ChlVPP - An effective and well-tolerated alternative to MOPP therapy for Hodgkin's disease

Julie Marie Vose, James Olen Armitage, D. Weisenburger, D. Moravec, M. Hutchins, D. Howe, S. Sorensen, M. Dowling, J. Okerbloom, W. Pevnick, W. Packard, R. Thompson

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Abstract

The substitution of chlorambucil for nitrogen mustard and vinblastine for vincristine has been suggested to be an equally effective and well-tolerated variation of the MOPP regimen (mechlorethamine, vincristine, procarbazine, and prednisone). We treated 76 patients with advanced (i.e., Stage III, IV, or II with bulky mediastinal mass) or recurrent Hodgkin's disease with chlorambucil 6 mg/m2, procarbazine 100 mg/m2, and prednisone 40 mg p.o. daily, all on days 1-14; plus vinblastine 6 mg/m2 i.v. on day 1 and 8 of each 28-day cycle (ChlVPP). There was no maximum dose of the myelosuppressive agents. Patients who had not previously been irradiated received from 2,300 to 4,100 cGY to sites of previously bulky diseases after completing 6 cycles of ChlVPP. ChlVPP was easy to administer (i.e., 87% of patients without previous chemotherapy received ≥80% of the planned doses of myelosuppressive drugs) and was generally well tolerated, with only occasional vomiting from procarbazine and phlebitis from vinblastine. In patients without previous chemotherapy, 49 (76%) achieved a complete remission (CR) and 7 (11%) a stable partial remission (i.e., residual, stable radiographic abnormality). With a maximum follow-up of 4 years, only one CR has relapsed for an actuarial CR durability of 97%. ChlVPP with consolidative radiation therapy to sites of bulky disease is effective in advanced Hodgkin's disease and, compared with most other available regimens, is extremely well tolerated.

Original languageEnglish (US)
Pages (from-to)423-426
Number of pages4
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume11
Issue number4
DOIs
StatePublished - Jan 1 1988

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Procarbazine
Hodgkin Disease
Vinblastine
Chlorambucil
Mechlorethamine
Vincristine
Prednisone
Phlebitis
Drug Therapy
Therapeutics
Vomiting
Radiotherapy
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

ChlVPP - An effective and well-tolerated alternative to MOPP therapy for Hodgkin's disease. / Vose, Julie Marie; Armitage, James Olen; Weisenburger, D.; Moravec, D.; Hutchins, M.; Howe, D.; Sorensen, S.; Dowling, M.; Okerbloom, J.; Pevnick, W.; Packard, W.; Thompson, R.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 11, No. 4, 01.01.1988, p. 423-426.

Research output: Contribution to journalArticle

Vose, JM, Armitage, JO, Weisenburger, D, Moravec, D, Hutchins, M, Howe, D, Sorensen, S, Dowling, M, Okerbloom, J, Pevnick, W, Packard, W & Thompson, R 1988, 'ChlVPP - An effective and well-tolerated alternative to MOPP therapy for Hodgkin's disease', American Journal of Clinical Oncology: Cancer Clinical Trials, vol. 11, no. 4, pp. 423-426. https://doi.org/10.1097/00000421-198808000-00001
Vose, Julie Marie ; Armitage, James Olen ; Weisenburger, D. ; Moravec, D. ; Hutchins, M. ; Howe, D. ; Sorensen, S. ; Dowling, M. ; Okerbloom, J. ; Pevnick, W. ; Packard, W. ; Thompson, R. / ChlVPP - An effective and well-tolerated alternative to MOPP therapy for Hodgkin's disease. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 1988 ; Vol. 11, No. 4. pp. 423-426.
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AU - Armitage, James Olen

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AU - Hutchins, M.

AU - Howe, D.

AU - Sorensen, S.

AU - Dowling, M.

AU - Okerbloom, J.

AU - Pevnick, W.

AU - Packard, W.

AU - Thompson, R.

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N2 - The substitution of chlorambucil for nitrogen mustard and vinblastine for vincristine has been suggested to be an equally effective and well-tolerated variation of the MOPP regimen (mechlorethamine, vincristine, procarbazine, and prednisone). We treated 76 patients with advanced (i.e., Stage III, IV, or II with bulky mediastinal mass) or recurrent Hodgkin's disease with chlorambucil 6 mg/m2, procarbazine 100 mg/m2, and prednisone 40 mg p.o. daily, all on days 1-14; plus vinblastine 6 mg/m2 i.v. on day 1 and 8 of each 28-day cycle (ChlVPP). There was no maximum dose of the myelosuppressive agents. Patients who had not previously been irradiated received from 2,300 to 4,100 cGY to sites of previously bulky diseases after completing 6 cycles of ChlVPP. ChlVPP was easy to administer (i.e., 87% of patients without previous chemotherapy received ≥80% of the planned doses of myelosuppressive drugs) and was generally well tolerated, with only occasional vomiting from procarbazine and phlebitis from vinblastine. In patients without previous chemotherapy, 49 (76%) achieved a complete remission (CR) and 7 (11%) a stable partial remission (i.e., residual, stable radiographic abnormality). With a maximum follow-up of 4 years, only one CR has relapsed for an actuarial CR durability of 97%. ChlVPP with consolidative radiation therapy to sites of bulky disease is effective in advanced Hodgkin's disease and, compared with most other available regimens, is extremely well tolerated.

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