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COMBINATION CHEMOTHERAPY (MOPP) IN THE MANAGEMENT OF ADVANCED HODGKIN'S DISEASE: A PROGRESS REPORT ON 55 PATIENTS

Combination chemotherapy (MOPP) employing four drugs—nitrogen mustard, vincristine, procarbazine and prednisolone, all with different modes of action at cell level—were used in the management of 55 patients suffering from advanced progressive Hodgkin's disease. The drugs were administered under a strict protocol over a ten‐day period each month for six months with subsequent maintenance therapy being administered at longer intervals. Each period of drug administration was followed by a period during which no drug was given. Forty‐four patients had stage IV disease, and 11 stage III disease. All but six of the patients had received previous therapy with irradiation and/or chemical drugs. Twenty‐seven had received previous irradiation and chemotherapy and 22 irradiation alone. Forty‐six out of 55 patients (83.6%) had complete remission (total regression of all lesions) to the four‐drug combination, and three patients partial remission. The median length of remission has been estimated at 28 months. Those patients treated previously with both radiotherapy and chemotherapy have not responded as well as those who received irradiation alone. Those patients whose tissue biopsy showed greater than 50% atypical histiocytes tended to have a shorter remission time. Drug toxicity has not proved to be a major problem in the protocol employed. The first 27 months’ progress in this group of 55 patients is discussed.