Alternating sequential combination chemotherapy in the management of advanced Hodgkin's disease. A Southeastern...

The Southeastern Cancer Study Group has explored the use of alternating sequential combination chemotherapy in advanced Hodgkin's disease. Two hundred twelve evaluable patients were randomly assigned to treatment with the six-drug combination, BCNU, cyclophosphamide, vinblastine, procarbazine, prednisone, and bleomycin (BCVPP-Bleo) or with the same drugs alternating in monthly cycles with doxorubicin, dacarbazine, and bleomycin. Both regimens produced complete response rates of approximately 73%. The duration of remission and survival were similar for the two treatment regimens. Although our sequence of combinations does not rigorously meet the criteria for "non-cross-resistant" our results do not lend support to the hypothesis that alternating sequential non-cross-resistant drug combinations improves the outcome in advanced Hodgkin's disease.