CHEMOTHERAPY DOSE AND SURVIVAL IN ADVANCED HODGKINS-DISEASE

We analysed the effect of chemotherapy dose reductions on survival in 35 patients with Hodgkin's disease stage IIIB or IV treated at our ins titution by three double courses of C-MOPP/ABVD chemotherapy followed by either one further course or by involved-field radiotherapy. Patien ts receiving reduced doses of alkylating agents had markedly slower re sponses and worse survival than those not requiring dose reductions. T his experience with a very limited number of cases suggests that dose intensity may be an important prognostic factor in advanced Hodgkin's lymphoma, although dose reductions might have been necessary in patien ts with an intrinsically poor prognosis. Prospective randomized trials comparing standard chemotherapy with intensified protocols supported by hematopoietic growth factors are needed and are being conducted to determine the role of total chemotherapy dose and delivery time in the cure of Hodgkin's disease.