Treatment of advanced Hodgkin's disease with modified MOPP regimens. A long-term observation

Fifty-three patients with advanced Hodgkin's disease, most of them previously treated, received 8 to 16 courses of modified MOPP regimens (nitrogen mustard replaced by trichlormethine in arm A, with addition of vinblastine to the 4-drug regimen in arm B, and alternation of three drugs--trichlormethine, vincristine, and prednisone--with probably non-cross resistant two drugs--vinblastine and procarbazine in arm C). Thirty patients (57%) achieved complete remission. Higher complete remission rate and longer survival was recorded in patients treated with 5-drug regimens (arms B and C) as compared to the 4-drug regimen (arm A), but the differences were not significant. Higher complete remission rates were observed in asymptomatic patients, females, and patients with lymphocyte predominance and nodular sclerosis subtypes of Hodgkin's disease. Besides expected short-term toxicity, 4 out of 30 complete responders developed secondary malignancies (two acute myeloblastic leukemias, one hepatocellular carcinoma, and one cerebellar astrocytoma). Several other patients had serious toxicity which could be attributed to chemotherapy. Twenty-eight percent of the patients has been alive 15 to 18 years since the start of this study.