在关键研究 ECHELON-1 中，布伦妥单抗（BV）、阿霉素、长春新碱和地卡巴嗪（A+AVD）相较于博来霉素+AVD（ABVD）对晚期经典霍奇金淋巴瘤（cHL）的治疗显示出优越的疗效。然而，目前关于治疗期间 BV 剂量减少或省略的频率以及对患者预后的潜在影响的数据非常有限。在这项真实世界的分析中，我们回顾性地研究了从 2010 年 1 月到 2022 年 4 月期间用 A+AVD 作为一线治疗的 179 例 III 期和 IV 期 cHL 患者的特征和预后。治疗包括每个 28 天周期的第 1 天和第 15 天静脉注射总量达 1.2 毫克/千克的 BV 和标准剂量 AVD，共进行最多 6 个周期。治疗时的中位年龄为 37 岁，高危国际预后评分在 46% 的患者中观察到。总体而言，91% 的患者接受了六个周期的 AVD；55% 的患者未接受预计的 BV 累计剂量（CDB）；28% 的患者接受了计划 CDB 的三分之二或更少剂量。在中位随访时间为 27.4 个月（95% CI：24.8 - 29 个月）时，进展生存期（PFS）中位数尚未达到，12 个月的 PFS 为 90.3%（95% 置信区间 [CI]，85.9-95.0）。CDB 对 PFS 的影响不具有显著性（p 值=0.15），高 CDB 与不良事件（AE）增加并不显著相关。根据真实世界的经验，A+AVD 对于晚期 cHL 患者是一种高效的治疗方法，包括剂量减少明显的患者。 © 2023 美国血液学会版权所有。

In the pivotal study ECHELON-1, brentuximab vedotin (BV), doxorubicin, vinblastine, and dacarbazine (A+AVD) demonstrated superior efficacy compared to bleomycin+AVD (ABVD) for the treatment of advanced-stage classic Hodgkin's lymphoma (cHL). However, there is minimal available data regarding the frequency of dose reductions or omission of BV during curative therapy and the potential impact on patient outcomes. In a real-world analysis, we retrospectively reviewed the characteristics and outcomes of 179 stage III and IV cHL patients treated with frontline A+AVD from January 2010 through April 2022. Treatment consisted of up to 1.2 mg/kg of BV and standard dose AVD intravenously on days 1 and 15 of each 28-day cycle for up to 6 cycles. At the time of treatment, the median age was 37 years, and high-risk International Prognostic Score was observed in 46% of patients. Overall, 91% of patients received six cycles of AVD; 55% of patients did not receive the intended cumulative dose of BV (CDB); 28% of patients received two-thirds or less than the planned CDB. At a median follow-up time of 27.4 months (95% CI: 24.8 - 29 months), the median progression-free survival (PFS) was not reached, and the 12-month PFS was 90.3% (95% confidence interval [CI], 85.9-95.0). The impact of CDB on PFS was not significant (p-value=0.15), nor was high CDB significantly associated with increased adverse events (AE). In real-world experience, A+AVD is a highly effective treatment for patients with advanced-stage cHL, including for patients with prominent dose reductions of BV.Copyright © 2023 American Society of Hematology.