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. 1990 Aug;62(2):279–285. doi: 10.1038/bjc.1990.278

ChlVPP combination chemotherapy for Hodgkin's disease: long-term results.

P Selby 1, P Patel 1, S Milan 1, M Meldrum 1, J Mansi 1, E Mbidde 1, M Brada 1, T Perren 1, G Forgeson 1, M Gore 1, et al.
PMCID: PMC1971832  PMID: 2386744

Abstract

Two hundred and eighty-four patients with advanced Hodgkin's disease (HD) (stage II with poor prognostic features and stage III/IV) have been treated with the ChlVPP combination chemotherapy regimen (chlorambucil, vinblastine, procarbazine and prednisolone) in a single-centre unselected series. Median follow up is 92 months. Fifty-five patients had previously received radiotherapy but none had received previous chemotherapy. Eighty-five per cent of previously untreated patients and 91% of previously irradiated patients entered complete remission (CR); 71% and 68% of these respectively remain in CR at 10 years and 65% and 64% of each group respectively are alive at 10 years. On univariate analysis, age, stage, site of visceral disease and lymphocyte count predicted survival and on multivariate analysis age, absence of symptoms, absence of lung, liver or bone marrow disease and achieving a CR remained important predictors of survival. Acute toxicity was mild. The 10 year actuarial risk of acute leukaemia was 2.7%. This study adds further support to the view that chlorambucil is as effective and less toxic than mustine in combination chemotherapy for HD. We suggest that MOPP chemotherapy is no longer routinely indicated for HD.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bakemeier R. F., Anderson J. R., Costello W., Rosner G., Horton J., Glick J. H., Hines J. D., Berard C. W., DeVita V. T., Jr BCVPP chemotherapy for advanced Hodgkin's disease: evidence for greater duration of complete remission, greater survival, and less toxicity than with a MOPP regimen. Results of the Eastern Cooperative Oncology Group study. Ann Intern Med. 1984 Oct;101(4):447–456. doi: 10.7326/0003-4819-101-4-447. [DOI] [PubMed] [Google Scholar]
  2. Carbone P. P., Kaplan H. S., Musshoff K., Smithers D. W., Tubiana M. Report of the Committee on Hodgkin's Disease Staging Classification. Cancer Res. 1971 Nov;31(11):1860–1861. [PubMed] [Google Scholar]
  3. Dady P. J., McElwain T. J., Austin D. E., Barrett A., Peckham M. J. Five years' experience with ChlVPP: effective low-toxicity combination chemotherapy for Hodgkin's disease. Br J Cancer. 1982 Jun;45(6):851–859. doi: 10.1038/bjc.1982.137. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. DeVita V. T., Jr, Simon R. M., Hubbard S. M., Young R. C., Berard C. W., Moxley J. H., 3rd, Frei E., 3rd, Carbone P. P., Canellos G. P. Curability of advanced Hodgkin's disease with chemotherapy. Long-term follow-up of MOPP-treated patients at the National Cancer Institute. Ann Intern Med. 1980 May;92(5):587–595. doi: 10.7326/0003-4819-92-5-587. [DOI] [PubMed] [Google Scholar]
  5. Longo D. L., Young R. C., Wesley M., Hubbard S. M., Duffey P. L., Jaffe E. S., DeVita V. T., Jr Twenty years of MOPP therapy for Hodgkin's disease. J Clin Oncol. 1986 Sep;4(9):1295–1306. doi: 10.1200/JCO.1986.4.9.1295. [DOI] [PubMed] [Google Scholar]
  6. Lukes R. J., Butler J. J. The pathology and nomenclature of Hodgkin's disease. Cancer Res. 1966 Jun;26(6):1063–1083. [PubMed] [Google Scholar]
  7. McElwain T. J., Toy J., Smith E., Peckham M. J., Austin D. E. A combination of chlorambucil, vinblastine, procarbazine and prednisolone for treatment of Hodgkin's disease. Br J Cancer. 1977 Aug;36(2):276–280. doi: 10.1038/bjc.1977.187. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. McKendrick J. J., Mead G. M., Sweetenham J., Jones D. H., Williams C. J., Ryall R., Whitehouse J. M. ChlVPP chemotherapy in advanced Hodgkin's disease. Eur J Cancer Clin Oncol. 1989 Mar;25(3):557–561. doi: 10.1016/0277-5379(89)90270-8. [DOI] [PubMed] [Google Scholar]
  9. Peto R., Pike M. C., Armitage P., Breslow N. E., Cox D. R., Howard S. V., Mantel N., McPherson K., Peto J., Smith P. G. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples. Br J Cancer. 1977 Jan;35(1):1–39. doi: 10.1038/bjc.1977.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Robinson B., Kingston J., Nogueira Costa R., Malpas J. S., Barrett A., McElwain T. J. Chemotherapy and irradiation in childhood Hodgkin's disease. Arch Dis Child. 1984 Dec;59(12):1162–1167. doi: 10.1136/adc.59.12.1162. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Russell J. A., Selby P. J., Ruether B. A., Mbidde E. K., Ashley S., Zulian G., Berry J., Houwen B., Jones A. R., Poon M. C. Treatment of advanced Hodgkin's disease with high dose melphalan and autologous bone marrow transplantation. Bone Marrow Transplant. 1989 Jul;4(4):425–429. [PubMed] [Google Scholar]
  12. Tucker M. A., Coleman C. N., Cox R. S., Varghese A., Rosenberg S. A. Risk of second cancers after treatment for Hodgkin's disease. N Engl J Med. 1988 Jan 14;318(2):76–81. doi: 10.1056/NEJM198801143180203. [DOI] [PubMed] [Google Scholar]
  13. Wagstaff J., Gregory W. M., Swindell R., Crowther D., Lister T. A. Prognostic factors for survival in stage IIIB and IV Hodgkin's disease: a multivariate analysis comparing two specialist treatment centres. Br J Cancer. 1988 Oct;58(4):487–492. doi: 10.1038/bjc.1988.246. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Zulian G. B., Selby P., Milan S., Nandi A., Gore M., Forgeson G., Perren T. J., McElwain T. J. High dose melphalan, BCNU and etoposide with autologous bone marrow transplantation for Hodgkin's disease. Br J Cancer. 1989 Apr;59(4):631–635. doi: 10.1038/bjc.1989.128. [DOI] [PMC free article] [PubMed] [Google Scholar]

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