CEP REGIMEN (CCNU, ETOPOSIDE, PREDNIMUSTINE) FOR RELAPSED REFRACTORY HODGKINS-DISEASE

Aims and background: Although initial treatment of Hodgkin's disease i nduces a complete remission in most patients, approximately 50% of pat ients with advanced disease will not achieve a complete remission or w ill relapse following the first complete remission. Patients and metho ds: Twenty-three patients with relapsed/resistant Hodgkin's disease, o bserved between January 1991 and October 1993, underwent CEP combinati on chemotherapy (CCNU, etoposide, prednimustine). All patients had pre viously received MOPP and ABVD regimens, in combination at diagnosis o r sequentially (at diagnosis and at the first relapse). Results: Thirt een (56%) patients achieved complete responses and 4 (18%) had partial responses. Two partial responders obtained a complete remission after a successive autologous bone marrow transplantation. The complete rem ission was not influenced by the timing of MOPP and ABVD treatments, p resence of extranodal involvement or presence of bulky disease, but wa s affected by the presence of a primary disease refractory to the firs t standard programs. All the complete responders but 2 were alive and relapse-free at a median follow-up of 15 months; no major toxic effect s were recorded. Conclusions: These data suggest, as did those of othe r studies, that CEP is an effective regimen in patients with Hodgkin's disease in first or second relapse, also to reduce the tumor burden a nd to determine chemosensitivity before contingent bone marrow or peri pheral blood stem cell support.