Since chemotherapy of Hodkgin’s lymphoma was introduced in early 60s, it has undergone fundamental changes that were associated with dramatic improvement in the disease prognosis. Currently, the various intensive modifications of original BEACOPP, such as BEACOPP-14 and escalate BEACOPP, are among the most widely used for treatment of advanced Hodkgin’s lymphoma. Initially, the International Prognostic Score (IPS) was developed for patients treated with MOPP and MOPP-ABVD protocols. We suggest that due to the well-known changing value of the various prognostic signs with protocols of different intensity, the significance of IPS for BEACOPP-based therapy should be reconsidered. One hundred seventy two patients with advanced Hodgkin’s lymphoma were included in our trial. All these patients were treated at the Hematology department of Volgograd Regional Oncology Clinic № 1. Treatment options were as follows: 64 (37%), 84 (49%), and 24 (14%) patients received intensive BEACOPP-based, standard BEACOPP, or ABVD therapy, respectively. The final data presented are related to the period up to June 30, 2012. We retrospectively evaluated the treatment outcomes for each IPS group. To distinguish the most significant prognostic signs from all six IPS factors, we studied the impact of each factor on treatment efficacy. The greatest difference in overall 3and 4-year survival was observed between the groups of patients with IPS 0-1 and ≥ 2; for IPS 0-1, 3and 4-year overall survival rate was 93%; for IPS ≥ 2, 3and 4-year overall survival rate was 81% and 75%, respectively (p = 0.05). 3-year overall survival was significantly negatively affected by such factors as age over 45 (70% versus 87%, relative risk (RR) = 3.95% CI: 1.7-7, p = 0.01) and albumin level < 40 g/L (79% versus 88%, RR= 2.8, 95% CI: 1.2-6.8, p = 0.02). Overall 3-year survival rate in males (n = 91) and females (n = 81) was 80% and 88%, respectively (p = 0.09). We found no effect on overall and freedom-from-treatment-failure survival (FFTF) of such factors as hemoglobin levels, lymphocyte count, leukocytes count, and IV stage disease. With respect to overall survival, multivariate analysis showed the greatest significance of age (relative risk, RR =3.6, 95% CI: 1.8-7, p = 0.001) and albumin level (OR = 2.6, 95% CI: 1.1-6, p = 0.036).

Today for the treatment of Hodgkin’s lymphoma schemes of varying intensity are used. The choice of first-line chemotherapy for Hodgkin’s lymphoma depends on the stage of the disease and risk factors. We present the results of patients with newly diagnosed Hodgkin’s lymphoma in the period from 2003 to 2008 (n = 244), treated in the Department of Hematology Volgograd Regional Clinical Cancer Dispensary No. 1. The early stages of Hodgkin’s lymphoma without risk factors were characterized by the best results with minimal adverse effects (3-year overall survival rate in this group is 95 %, free from treatment failure 90 %). In patients with early stages of Hodgkin’s lymphoma with risk factors there was no significant difference between ABVD and BEACOPP-basis schemes in terms of overall survival (3-year OS 80 % in each group) and free from treatment failure survival (3-year FFTF 76 % and 52 % respectively, p = 0,73). There is a slight tendency to improve OS and FFTF in these patients when treated with BEACOPP-escalated and BEACOPP-14, but the lack of patients can’t prove the benefit of these programs. Among patients with advanced Hodgkin’s lymphoma the greatest differences in OS were observed between those who received BEACOPP-basis and intensive variants of BEACOPP scheme (OS rate 74 % and 95 % (p < 0,01), FFTF 55 % and 72 % (p = 0,05) respectively.

1 SUMMARY Today for the treatment of Hodgkin's lymphoma schemes of varying intensity are used. The choice of first-line chemotherapy for Hodgkin's lymphoma depends on the stage of the disease and risk factors. We present the results of patients with newly diagnosed Hodgkin's lymphoma in the period from 2003 to 2008 (n = 244), treated in the Department of Hematology Volgograd Regional Clinical Cancer Dispensary No. 1. The early stages of Hodgkin's lymphoma without risk factors were characterized by the best results with minimal adverse effects (3-year overall survival rate in this group is 95 %, free from treatment failure — 90 %). In patients with early stages of Hodgkin's lymphoma with risk factors there was no significant difference between ABVD and BEACOPP-basis schemes in terms of overall survival (3-year OS — 80 % in each group) and free from treatment failure survival (3-year FFTF — 76 % and 52 % respectively, p = 0,73). There is a slight tendency to improve OS and FFTF in these patients when treated with BEACOPP-escalated and BEACOPP-14, but the lack of patients can't prove the benefit of these programs. Among patients with advanced Hodgkin's lymphoma the greatest differences in OS were observed between those who received BEACOPP-basis and intensive variants of BEACOPP scheme (OS rate 74 % and 95 % (p < 0,01), FFTF 55 % and 72 % (p = 0,05) respectively.