Onco Wiki / Regimen

AV (Doxorubicin + Vinblastine, ABVD-modified for HL with severe hepatic impairment Child-Pugh C)

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Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.

Source YAML: complete record

Notes

ABVD = doxorubicin + bleomycin + vinblastine + dacarbazine. In severe hepatic impairment (Child-Pugh C, often from HL infiltration of liver / bulky abdominal disease compressing biliary tree), bleomycin (pulmonary toxicity additive risk; hepatic metabolism) and dacarbazine (significant hepatotoxicity; rare hepatic veno- occlusive syndrome) carry unacceptable risk. Modified AV (doxo + vinblastine only) preserves the two most active agents while removing the two with the worst hepatic / pulmonary safety in this setting. Reassess Child-Pugh weekly initially; reintroduce DTIC or bleomycin once bilirubin normalizes if HL response is partial. For newly-diagnosed advanced HL with severe hepatic dysfunction, brentuximab-AVD (BV + AVD; BV replaces bleomycin) is the better evidence-based choice if Bv accessible; AV is a second-line bridge when BV unavailable.

Used By

Indication

• IND-CHL-CHILD-PUGH-C-MOD - IND-CHL-CHILD-PUGH-C-MOD