Background and Objectives. No specific chemotherapy regimens have yet been
recommended for elderly Hodgkin's disease (HD) patients. We investigated th
e therapeutic efficacy and toxicity of the three-drug-combination VBM (vinb
lastine, bleomycin, and methotrexate) regimen in a group of 19 elderly HD p
atients.
Design and Methods. Vinblastine (6 mg/m(2) i.v.), bleomycin (10 mg/m(2) i.v
.) and methotrexate (25 mg/m(2) i.v.) were administered on days 1 and 8. Ch
emotherapy was repeated every 28 days for a total of 6 cycles. Local radiot
herapy was given only to patients who presented bulky disease at the time o
f diagnosis. Of the 19 patients, 13 had stage II, 2 stage III, and 4 stage
IV disease; the median age was 68 years (range 60 to 75).
Results. Of the 19 patients, 15 (79%) achieved complete response (CR) and 3
(16%) partial response, while the remaining patient showed no benefit from
the treatment. With a median follow-up of 48 months, the estimated 5-year
relapse-free survival was 79%, and overall survival was 64%. Hematologic gr
ade 3-4 toxicity was seen in only 1 (5%) patient; no severe non-hematologic
side effects or deaths were associated with the administration of the VBM
regimen.
Interpretation and Conclusions. These preliminary data indicate that the VB
M regimen provides a safe and effective therapeutic option for elderly pati
ents with untreated HD. (C) 2000, Ferrata Storti Foundation.