The therapy of Hodgkin's disease in Nigeria: a five year study

Between 1970 and 1974 seventy patients suffering from Hodgkin's disease were admitted and treated in University College Hospital (UCH), Ibadan, out of which fifty (71.4%) had well documented chemotherapy. Standard combination chemotherapy of COPP/MOPP i.e. cyclophosphamide or mustine hydrochloride, oncovin, procarbazine and prednisolone was used on nineteen cases. Of these, twelve (63.2%) achieved complete remission. The longest survival to date is 4 years. Two patients (4%) had surgical excision of the affected lymph node and are alive and disease-free after 4 years of this treatment. They have had no maintenance therapy. The two patients (4%) in whom surgical removal of glands was followed by combination chemotherapy are also alive, well and disease free. Four patients had single agent therapy (Endozan) and died soon after starting treatment. One patient died shortly after diagnosis before therapy was instituted. Of the group treated with MOPP or COPP, all the patients were clinically stage IV and sixteen of the nineteen (84.5%) had histological mixed cellularity type of Hodgkin's disease. We confirm that combination chemotherapy gives very good tumour response and longest survival to patients with Stage IV disease. The main problems encountered during the period were the difficulty and the irregularities of supply of the chemotherapeutic agents. Better results can be obtained if these problems and that of high default rate can be solved.