Outcome of patients with Hodgkin's disease failing after primary MOPP- ABVD

V. Bonfante, A. Santoro, S. Viviani, L. Devizzi, M. Balzarotti, F. Soncini, M. Zanini, P. Valagussa, G. Bonadonna

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: This study analyzed long-term results in patients with Hodgkin's disease who were resistant to or relapsed after first-line treatment with MOPP and ABVD. Response to salvage treatments and prognostic factors were also evaluated. Patients and Methods: The study population included 115 refractory or relapsed patients among a total of 415 patients treated with alternating or hybrid MOPP-ABVD followed by radiotherapy (25 to 30 Gy) to initial bulky sites. The median follow-up duration of the present series was 91 months. Thirty-nine of 115 patients (34%) showed disease progression while on primary treatment (induction failures); 48 relapsed after complete remissions that lasted ≤ 12 months and 28 after complete remission that lasted more than 12 months from the end of all treatments. Results: At 8 years, the overall survival rate was 27%, being 54% and 28% in patients whose initial complete remission was longer or shorter than 12 months, respectively, and 8% in induction failures (P <.001). Response to first-line chemotherapy and disease extent at first progression significantly influenced long-term results, as well as the incidence and duration of complete remission. Conclusion: The present data confirm previous observations that showed the main prognostic factors to influence outcome after salvage treatment are response duration to first-line therapy and disease extent at relapse. The results indicate that patients who relapse after the alternating MOPP/ABVD regimen have a prognosis similar to that of patients who relapse after a four-drug regimen (MOPP or ABVD alone). Re- treatment with initial chemotherapy seems the treatment of choice for patients who relapse after an initial complete remission that lasts greater than 12 months, while the real impact of high-dose chemotherapy or new regimens should be assessed in resistant patients.

Original languageEnglish
Pages (from-to)528-534
Number of pages7
JournalJournal of Clinical Oncology
Volume15
Issue number2
Publication statusPublished - Feb 1997

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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