Combination chemotherapy for stage IV Hodgkin's disease (Report no 14)

From 1970 to 1975 patients with Stage IV Hodgkin's disease randomised for treatment in the British National Lymphoma Investigation were treated either with MOPP (nitrogen mustard, vincristine, procarbazine and prednisone) or MOP (the same combination without prednisone). The incidence of complete remission was significantly higher for patients treated with MOPP than for those who received MOP (69 vs. 36%, P less than 0.01) and the duration of survival also favoured the former group. From 1976 to 1979 patients with Stage IV disease were treated wither with MOPP or with MOPP plus bleomycin at low dosage (B-MOPP); the incidence of complete remission was not significantly different in the two groups of patients (52 vs. 65%) and a trend in survival favouring those treated by B-MOPP was not significant. The present trial is a comparison of MOPP with the same combination in which chlorambucil has been substituted for nitrogen mustard (LOPP). A proportion of those patients who achieved complete remission after treatment with MOPP or B-MOPP was randomised for maintenance for six months with the CVB combination (CCNU, vinblastine and bleomycin). No advantage could be discerned for patients 'maintained' in this way.