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Drugs Oct 1985The prognosis of patients with Hodgkin's disease has dramatically improved over the past few decades. Treatment with currently standard radiotherapy or combination... (Review)
Review
The prognosis of patients with Hodgkin's disease has dramatically improved over the past few decades. Treatment with currently standard radiotherapy or combination chemotherapy programmes will result in durable complete remissions and probable cure in most patients. However, these programmes are intensive, technically demanding, and associated with a risk of certain acute side effects and long term complications which vary in nature and severity according to the specific therapy employed. The outlook for the few patients who do not achieve complete remission with induction therapy, or for those who later relapse (especially after complete remissions induced by chemotherapy), is less optimistic. Current trials of innovative induction and salvage therapies may lead to improved treatment approaches for such patients.
Topics: Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Hodgkin Disease; Humans; Leukemia; Leukemia, Radiation-Induced; Mechlorethamine; Prednisone; Procarbazine; Vincristine
PubMed: 3905335
DOI: 10.2165/00003495-198530040-00004 -
American Journal of Industrial Medicine 1983Radiation, alkylating agents and the vinca alkaloids produce variable degrees of gonadal dysfunction in humans; additional drugs have been linked to gonadal damage in... (Review)
Review
Radiation, alkylating agents and the vinca alkaloids produce variable degrees of gonadal dysfunction in humans; additional drugs have been linked to gonadal damage in males only. Age at time of exposure and total dose of drug administered are associated with the degree of gonadal injury. Irreversible sterility develops at lower doses in men than in women. The infertile men usually retain sexual function, whereas the infertile women experience premature menopause and sexual dysfunction. Subfertility with normal sexual function is the sequela of lesser degrees of gonadal injury in men and women. For a given drug dose, children apparently sustain less gonadal damage than their adult counterparts. Rigorous reporting of basic essential data will enhance our understanding of drug-induced gonadal damage; incomplete reports only cloud the issue.
Topics: Adolescent; Adrenal Cortex Hormones; Adult; Alkylating Agents; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Cyclophosphamide; Female; Gonads; Humans; Male; Mechlorethamine; Ovary; Prednisolone; Prednisone; Procarbazine; Puberty; Testis; Vinblastine; Vinca Alkaloids; Vincristine
PubMed: 6340475
DOI: No ID Found -
Journal of Clinical Oncology : Official... Sep 1986The results of treatment of 198 patients with MOPP (mechlorethamine, vincristine, procarbazine, and prednisone) for Hodgkin's disease were analyzed after a median of 14... (Clinical Trial)
Clinical Trial
The results of treatment of 198 patients with MOPP (mechlorethamine, vincristine, procarbazine, and prednisone) for Hodgkin's disease were analyzed after a median of 14 years of follow-up. Throughout the period of follow-up, 103 patients have remained continuously free of disease. Review of biopsy specimens of 43 patients originally classified as Hodgkin's disease, lymphocyte-depleted type, revealed that ten of these patients actually had diffuse immunoblastic or large cell non-Hodgkin's lymphomas. Of the 188 patients with Hodgkin's disease, 157 achieved a complete response (CR) (84%), and 66% of them (101 patients) have remained disease-free more than 10 years from the end of treatment. Absence of B symptoms and receiving higher doses of vincristine were factors associated with a higher CR rate and longer survival. Patients entering complete remission in five cycles or less had significantly longer remissions than those requiring six or more cycles. Forty-eight percent of the Hodgkin's disease patients have survived between 9 and 21 years (median, 14 years) from the end of treatment. Nineteen percent of the CRs have died of intercurrent illnesses, free of Hodgkin's disease.
Topics: Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Child; Clinical Trials as Topic; Drug Administration Schedule; Follow-Up Studies; Hodgkin Disease; Humans; Mechlorethamine; Middle Aged; Prednisone; Procarbazine; Vincristine
PubMed: 3528400
DOI: 10.1200/JCO.1986.4.9.1295 -
Oncology 2001Hodgkin's disease remains one of the few malignant diseases which can be cured by modern chemotherapy in most cases even in advanced stages. Adriamycin-containing... (Review)
Review
Hodgkin's disease remains one of the few malignant diseases which can be cured by modern chemotherapy in most cases even in advanced stages. Adriamycin-containing chemotherapy regimens are considered as the standard therapy which induce long-term remission in about 60-70% of patients. The ABVD scheme, developed by Bonadonna and colleagues in Milan, has a favorable toxicity profile and causes less myelotoxicity, acute leukemia or sterility relative to many previous treatment programs containing alkylating agents. However, 20- 30 % of patients eventually relapse and are then frequently treated with high-dose programs including stem cell transplantation. There are two major goals in advanced Hodgkin's disease: (1) to improve the cure rate and (2) to reduce acute and long-term toxicities. The recent definition of prognostic factors identified patients who are at a high risk of treatment failure as well as those in whom less toxic approaches can be applied. The optimal approach or program has not yet been defined, although new chemotherapy regimens such as BEACOPP and Stanford V with increased tumor response rates have been identified. These new drug combinations are currently analyzed and compared with ABVD in several international trials. While the addition of radiotherapy improved disease control in some trials a survival benefit was not identified and the role of radiotherapy remains controversial. High dose programs remain experimental in advanced stage Hodgkin's disease and should be restricted to prospective clinical trials.
Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Chemotherapy, Adjuvant; Dacarbazine; Doxorubicin; Drug Administration Schedule; Hematopoietic Stem Cell Transplantation; Hodgkin Disease; Humans; Mechlorethamine; Neoplasm Staging; Prednisone; Procarbazine; Prognosis; Radiotherapy, Adjuvant; Vinblastine; Vincristine
PubMed: 11244323
DOI: 10.1159/000055305 -
Haematologica 1990The gonadal function of 38 patients with Hodgkin's disease (HD) treated with MOPP chemotherapy (12 patients), ABVD (9 patients) and alternating MOPP/ABVD (17 patients)... (Comparative Study)
Comparative Study
The gonadal function of 38 patients with Hodgkin's disease (HD) treated with MOPP chemotherapy (12 patients), ABVD (9 patients) and alternating MOPP/ABVD (17 patients) has been retrospectively investigated with semen analysis. Median age of patients was 25 years (range 16-41 years). Azoospermia was found in all patients from the MOPP group (100%), in 3 of the ABVD group (33%) and in 13 of the MOPP/ABVD group (76%). After temporary oligospermia full recovery of spermatogenesis was observed in 67% of patients treated with ABVD, versus 25% of MOPP-treated patients following a prolonged period of azoospermia and oligospermia. Patients receiving MOPP/ABVD scheme had complete recovery of testicular function after oligospermia in 24% of cases. These results confirm the higher gonadal toxicity of the MOPP regimen as compared to others such as ABVD without alkylating agents.
Topics: Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Dacarbazine; Doxorubicin; Hodgkin Disease; Humans; Infertility, Male; Male; Mechlorethamine; Prednisone; Procarbazine; Risk Factors; Vinblastine; Vincristine
PubMed: 1694156
DOI: No ID Found -
Recent Results in Cancer Research.... 1989The report includes the essential therapeutic and toxic results following MOPP vs. MOPP/ABVD and MOPP vs. ABVD within a combined modality setting. The findings indicate... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
The report includes the essential therapeutic and toxic results following MOPP vs. MOPP/ABVD and MOPP vs. ABVD within a combined modality setting. The findings indicate that in stage IV the alternating regimen is superior to MOPP while in stage IIB-III ABVD plus radiotherapy yielded superior results associated with no treatment-induced sterility and leukemia compared with MOPP plus radiotherapy.
Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Combined Modality Therapy; Dacarbazine; Doxorubicin; Hodgkin Disease; Humans; Mechlorethamine; Prednisone; Procarbazine; Randomized Controlled Trials as Topic; Vinblastine; Vincristine
PubMed: 2481328
DOI: 10.1007/978-3-642-83781-4_17 -
Oncology (Williston Park, N.Y.) Feb 1996In most patients with newly diagnosed Hodgkin's disease, initial therapy is curative. However, a small portion of patients treated with radiotherapy alone for limited... (Review)
Review
In most patients with newly diagnosed Hodgkin's disease, initial therapy is curative. However, a small portion of patients treated with radiotherapy alone for limited favorable disease, and a larger percentage of patients treated with combination chemotherapy, with or without radiotherapy, for advanced-stage or unfavorable disease relapse after initial remission. Patients relapsing after radiotherapy alone should do as well with salvage combination chemotherapy as patients with advanced disease who have never received radiation. In patients who relapse after combination chemotherapy, retreatment with the same regimen or employment of a non-cross-resistant regimen offers high response rates among those with favorable characteristics. However, long-term disease-free survival is achieved in a minority of these patients, and in even fewer of those with early relapse or other unfavorable characteristics. High-dose therapy with autografting shows the greatest promise in the treatment of patients at relapse.
Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Bone Marrow Transplantation; Combined Modality Therapy; Dacarbazine; Doxorubicin; Hematopoietic Stem Cell Transplantation; Hodgkin Disease; Humans; Mechlorethamine; Prednisone; Procarbazine; Prognosis; Recurrence; Salvage Therapy; Time Factors; Transplantation, Autologous; Vinblastine; Vincristine
PubMed: 8838268
DOI: No ID Found -
Leukemia 1991From January '85 to April '87, 81 patients (pts) with diffuse intermediate and high-grade non-Hodgkin's lymphomas were treated with the ProMace/MOPP protocol in a large... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
From January '85 to April '87, 81 patients (pts) with diffuse intermediate and high-grade non-Hodgkin's lymphomas were treated with the ProMace/MOPP protocol in a large Italian Cooperative Study Group (NHLCSG). Criteria for entry into the study included: no prior therapy, stage III-IV or stage II with bulky disease and/or B-symptoms, age below 65. 79 pts were evaluable for response. Almost all pts received six courses of chemotherapy, plus radiotherapy on bulky disease. 53 pts (67%) achieved complete remission (CR), 7 (9%) partial remission (PR), 4 (5%) were considered stable disease (SD) and 15 (19%) progression disease (PD) with 5 of them died early during treatment. The actuarial overall survival (OS) and disease free survival (DFS) are respectively 54% at 61 mos and 62% at 41 mos. The median follow-up from the end of therapy is 56 mos (range 40-68). Until now 20 pts (38%) relapsed on a median time of 8 mos (range 2-21) from CR. These data allowed to us to consider this regimen as effective as the third generation protocols also taking into account the multicenter basis of this study. With the aim to evaluate the impact of the third generation regimen on the outcome of these pts, a randomized study has been performed comparing ProMACE-MOPP with the third generation regimens MACOP-B. Therefore, from 1988 up to now, 206 pts with similar clinical and histological characteristics, have been enrolled in the two arms. No differences in terms of CR and DFS have been registered between the two treatments, with roughly the same toxicity. An analysis of prognostic factors in the larger series of pts treated with ProMACE-MOPP in the first and in the second study (167 pts) was performed. On these basis it seems reasonable that our next step would be to candidate these poor prognosis pts to a new therapeutic strategy which included the use of ABMT and/or PBSC transplantation as first line.
Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cyclophosphamide; Doxorubicin; Etoposide; Female; Humans; Lymphoma, Non-Hodgkin; Male; Mechlorethamine; Methotrexate; Middle Aged; Prednisolone; Prednisone; Procarbazine; Vincristine
PubMed: 1716334
DOI: No ID Found -
European Journal of Cancer (Oxford,... 1990
Clinical Trial Randomized Controlled Trial
Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Child; Hodgkin Disease; Humans; Mechlorethamine; Prednisone; Procarbazine; Prognosis; Vincristine
PubMed: 2149991
DOI: 10.1016/0277-5379(90)90265-u -
Journal of Clinical Oncology : Official... Apr 1990
Topics: Antineoplastic Combined Chemotherapy Protocols; Hodgkin Disease; Humans; Mechlorethamine; Prednisone; Procarbazine; Retrospective Studies; Survival Rate; Vincristine
PubMed: 2313341
DOI: 10.1200/JCO.1990.8.4.756