ChlVPP/ABV-VP16 hybrid regimen for advanced Hodgkin's disease: a study in 36 patients

Prolonged remission can now be induced in the majority of patients with adv anced Hodgkin's disease (HD) by the use of non-cross-resistant regimens. Th e aim of this retrospective analysis was to evaluate the efficacy and toler ability of a hybrid chemotherapy regimen (Ch1VPP/ABV-VP16) in this unfavora ble subset of patients. From 1982 to 1997 thirty-six previously untreated p atients with advanced HD, Stages IIB to IV according to the Ann Arbor class ification, were treated with the Ch1VPP/ABV-VP16 regimen. The median age of the group was 29 years (range, 18 to 74), and 50% of them had bulky diseas e. Complete remission (CR) was induced in 31 patients (86%); 3 patients ach ieved pal-tial responses and ? had progressive disease. The median follow-u p duration is 5.7 years, with a 5-year overall survival rate of 80%. At 5 y ears, the time to progression (TTP) and event-free survival (EFS) were 71% and 64%, respectively. Acute toxicity was quite acceptable, and there were no treatment-related deaths. A total of 3 second malignancies (8%) were doc umented. In conclusion, the Ch1VPP/ABV-VP16 hybrid is an active regimen for use in advanced HD. Its overall survival, TTP and CR rates make this regim en an attractive alternative to MOPP/ABVD. However, the possibility of the development of second tumors is worrisome, although the relatively brief in terval between the end of treatment and tumor detection may imply caution a bout the possible relationship.