Journal of Clinical Oncology, Vol 1, 432-439, Copyright © 1983 by American Society of Clinical Oncology
Long-term follow-up with ABDIC salvage chemotherapy of MOPP-resistant Hodgkin's disease
N Tannir, F Hagemeister, W Velasquez and F Cabanillas
Thirty-six consecutive patients with advanced recurrent Hodgkin's disease
resistant to chemotherapy with mechlorethamine, vincristine, procarbazine,
and prednisone (MOPP) were treated with doxorubicin (Adriamycin),
bleomycin, (dacarbazine) DTIC, (lomustine) CCNU, and prednisone (ABDIC).
Among the 34 patients evaluable for response, complete remission occurred
in 35% and partial remission in 35%. The achievement of complete remission
during primary MOPP induction was a statistically significant prognostic
factor that predicted complete remission with ABDIC (p less than 0.01). The
median time to complete remission was 2 months (range 1-11 mo). The median
relapse-free survival time for complete responders is 47 months, and an
estimated 53% of all patients who achieve complete remission are projected
to be alive, free of disease off therapy at 3 years from initiation of
ABDIC. The median survival of all patients is 24 months. The median
survival of complete responders, partial responders, and nonresponders is
70, 17, and 4 months, respectively. The survival curve for complete
responders is significantly different from that for partial responders (p
less than 0.01); the survival curve for partial responders is also
significantly different from that of nonresponders (p less than 0.01).
Toxicity of ABDIC was acceptable; only one patient died from complications
of myelosuppression. Our results indicate that ABDIC is a potentially
curative regimen for a fraction of patients with MOPP- resistant Hodgkin's
disease who achieve complete remission with prior MOPP therapy. It also
prolongs the survival of patients who do not achieve complete remission
with prior MOPP therapy.
