Toxicity of a combination of ABVD chemotherapy and mediastinal irradiation for Hodgkin's disease patients with massive initial mediastinal involvement.

The authors report on 5 Hodgkin's disease (HD) patients with a mediastinothoracic ratio greater than or equal to 0.35 treated by ABVD chemotherapy (adriamycin, bleomycin, vindesine, DTIC) and irradiation. All 5 patients developed complications and there was 1 death. Administration of adriamycin and bleomycin in combination with irradiation may have been responsible for this poor treatment tolerance. Use of such protocols, and especially use of ABVD after mediastinal irradiation, should probably be avoided in the management of patients with massive mediastinal involvement.