Combination chemotherapy for MOPP resistant Hodgkin's disease (BVDS)
A combination chemotherapy program including Bleomycin, Velban, Doxorubicin (Adriamycin) and Streptozoticin was employed for previously treated patients with advanced Hodgkin's disease. Seven patients received the following regimen: Bleomycin 5 mg/M2 IV day 1 and 15, Velban 6 mg/M2 IV day 1 and 15, Doxorubicin 30 mg/M2 IV day 1 and Streptozoticin 1.5 mg/M2 day 1 and 15. Each course was repeated monthly. All patients were resistant to either standard MOPP therapy (6 patients) or MOPP substituting CCNU for nitrogen mustard (1 patient) and 4 patients also received prior radiotherapy. One patient was clinical stage IIB, one IIIB and five were stage IVB. Three patients were mixed cellularity, 2 nodular sclerosis and 2 lymphocyte depleted. Four patients are in complete remission after 2, 3, 5 and 9 months of treatment. One patient developed a partial remission (greater than 50% reduction in measurable disease) after 3 months and 2 patients had no response after 1 1/2 and 2 months. Toxicity included alopecia, nausea and vomiting and bone marrow suppression. The response rate (complete and partial remissions) of 71% suggests that this regimen is active in advanced MOPP resistant Hodgkin's disease. BVDS is not cross resistant to MOPP and is presently undergoing clinical trials in conjunction with standard therapy as alternating cycles.