Fifty untreated adult patients with advanced
Hodgkin's disease (HD) were given alternating MOPP-ABVD
chemotherapy in a prospective eight-cycle program. This series included 33 patients with stage II-III disease and bulky
lymphoma and/or B symptoms, and 17 patients with stage IV disease. Nodular
sclerosis amounted to 52%, and systemic symptoms were present in 70% of patients. The median follow-up was 50 months from the initiation of
therapy (range: 36-78 months). The complete remission rate was 80%, with no differences according to the main patient characteristics before
therapy, except for bulky (65%) versus non bulky (88%) disease (p = 0.05). The actuarial 4-year overall (OS) and relapse-free survival were 78% and 71%, respectively. No clear-cut pretreatment characteristics showed an influence on survival, although there was a trend favoring non bulky versus bulky disease (p = 0.08). The actuarial 4-year OS of complete responders was 92%; all 13 patients who died had evidence of HD; the cause of death was
disease progression and organ failure in 11 cases, acute myelomonocytic and
opportunistic infections with
AIDS in the other two cases, respectively. No severe
pancytopenia episodes or life-threatening complications occurred during
therapy; gastrointestinal and neurological toxicity were mild and no patient refused to complete the treatment. Menstruating women were given
estrogen-
progesterone combinations, and all continued to have regular menses throughout
chemotherapy and afterwards; a young woman had a normal pregnancy resulting in a normal live birth. Only one case of stable
amenorrhea was observed.
Oligospermia after
chemotherapy was seen in seven of 10 tested males, and
azoospermia in one case.(ABSTRACT TRUNCATED AT 250 WORDS)