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Combination Chemotherapy for Advanced Hodgkin's Disease After Failure of MOPP: ABVD and B-CAVe

[+] Article, Author, and Disclosure Information

Grant support: in part by grants CA 05838, CA 34233, CA 21555, and CA 09287 from The National Cancer Institute. Dr. Rosenberg is an American Cancer Society Professor of Clinical Oncology.

▸Requests for reprints should be addressed to Saul A. Rosenberg, M.D.; Room S025, Stanford University Medical Center; Stanford, CA 94305.

Stanford, California

© 1984 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1984;101(4):440-446. doi:10.7326/0003-4819-101-4-440
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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, < 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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