Bendamustine Study in Classical Hodgkin Lymphoma Patients Over 60 Treated by Prednisone, Vinblastine and Doxorubicin

Inclusion Criteria:

* Patient with a first diagnosis of classical Hodgkin lymphoma according to the World Health Organization (WHO) criteria excluding nodular lymphocyte predominant subtype
* Age of 61 years or older
* No previous treatment for Hodgkin lymphoma
* Ann Arbor stages:

  * II with mediastinum/thorax ≥0.33 or extranodal localization and with B symptoms
  * Or III
  * Or IV
* Baseline 18-FluoroDeoxyGlucose (FDG) PET scan (PET0) performed before any treatment with at least one hypermetabolic lesion
* Eastern Cooperative Oncology Group (ECOG) performance status 0-2
* Adequate cardio-pulmonary function with Left Ventricular Ejection Fraction (LVEF) ≥ 50%
* Adequate renal function with creatinine clearance ≥ 40 mL/mn (MDRD formula)
* For patients aged 70 years old and more, a Mini Nutritional Assessment (MNA) ≥ 17
* A minimum life expectancy of 3 months
* Negative Human Immunodeficiency Virus, Hepatitis B (HB) Virus (anti-HB c negativity) and Hepatitis C Virus serologies tests ≤ 30 days before inclusion (except after vaccination)
* Having previously signed a written informed consent
* The patient must be covered by a social security system, if applicable
* Men patient must agree to use an adequate method of contraception during the study treatment and until 6 months after the end of the study treatment.

Exclusion Criteria:

* Any other type of lymphoma including nodular lymphocyte predominant subtype
* Any history of treated Hodgkin lymphoma
* Contra-indication to any drug contained in the chemotherapy regimens
* Any serious active disease (according to the investigator's decision)
* Poor hepatic function (total bilirubin level \> 30 μmol/L or transaminases \> 2.5 maximum normal level) unless these abnormalities are related to the lymphoma
* Poor bone marrow reserve as defined by leukocytes \< 2 G/L or platelets \< 100 G/L, unless related to bone marrow infiltration
* Any history of cancer during the last 3 years with the exception of non-melanoma skin tumors or stage 0 (in situ) cervical carcinoma. Patients previously diagnosed with prostate cancer are eligible if they fulfil all the followings:

  1. their disease was T1-T2a, N0, M0, with a Gleason score ≤ 7, and a prostate specific antigen (PSA) ≤ 10 ng/mL prior to initial therapy,
  2. they had definitive curative therapy (i.e. prostatectomy or radiotherapy) ≥ 2 years before Day 1 of Cycle 1,
  3. at a minimum 2 years following therapy, they had no clinical evidence of prostate cancer and their PSA was undetectable if they underwent prostatectomy or \< 1 ng/mL if they did not undergo prostatectomy
* Severe metabolic disease interfering with normal application of protocol treatment as uncontrolled diabetes mellitus leading to impossibility to perform PET scan
* Treatment with any investigational drug within 30 days before planned first cycle of chemotherapy and during the study
* Adult under tutelage