Routine clinical and laboratory factors as predictive markers for non‑response to ABVD chemotherapy in classical Hodgkin lymphoma: a prospective cohort study

Abstract

Introduction: Classical Hodgkin lymphoma (cHL) is a highly curable lymphoma, and the ABVD (Adriamycin, Bleomycin, Vincristine, Dacarbazine) regimen is the standard treatment for early stages. However, 20-25% of patients do not respond adequately, exposing them to dual toxicity.

Objective: To evaluate the ability of clinical and laboratory factors to predict failure to achieve complete remission in cHL patients treated with ABVD.

Methods: Our prospective cohort study included 144 patients at Latakia University Hospital. Laboratory variables were measured before treatment, and response was classified according to Lugano criteria. logistic regression analyses were performed.

Results: Complete remission was achieved by 78.5% of patients, while 21.5% did not. B symptoms, bulky mass, and low lymphocyte count before treatment were independently associated with failure to achieve complete remission. A synergistic interaction was found between B symptoms and bulky mass, and their combined presence increased the risk of non-response 6.6-fold.

Conclusion: Routine factors (B symptoms, bulky mass, low lymphocyte count) constitute a practical predictive tool to identify patients at risk of non-response to the ABVD, and validation of the results in larger studies is recommended.