Skip to main content
NCBI home page
British Journal of Cancer logoLink to British Journal of Cancer
. 1992 May;65(5):756–760. doi: 10.1038/bjc.1992.159

'VEEP' in children with Hodgkin's disease--a regimen to decrease late sequelae.

M E O'Brien 1, C R Pinkerton 1, J Kingston 1, M Mott 1, D Tait 1, S Meller 1, M Radford 1, J Malpas 1, T J McElwain 1
PMCID: PMC1977393  PMID: 1586603

Abstract

In an attempt to decrease the risk of second malignancies and future infertility in children with Hodgkin's disease (HD) while retaining acceptable remission rates, an anthracycline based regimen containing no alkylating agent has been devised. VEEP contains vincristine, epirubicin, etoposide and prednisolone given at 3 weekly intervals. Forty-four patients, aged 2-15 years, have been treated: ten relapsed patients and 34 previously untreated with chemotherapy (including three relapsed stage I treated initially with radiotherapy). The median follow up for all patients is 25 months (range 6-52 months). The response rate in previously treated patients was 80% (95% CI 44-97%) and five remain alive in remission. The response rate in untreated patients was 88% (95% CI 72-97%) with 62% CR + CR(u) (uncertain/unconfirmed) (95% CI 44-77%). Of four patients who had a final response of CR(u) three have relapsed at 9, 16 and 38 months. Two of the children in CR have relapsed at 6 and 16 months. The relapse free rate at 3 years is 67% (95% CI 17-82%). In this pilot study the event free survival appears somewhat poorer than conventional combinations and further follow up is required to confirm the salvagability of relapsed patients.

Full text

PDF
756

Selected References

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

  1. Barrett A., Crennan E., Barnes J., Martin J., Radford M. Treatment of clinical stage I Hodgkin's disease by local radiation therapy alone. A United Kingdom Childrens Cancer Study Group study. Cancer. 1990 Aug 15;66(4):670–674. doi: 10.1002/1097-0142(19900815)66:4<670::aid-cncr2820660412>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
  2. Behrendt H., Van Bunningen B. N., Van Leeuwen E. F. Treatment of Hodgkin's disease in children with or without radiotherapy. Cancer. 1987 Jun 1;59(11):1870–1873. doi: 10.1002/1097-0142(19870601)59:11<1870::aid-cncr2820591105>3.0.co;2-d. [DOI] [PubMed] [Google Scholar]
  3. 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]
  4. Crowther D., Lister T. A. The Cotswolds report on the investigation and staging of Hodgkin's disease. Br J Cancer. 1990 Oct;62(4):551–552. doi: 10.1038/bjc.1990.328. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Donaldson S. S., Kaplan H. S. Complications of treatment of Hodgkin's disease in children. Cancer Treat Rep. 1982 Apr;66(4):977–989. [PubMed] [Google Scholar]
  6. Ekert H., Waters K. D., Smith P. J., Toogood I., Mauger D. Treatment with MOPP or ChlVPP chemotherapy only for all stages of childhood Hodgkin's disease. J Clin Oncol. 1988 Dec;6(12):1845–1850. doi: 10.1200/JCO.1988.6.12.1845. [DOI] [PubMed] [Google Scholar]
  7. Jenkin D., Chan H., Freedman M., Greenberg M., Gribbin M., McClure P., Saunders F., Sonley M. Hodgkin's disease in children: treatment results with MOPP and low-dose, extended-field irradiation. Cancer Treat Rep. 1982 Apr;66(4):949–959. [PubMed] [Google Scholar]
  8. Neri B., Cini-Neri G., Bandinelli M., Pacini P., Bartalucci S., Ciapini A. Doxorubicin and epirubicin cardiotoxicity: experimental and clinical aspects. Int J Clin Pharmacol Ther Toxicol. 1989 May;27(5):217–221. [PubMed] [Google Scholar]
  9. Pedersen-Bjergaard J., Daugaard G., Hansen S. W., Philip P., Larsen S. O., Rørth M. Increased risk of myelodysplasia and leukaemia after etoposide, cisplatin, and bleomycin for germ-cell tumours. Lancet. 1991 Aug 10;338(8763):359–363. doi: 10.1016/0140-6736(91)90490-g. [DOI] [PubMed] [Google Scholar]
  10. Perren T. J., Selby P. J., Milan S., Meldrum M., McElwain T. J. Etoposide and adriamycin containing combination chemotherapy (HOPE-Bleo) for relapsed Hodgkin's disease. Br J Cancer. 1990 Jun;61(6):919–923. doi: 10.1038/bjc.1990.206. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Pui C. H., Behm F. G., Raimondi S. C., Dodge R. K., George S. L., Rivera G. K., Mirro J., Jr, Kalwinsky D. K., Dahl G. V., Murphy S. B. Secondary acute myeloid leukemia in children treated for acute lymphoid leukemia. N Engl J Med. 1989 Jul 20;321(3):136–142. doi: 10.1056/NEJM198907203210302. [DOI] [PubMed] [Google Scholar]
  12. Radford J. A., Cowan R. A., Flanagan M., Dunn G., Crowther D., Johnson R. J., Eddleston B. The significance of residual mediastinal abnormality on the chest radiograph following treatment for Hodgkin's disease. J Clin Oncol. 1988 Jun;6(6):940–946. doi: 10.1200/JCO.1988.6.6.940. [DOI] [PubMed] [Google Scholar]
  13. 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]
  14. Selby P., Patel P., Milan S., Meldrum M., Mansi J., Mbidde E., Brada M., Perren T., Forgeson G., Gore M. ChlVPP combination chemotherapy for Hodgkin's disease: long-term results. Br J Cancer. 1990 Aug;62(2):279–285. doi: 10.1038/bjc.1990.278. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Taylor R. E., McElwain T. J., Barrett A., Peckham M. J. Etoposide as a single agent in relapsed advanced lymphomas. A phase II study. Cancer Chemother Pharmacol. 1982;7(2-3):175–177. doi: 10.1007/BF00254543. [DOI] [PubMed] [Google Scholar]
  16. Weiner M. A., Leventhal B. G., Marcus R., Brecher M., Ternberg J., Behm F. G., Cantor A., Wharam M., Chauvenet A. Intensive chemotherapy and low-dose radiotherapy for the treatment of advanced-stage Hodgkin's disease in pediatric patients: a Pediatric Oncology Group study. J Clin Oncol. 1991 Sep;9(9):1591–1598. doi: 10.1200/JCO.1991.9.9.1591. [DOI] [PubMed] [Google Scholar]
  17. Whitlock J. A., Greer J. P., Lukens J. N. Epipodophyllotoxin-related leukemia. Identification of a new subset of secondary leukemia. Cancer. 1991 Aug 1;68(3):600–604. doi: 10.1002/1097-0142(19910801)68:3<600::aid-cncr2820680326>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES