Combination Chemotherapy in Advanced Hodgkin's Disease

Abstract

One hundred and seventy-eight patients with stages III and IV Hodgkin's disease were treated with combination chemotherapy (mechlorethamine, vincristine [Oncovin®], procarbazine, and prednisone [MOPP]). The complete remission rate for all patients was 66%. After 6 months of MOPP treatment, patients in complete remission were randomly allocated either to continued MOPP treatment every 2 months for a total of 18 months (maintained remission) or to no further treatment (unmaintained remission). The relapse rate was significantly less in the patients in maintained remission, whether plotted from time of randomization or from end of MOPP treatment. Thus 75% of the maintained patients were in complete remission 3 years after the start of the study, compared with 46% for the unmaintained patients. Eighty percent of patients entering complete remission were alive at 4 years, and there was no difference between the maintained and unmaintained groups. This lack of difference was caused largely by more effective secondary treatment in patients receiving only six courses of MOPP. The anatomical distribution of sites of relapse correlated highly with the anatomical distribution of major pretreatment sites of involvement.