Hodgkin's disease in children. A ten-year experience in South Africa.

Twenty-seven children with Hodgkin's disease were treated with MVOPP (mustine, Velban [vinblastine], Oncovin [vincristine], procarbazine, prednisone) combination chemotherapy. All 11 children with Stage I or Stage II disease achieved complete remission and no relapses have occurred between 34 and 179 months of continuous follow-up. Of the 16 children with Stage III or Stage IV disease, two with partial remission and three nonresponding patients died with a median survival of 18 months. The remaining 11 (68%) achieved complete remission. Of these, 6 (55%) have relapsed with a median remission duration of 36 months; five have been retreated with MVOPP, and one with total nodal irradiation, and all achieved second complete remission. Three of the children have died of Hodgkin's disease, with a median survival of 55 months; one child died of acute myeloblastic leukemia while in remission; and one child remains disease-free off all therapy at 165 months; the sixth child treated with total nodal irradiation is disease-free at 166 months. The initial complete remission has been sustained in all 11 children with Stage I or Stage II Hodgkin's disease, suggesting that combination chemotherapy is an alternative to radiotherapy as the initial form of treatment in this group of individuals.