An update on the Vancouver experience in the management of advanced Hodgkin's disease treated with the MOPP/ABV Hybrid program.

Between February 1980 and July 1984, 79 patients with newly diagnosed advanced Hodgkin's disease were treated with a new seven-drug regimen, the mechlorethamine, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, vinblastine) MOPP/ABV) Hybrid. The treatment plan allowed for a course of involved-field radiotherapy (RT) (3,500 cGy in 20 fractions) to a single area of residual lymph-node-related abnormalities if still present after six cycles of chemotherapy. Of 76 evaluable patients, 74 (97.5%) achieved complete remission (CR), ten (13%) with assistance of involved-field RT. Only two patients (2.5%) were primary treatment failures. Seven patients (9.5%) relapsed; all relapses occurred in the first 24 months of follow-up. The majority of relapses were males with large mediastinal masses and B symptoms. The actuarial overall survival of all 79 patients with the maximum and median follow-up times of 80 and 53 months, respectively, is 93.5%. The actuarial relapse-free survival for the 74 CRs with the maximum and median follow-up times of 71 and 46 months, respectively, is 90.5%. The treatment tolerance was acceptable; only one patient died from causes directly related to the treatment, and less than 10% of patients required hospitalization for suspected or proven systemic infection. The treatment delivery was excellent, as greater than 75% of the treated patients took greater than 90% of the prescribed treatment; greater than 90% of patients received at least 75% of the calculated doses of drugs. This long-term follow-up report supports our initial impression that the MOPP/ABV Hybrid chemotherapy is an effective and well-tolerated program for patients with advanced Hodgkin's disease.