Combination chemotherapy of Hodgkin's disease with adriamycin, bleomycin, vinblastine, and imidazole carboxamide versus MOPP

Abstract

This paper reports the preliminary results of a controlled study randomizing MOPP vs. a new four-drug combination (ABVD) in advanced Hodgkin's disease. ABVD consists of 6 cycles of adriamycin, bleomycin, vinblastine, and imidazole carboxamide. The purpose for designing this new combination was two-fold: to compare the efficacy of ABVD with MOPP, and to demonstrate absence of cross-resistance between the two regimens. Of 60 patients entered into the study, 45 (MOPP 25, ABVD 20) are presently evaluable for the analysis of remission induction. No patient was previously treated with chemotherapy; 20W had relapsed after primary radiotherapy. Whenever possible, complete remission was defined also through rebiopsy of known organ involvement.Complete remission occurred in 76% of patients treated with MOPP and in 75% of those given ABVD, with no difference between the two regimens as far as stage (IIIB-IIIs and IV), histologic type, and prior irradiation were concerned. Crossover carried out for progressive disease or for relapse after initial remission showed absence of cross-resistance between MOPP and ABVD. Toxic manifestations after ABVD were in general well tolerated and reversible. T h e percent of optimal dose for each drug was as follows: adriamycin 87%, vinblastine 87%, bleomycin 96%, and imidazole carboxamide 96%. These preliminary results indicate that in terms of complete remission, ABVD could represent a successful alternative to MOPP to be used either in MOPP failures or in sequential combination with MOPP. However, the lack of long-term followup limits at the present time a n adequate comparison between the two treatments.Cancer 36:252-259, 1975.

High‐dose sequential chemotherapy and peripheral blood progenitor cell autografting in patients with refractory and/or recurrent Hodgkin lymphoma

“…In addition, most patients had received highly effective chemotherapy regimens prior to salvage HDS chemotherapy, including ABVD or other multiple-drug combination schemes. [31][32][33][34] Thus, our patients had the clinical presentation observed commonly in patients with refractory or recurrent HL. 39 The feasibility of HDS chemotherapy was among the primary endpoints of the study.…”

Prognostic value of FDG-PET scan imaging in lymphoma patients undergoing autologous stem cell transplantation

“…1,2 For the majority of patients who are primary refractory or who relapse after complete response (CR), a combination of salvage chemotherapy followed by high-dose chemotherapy and autologous stem cell transplantation (ASCT) is considered the standard of care. In non-Hodgkin's lymphoma (NHL), the clinical benefit of adding high-dose chemotherapy and ASCT is limited only to those patients with disease sensitive to salvage chemotherapy.…”

The clinical value of tumor burden at diagnosis in Hodgkin lymphoma

“…Patients with any stage of disease were accepted in the study. Therapy differed as follows: Seven patients with Stage I disease who had a very favorable clinical presentation underwent extended-field radiotherapy alone; 53 patients with Stage I and II disease who had no more than 1 factor present among extranodal lesion, ESR Ͼ40 mm at the first hour, and LDH higher than normal level, received chemotherapy with vinblastine, bleomycin, and methotrexate (VBM) 12 combined with extended-field radiotherapy (before 1997) or involved-field radiotherapy (after 1997); 126 patients with Stage I and II disease who had an unfavorable presentation because of lymphocyte-depleted histologic type or bulky mass or who had more than 1 factor among extranodal lesion, high ESR, and high LDH, were treated with 4 cycles of chemotherapy 13 with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by extended-field radiotherapy; 172 patients with Stage IIB, III, or IV disease were treated with 6 cycles of ABVD, or with alternating mechloretamine, vincristine, procarbazine, and prednisone (MOPP)/ABVD, 14 or with a hybrid schedule providing mechloretamine, vincristine, procarbazine, prednisone, epidoxorubicin, bleomycin, vinblastine, lomustine, melphalan, and vindesine (MOPPEB-VCAD). 15 In these patients with advanced-stage disease, radiotherapy was added optionally to the chemotherapy and was delivered only to lymphomatous lesions that responded slowly during chemotherapy or incompletely after the end of chemotherapy.…”