV on days 1 through 3
Doxorubicin 35 mg/m2 IV on day 1
CyclophosphamideΔ 1250 mg/m2 IV on day 1
Vincristine 1.4 mg/m2 (maximum 2 mg) IV on day 8
Procarbazine 100 mg/m2 oral on days 1 through 7
Prednisone 40 mg/m2 oral on days 1 through 14
G-CSF SQ starting on day 8
IV: intravenous; SQ: subcutaneous; G-CSF: granulocyte colony-stimulating factor.
* 1 unit = 1 mg bleomycin.
¶ Note that these doses are for the Escalated BEACOPP regimen. The Baseline BEACOPP regimen differs from Escalated BEACOPP because the doses of three of the drugs are reduced:
  • Etoposide 100 mg/m2 (instead of 200 mg/m2)
  • Doxorubicin 25 mg/m2 (instead of 35 mg/m2)
  • Cyclophosphamide 650 mg/m2 (instead of 1250 mg/m2)
Δ Mesna, total dose is the same as that of cyclophosphamide, administered: 20 percent IV at hour 0; 40 percent orally at hour 2; 40 percent orally at hour 5.
◊ Vinblastine dose reduced to 4 mg/m2 and vincristine dose to 1 mg/m2 (maximum 2 mg) during cycle 3 for patients 50 years of age or older.
References:
  1. Canellos GP, Anderson JR, Propert KJ, et al. Chemotherapy of advanced Hodgkin's disease with MOPP, ABVD, or MOPP alternating with ABVD. N Engl J Med 1992; 327:1478.
  2. Connors JM, Jurczak W, Straus DJ, et al. Brentuximab vedotin with chemotherapy for stage III or IV Hodgkin's lymphoma. N Engl J Med 2018; 378:331.
  3. Dann EJ, Bar-Shalom R, Tamir A, et al. Risk-adapted BEACOPP regimen can reduce the cumulative dose of chemotherapy for standard and high-risk Hodgkin lymphoma with no impairment of outcome. Blood 2007; 109:905.
  4. Eich HT, Diehl V, Görgen H, et al. Intensified chemotherapy and dose-reduced involved-field radiotherapy in patients with early unfavorable Hodgkin's lymphoma: final analysis of the German Hodgkin Study Group HD11 trial. J Clin Oncol 2010; 28:4199.

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