RESULTS OF A LOW AGGRESSIVITY CHEMOTHERAPY REGIMEN (CVP CEB) IN ELDERLY HODGKINS-DISEASE PATIENTS/

Background. Hodgkin's disease (HD) after the age of 65 years is uncomm on and there are no published data on chemotherapy regimens devised fo r elderly HD patients. Patients and Methods. From 1990 to 1993, 25 eld erly HD patients were treated with the CVP/CEB regimen: chlorambucil 6 mg/sqm p.o. days 1 through 7, vinblastine 6 mg/sqm i.v. on day 1, pro carbazine 100 mg/sqm p.o. days 1 through 7, prednisone 30 mg/sqm p.o. days 1 through 7, cyclophosphamide 500 mg./sqm i.v. day 15, etoposide 70 mg/sqm i.v. day 15, bleomycin 10 mg/sqm i.v. day 15. Each course wa s repeated every 4 weeks. Stage I and II patients were treated with 3 courses followed by involved held radiotherapy, while more advanced st age patients received 6 courses and radiotherapy was limited to bulky areas. The results of the CVP/CEB regimen are retrospectively compared to those of 74 elderly patients treated between 1982 and 1989 and sub divided into the following 2 groups: 32 patients treated according to the same therapy used at that time in younger patients, and 42 patient s given alternative low aggressivity or palliative treatment. Results. CVP/CEB is a well-tolerated regimen, with only 1 (4%) toxic death and 2 (8%) protocol violations/interruptions. The CVP/CEB complete remiss ion rate (73%) compares favorably with our previous groups of patients , mainly because of the lower toxic death rate. However, the CVP/CEB r elapse-free survival rate is lower than that of patients treated with more aggressive conventional regimens (47% vs. 77%, p<0.02). The CVP/C EB overall survival and event-free survival rates are 55% and 32%, res pectively, and they are not statistically different from those of pati ents treated before 1990. Conclusions. CVP/CEB is a well-tolerated low toxicity regimen with a high CR rate. The relapse rate is high and ev ent-free survival is comparable to that of patients treated convention ally. Our results suggest the need for individualized treatment criter ia for older patients with HD.