Medline: 6206757

Annals of Internal Medicine 101(4): 440-446, 1984.

Combination chemotherapy for advanced Hodgkin's disease after failure of MOPP: ABVD and B-CAVe.

Harker WG, Kushlan P, Rosenberg SA


Between 1973 and 1982, 110 patients with advanced Hodgkin's disease who had had disease progression while receiving MOPP (mechlorethamine, vincristine, procarbazine, and prednisone) chemotherapy or a relapse after a MOPP-induced complete remission were treated with either ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) (58 patients) or B-CAVe (bleomycin, lomustine, doxorubicin, and vinblastine) (52 patients) chemotherapy in concurrent nonrandomized trials. Responses were seen in 39 of 55 (71%) evaluable ABVD-treated patients--21 (38%) complete and 18 partial responses--and in 34 of 48 (71%) evaluable B-CAVe-treated patients--21 (44%) complete and 13 partial responses. The median duration of the ABVD-induced complete remissions is greater than 25 months compared with 24.3 months for B-CAVe-induced remissions. The 5-year actuarial freedom from progression is 8.5% for evaluable ABVD-treated patients and 25% for B-CAVe-treated patients (p = 0.10). Toxicity in the two treatment groups was similar, with only significant thrombocytopenia (platelet count, less than 50 000/mm3) being more common with B-CAVe. Although most patients with Hodgkin's disease refractory to MOPP treatment will respond to either ABVD or B-CAVe chemotherapy, subsequent long-term disease-free survival is unusual. The need for improved treatment programs for this patient group is evident.

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