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ABVD + escalated BEACOPP refers to a response-adapted chemotherapy strategy evaluated in the CALGB 50801 (Alliance) Phase II clinical trial, sponsored by the ECOG-ACRIN Cancer Research Group. This protocol is designed for patients with bulky stage I or II classical Hodgkin lymphoma. The treatment begins with two cycles of the ABVD regimen (doxorubicin, bleomycin, vinblastine, and dacarbazine). Following an interim PET scan, patients with a negative response continue with four additional cycles of ABVD, while those with a positive response are escalated to four cycles of escalated BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) followed by involved-field radiotherapy. The regimen utilizes a combination of cytotoxic small molecules that target DNA through alkylation, intercalation, and cleavage, as well as inhibitors of topoisomerase II and microtubule assembly, to eliminate malignant Reed-Sternberg cells.
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