C-MOPP ABV YIELDS GOOD RESULTS IN A PUBLIC HOSPITAL POPULATION WITH HODGKIN DISEASE IN BRAZIL

Background. Over the last 15 years, a number of combination chemothera py regimens have been reported to induce more than 80% complete remiss ions (CR) in patients with advanced Hodgkin disease (HD). Almost all s uch studies have been conducted in large institutions from North Ameri ca and Europe. It remains to be proven, however, that those regimens a re equally effective for the larger population of patients with HD who live in very different social conditions in third-world countries. Me thods. Fifty-nine patients with advanced-stage or early bulky HD were treated in two public hospitals with the C-MOPP/ABV hybrid program, in which cyclophosphamide was substituted for mechlorethamine. Results. The median number of cycles administered was six, and the median follo w-up was 32 months. Fifty patients (85%) reached a CR. The actuarial f ailure-free survival (FFS) rate was 69%, and the actuarial overall sur vival rate was 78% at 68 months. The only significant prognostic facto r that predicted for improved FFS rate was the absence of B symptoms ( P = 0.02). Overall survival was better for patients who reached a CR ( P = 0.0003) and those with no systemic symptoms (P = 0.007). Toxic eff ects were moderate, with one treatment-related death and six episodes of serious infection. Conclusions. The target population consisted of lower-class Brazilians, many living in poor social conditions. Neverth eless, these results compare equitably with other results reported in the literature. C-MOPP/ABV is an adequate treatment for HD in third-wo rld populations.