Treatment of children with Hodgkin's disease – Results of the German Pediatric Oncology Group

Treatment of Hodgkin's disease in children with alternating mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) and adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) courses without radiotherapy

“…The relation between clinical stage (CS) and pathologic findings is shown in Table II. The distribution of CS and histopathology is similar to other literature reports [15][16][17][18][19]. In one patient no histopathologic subtype was available, as the diagnosis of HD was made on cytologic criteria.…”

“…Since the addition of MOPP chemotherapy to EF combined therapy has become standard treatment for HD in most centers [15,19,20]. Ziegler et al [21] reported survival rates of 65% in CS I and CS II children following MOPP chemotherapy alone.…”

The effects of etoposide on testicular function in boys treated for Hodgkin's disease

“…19 Unfortunately, the recurrence rate has been high in patients receiving OPA or OPA/COMP chemotherapy. 20 Thus we added etoposide to the OPA regimen (OEPA) and replaced methotrexate with procarbazine in the COMP regimen, resuming the previous COPP chemotherapy (HD-90 protocol). Introducing etoposide into the chemotherapeutic regimen (i.e., OEPA) will allow evaluation of its gonadotoxic potential in pediatric patients and comparison with results obtained in adults.…”

A discourse: The 2002 Wataru W. Sutow lecture Hodgkin disease in children—perspectives and progress

“…On occasion, a substitution of drugs has yielded an inferior outcome. This was recognized in the German-Austrian HD-85 study, when an attempt was made to omit procarbazine in their OPPA regimen (oncovin, procarbazine, prednisone, adriamycin) and to substitute methotrexate for procarbazine in patients given COMP (cyclophosphamide, oncovin, methotrexate, prednisone) rather than COPP (cyclophosphamide, oncovin, procarbazine, prednisone) [28,29]. This substitution led to inferior event-free survival and led to the introduction of etoposide in the HD-90 studies [30].…”

“…Study protocols have used 4-6 cycles of more aggressive alkylating agent and anthracycline-based chemotherapy [such as MOPP/ABVD, COPP/ABVD, OPPA/ COPP, OE(etoposide)PA/COPP] with involved-field radiation and have resulted in five-year survival rates of 80-94% and overall survival of 90-98% [26,28,30,40]. Investigators have recently divided the prior unfavorable risk group into an intermediate-risk group of patients with I-IIA/B bulky or extranodal disease, and IIIA disease.…”