STUDY POPULATION Patients affected by Hodgkin's lymphoma, any stage, older than 69 years. Patients affected by Hodgkin's Lymphoma with concomitant cardiopaty, older than 18 years.~AIMS OF THE STUDY~To evaluate in elderly and/or cardiopathic HL patients, the cardiologic toxicity of the MBVD regimen, where liposomal doxorubicin (Myocet®) is substituted for doxorubicin in the conventional ABVD regimen~To compare in a pair-match retrospective analysis the results obtained with MBVD with those obtained in patients comparable for clinical variables and treated with ABVD or with the reduced intensity VEPEMB schedule.~STUDY DESIGN Multi-centre phase II study SAMPLE SIZE 50 patients~STUDY PROCEDURES~Histologic diagnosis of Hodgkin Lymphoma.~Early Staging evaluation including:~Blood tests~CT, PET and bone marrow biopsy.~Heart and lung function evaluation.~Geriatric assessment.~Quality of life evaluation.~2 MBVD courses~Early restaging with PET scan (PET-2)~The subsequent treatment will be planned as follows:~Stage I and IIA patients will go on with 1 more course of MBVD (total of 3 courses) followed by involved field radiotherapy (30 Gy-36Gy).~Advanced stage (IIB-IV) patients will go on with 4 more courses of MBVD (total of 6 courses). Radiotherapy limited to bulky or non complete responder areas (30-36 Gy) is optional.~Final restaging including:~Blood tests~CT, PET~bone marrow biopsy if positive at baseline.~Heart and lung function evaluation.~Geriatric assessment.~Quality of life evaluation~Follow up procedures will include:~a clinical and laboratory evaluation (with troponin, proBNP / BNP, cardiology visit, ECG and echocardiogram) every 6 months in the first 2 years, then annually.~CT scans will be planned annually.~Compilation of geriatric evaluation scales every 6 months in the first 2 years, then annually.~MBVD will be scheduled as follows (4 weeks):~Myocet 25 mg/mq i.v. day 1 and 15 Bleomycin 10 mg/mq i.v. day 1 and 15 Vinblastine 6 mg/mq i.v. day 1 and 15 Dacarbazine 375 mg/mq i.v. day 1 and 15 Supportive treatment with G-CSF and/or Erythropoietin will be planned according to international guide-lines.
The study has the purpose to evaluate in elderly and/or cardiopathic HL patients, the cardiologic toxicity of the MBVD regimen, where liposomal doxorubicin (Myocet®) is substituted for doxorubicin in the conventional ABVD regimen.