A Study of BV-AVD in People With Bulky Hodgkin Lymphoma

Eligibility Criteria

• * Histological diagnosis of classical, CD30-positive Hodgkin lymphoma confirmed at enrolling institution.
• * Ann Arbor stage I or II FDG-avid disease by FDG-PET/CT.
• * Disease bulk defined as any lymph node mass with transverse maximal diameter ≥ 7.0 cm or coronal maximal diameter ≥ 7.0 cm on CT imaging.
• * Age 18 and over.
• * ECOG Performance Status ≤ 2
• * Females of childbearing age must be on an acceptable form of birth control per institutional standards during the treatment period.
• * Males must consistently use an acceptable form of contraception per institutional standards during the treatment period.
• * Prior systemic therapy or radiation therapy for Hodgkin lymphoma (excluding corticosteroids)
• * Cardiac ejection fraction \< 50% as measured by echocardiogram.
• * Platelet count ≤ 75,000/µL.
• * Hemoglobin level ≤ 7.0 mg/dL.
• * Absolute neutrophil count ≤ 1.0 K/µL.
• * Serum creatinine clearance \< 30 mL/minute as estimated by the Cockcroft-Gault Method.
• * Transaminase levels \> 3 times the upper limit of normal in the absence of a history of Gilbert's disease or hepatic involvement. In patients with Gilbert's disease, \> 5 times the upper limit of normal is exclusionary.
• * Total bilirubin ≥ 1.5 the upper limit of normal in the absence of a history of Gilbert's disease or hepatic involvement. In patients with Gilbert's disease, \> 3 times the upper limit of normal is exclusionary.
• * Pre-existing peripheral neuropathy ≥ grade 2 prior to participation.
• * Known pregnancy or breast-feeding
• * Active viral infection with hepatitis B or hepatitis C. For hepatitis B, patients who are seropositive (hepatitis B core Ab positive) are permitted if HBV DNA is negative by PCR. For hepatitis C, patients who are seropositive (hepatits C Ab positive) are eligible if HCV DNA is negative by PCR and curative therapy has been completed.
• * Concurrent malignancy requiring active therapy within the last 2 years with the exception of basal cell or squamous cell carcinoma limited to the skin, carcinoma in situ of the cervix, breast or localized prostate cancer. Adjuvant hormonal therapy for cancer previously treated for curative intent is permitted.
• * Patients with autoimmune conditions requiring active, ongoing systemic immunosuppressive therapy.
• * Medical illness unrelated to Hodgkin lymphoma which in the opinion of the treating physician and/or principal investigator makes participation inappropriate.