Because of high single-agent activity and modest toxicity, we hypothesized the combination
of gemcitabine (G), vinorelbine (V), and pegylated liposomal doxorubicin (D) would
be an effective salvage therapy for Hodgkin's lymphoma (HL).
A total of 91 patients participated. GVD was administered on days 1 and 8 every 21
days at doses of G 1000 mg/m(2), V 20 mg/m(2), and D 15 mg/m(2) for transplant-naive
patients, and G 800 mg/m(2), V 15 mg/m(2), and D 10 mg/m(2) for post-transplant patients.
The dose-limiting toxicity was mucositis for the transplant-naive patients and febrile
neutropenia for post-transplant patients. The overall response rate (RR) for all patients
was 70% [95% confidence interval (CI) 59.8, 79.7], with 19% complete remissions. The
4-year event-free and overall survival rates in transplant-naive patients treated
with GVD followed by autologous transplant were 52% (95% CI 0.34, 0.68) and 70% (95%
CI 0.49, 0.84), and in the patients in whom prior transplant failed, these were 10%
(95% CI 0.03, 0.22) and 34% (95% CI 0.17, 0.52), respectively.
GVD is a well-tolerated, active regimen for relapsed HL with results similar to those
reported for more toxic regimens. High RRs in patients in whom prior transplant failed
confirms this regimen's activity even in heavily pretreated patients.