MOPP/ABV hybrid chemotherapy for advanced Hodgkin's disease.

Seventy-six patients with previously untreated advanced Hodgkin's disease have been treated with the MOPP/ABV (mechlorethamine, vincristine, procarbazine, prednisone/doxorubicin, bleomycin, vincristine) hybrid program. Ten patients also received involved field radiation to the mediastinum for residual nodal disease after six cycles of chemotherapy. Of the 74 evaluable patients, 71 (96%) had a complete response. The actuarial relapse-free survival for the complete responders after 62 months off treatment is 90% (median follow-up from treatment completion was 35 months; range, 4 to 62 months). Actuarial overall survival for all 76 patients including all causes of death is 95% (median follow-up time from diagnosis was 43 months; range, 4 to 70 months). Toxicity was modest. Only one death occurred during treatment, and toxicity-related hospitalization was necessary for only 8% of patients. Failure analysis indicates that a disproportionate number of treatment failures occurred in the sub-group with B symptoms and a mediastinal mass ratio greater than one third the transthoracic diameter. This updated report confirms the efficacy and safety of the MOPP/ABV hybrid program for advanced Hodgkin's disease, which is now being tested in a prospective, randomized, multicenter trial.