Doxorubicin, bleomycin, vinblastine, and dacarbazine for Hodgkin lymphoma: Real-world experience from a Los Angeles County hospital

Abstract

Objective: While there are significant ongoing advancements in the management of Hodgkin lymphoma, doxorubicin + bleomycin + vinblastine + dacarbazine remains a preferred option for early stage Hodgkin lymphoma and is a frequently used first-line treatment globally. The aim of this retrospective study is to analyze real-world doxorubicin + bleomycin + vinblastine + dacarbazine outcomes from a safety net hospital setting. Methods: This retrospective cohort consisted of 69 adult patients with classical Hodgkin lymphoma who received first-line doxorubicin + bleomycin + vinblastine + dacarbazine at Harbor-UCLA Medical Center from 2009 to 2024. Early (I–II) and advanced (III–IV) stage patients were included. Results: The median patient age was 41 years old (range 18–71). There was balanced distribution of early stage (7.2% stage I, 40.6% stage II) and advanced stage (20.3% stage III, 31.9% stage IV) Hodgkin lymphoma. With a median of six cycles (range 2–7) of doxorubicin + bleomycin + vinblastine + dacarbazine, the complete response rate was 78.3% and overall response rate was 82.6%. Five-year progression-free survival was 70.7% (70.2% for stage I–II, 71.3% for stage III–IV). Overall survival at 5 years was 95.4% (100% for stages I–II, 91.5% for stages III–IV). Bleomycin-associated lung toxicity was observed in 10 (14.5%) patients, including one treatment-related death. Conclusions: Response rates and overall survival from this real-world cohort are comparable to previously published contemporary studies. The high complete response rate, 5-year progression-free survival, and 5-year overall survival in this study further support the robust curative potential of doxorubicin + bleomycin + vinblastine + dacarbazine and validate its continued use in resource-limited settings.