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The New England Journal of Medicine Nov 1992MOPP (mechlorethamine, vincristine, procarbazine, and prednisone) has been the standard treatment for Hodgkin's disease for almost 20 years. In a randomized, multicenter... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
BACKGROUND AND METHODS
MOPP (mechlorethamine, vincristine, procarbazine, and prednisone) has been the standard treatment for Hodgkin's disease for almost 20 years. In a randomized, multicenter trial, we compared three regimens of primary systemic therapy for newly diagnosed advanced Hodgkin's disease in Stages IIIA2, IIIB, and IVA or IVB: (1) MOPP alone given for 6 to 8 cycles, (2) MOPP alternating with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) for 12 cycles, and (3) ABVD alone for 6 to 8 cycles. Patients in a first relapse after radiation therapy were eligible. No additional radiation therapy was given. Patients who did not have a complete response or who had a relapse with either MOPP alone or ABVD alone were switched to the opposite regimen.
RESULTS
Of 361 eligible patients, 123 received MOPP, 123 received MOPP alternating with ABVD, and 115 received ABVD alone. The patients were stratified according to age, stage, previous radiation, histologic features, and performance status. The overall response rate was 93 percent, with complete responses in 77 percent: 67 percent in the MOPP group, 82 percent in the ABVD group, and 83 percent in the MOPP-ABVD group (P = 0.006 for the comparison of MOPP with the other two regimens, both of which contained doxorubicin). The rates of failure-free survival at five years were 50 percent for MOPP, 61 percent for ABVD, and 65 percent for MOPP-ABVD. Age, stage (III vs. IV), and regimen influenced failure-free survival significantly. Overall survival at five years was 66 percent for MOPP, 73 percent for ABVD, and 75 percent for MOPP-ABVD (P = 0.28 for the comparison of MOPP with the doxorubicin regimens). MOPP had more severe toxic effects on bone marrow than ABVD and was associated with greater reductions in the prescribed dose.
CONCLUSIONS
In this trial, ABVD therapy for 6 to 8 months was as effective as 12 months of MOPP alternating with ABVD, and both were superior to MOPP alone in the treatment of advanced Hodgkin's disease. ABVD was less myelotoxic than MOPP or ABVD alternating with MOPP.
Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Dacarbazine; Doxorubicin; Drug Administration Schedule; Female; Hodgkin Disease; Humans; Male; Mechlorethamine; Middle Aged; Prednisone; Procarbazine; Remission Induction; Vinblastine; Vincristine
PubMed: 1383821
DOI: 10.1056/NEJM199211193272102 -
Blood May 1981
Review
Topics: Antineoplastic Combined Chemotherapy Protocols; Cell Transformation, Neoplastic; Giant Cell Tumors; Hodgkin Disease; Humans; Immunity, Cellular; Mechlorethamine; Prednisone; Procarbazine; Prognosis; Spleen; Vincristine
PubMed: 7011441
DOI: No ID Found -
The British Journal of Cancer.... Mar 1975The results obtained with intensive chemotherapy and intensive chemotherapy plus radiotherapy in non-Hodgkin's lymphomata are reported. A quintuple drug regimen... (Clinical Trial)
Clinical Trial Comparative Study
The results obtained with intensive chemotherapy and intensive chemotherapy plus radiotherapy in non-Hodgkin's lymphomata are reported. A quintuple drug regimen (mechloretamine, adriamycin, bleomycin, vincristine and prednisone) in histiocytic lymphomata (Stage III and IV) yielded complete remissions in 53% and complete plus partial remissions in 77%. These figures were 44% and 64% respectively in lymphocytic lymphoma. In Stage III complete responders after combination chemotherapy were subsequently irradiated (involved field irradiation). The median duration of complete remission after completion of radiotherapy was 9-5 months in histiocytic and 12-0 months in lymphocytic lymphomata. At 2 years actuarial survival in Stage III and IV was better in patients with the lymphocytic type and with nodular pattern than with histiocytic and diffuse patterns. A more recent trial compares, in Stage IV patients, cyclophosphamide, vincristine and prednisone (CVP) versus adriamycin, bleomycin and prednisone (ABP). Although the number of evaluable patients is still limited, there appears to be no difference in the response rate between CVP and ABP. In Stages I and II, 6 cycles of CVP were given as adjuvant treatment after radiotherapy. At the present moment, there is no statistical difference in the relapse rate between the group of patients treated with radiotherapy alone and that with radiotherapy plus CVP.
Topics: Antineoplastic Agents; Bleomycin; Bone Marrow; Clinical Trials as Topic; Cyclophosphamide; Doxorubicin; Drug Therapy, Combination; Humans; Leukopenia; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Mechlorethamine; Prednisone; Radiotherapy; Vincristine
PubMed: 52367
DOI: No ID Found -
Journal of Feline Medicine and Surgery Apr 2020The aims of this study were to evaluate the safety of mustargen, vincristine, procarbazine and prednisone (MOPP) chemotherapy in the treatment of relapsed or refractory...
OBJECTIVES
The aims of this study were to evaluate the safety of mustargen, vincristine, procarbazine and prednisone (MOPP) chemotherapy in the treatment of relapsed or refractory feline lymphoma, and to determine the overall response rate and median remission time with this protocol.
METHODS
The medical records of 38 cats with relapsed or refractory lymphoma treated with MOPP chemotherapy at three institutions (University of Pennsylvania, the Animal Medical Center, and VCA Western Veterinary Specialist and Emergency Centre) were examined. Information evaluated included patient signalment, feline immunodeficiency virus/feline leukemia virus status, anatomic location(s) of lymphoma, prior protocols (type and number), MOPP doses, MOPP response, remission duration, hematologic and biochemical parameters, and owner-reported adverse effects.
RESULTS
Overall, 70.3% of cats responded to MOPP chemotherapy. Among the responders, the median remission duration was 166 days. The most common adverse effects were neutropenia and gastrointestinal upset, which were reported in 18.4% of cats. In 55.3% of cats, no adverse effects were reported. In total, 30.8% of responders continued to respond 6 months following the initiation of MOPP, and 15.4% maintained a response 1 year after starting MOPP.
CONCLUSIONS AND RELEVANCE
MOPP is a safe protocol for the treatment of relapsed or refractory feline lymphoma, with a promising overall response rate and median remission time.
Topics: Animals; Antineoplastic Combined Chemotherapy Protocols; Cat Diseases; Cats; Lymphoma; Mechlorethamine; Prednisone; Procarbazine; Treatment Outcome; Vincristine
PubMed: 30994392
DOI: 10.1177/1098612X19841916 -
Molecular and Cellular Biology Nov 2000The mechanisms by which DNA interstrand cross-links (ICLs) are repaired in mammalian cells are unclear. Studies in bacteria and yeasts indicate that both nucleotide...
The mechanisms by which DNA interstrand cross-links (ICLs) are repaired in mammalian cells are unclear. Studies in bacteria and yeasts indicate that both nucleotide excision repair (NER) and recombination are required for their removal and that double-strand breaks are produced as repair intermediates in yeast cells. The role of NER and recombination in the repair of ICLs induced by nitrogen mustard (HN2) was investigated using Chinese hamster ovary mutant cell lines. XPF and ERCC1 mutants (defective in genes required for NER and some types of recombination) and XRCC2 and XRCC3 mutants (defective in RAD51-related homologous recombination genes) were highly sensitive to HN2. Cell lines defective in other genes involved in NER (XPB, XPD, and XPG), together with a mutant defective in nonhomologous end joining (XRCC5), showed only mild sensitivity. In agreement with their extreme sensitivity, the XPF and ERCC1 mutants were defective in the incision or "unhooking" step of ICL repair. In contrast, the other mutants defective in NER activities, the XRCC2 and XRCC3 mutants, and the XRCC5 mutant all showed normal unhooking kinetics. Using pulsed-field gel electrophoresis, DNA double-strand breaks (DSBs) were found to be induced following nitrogen mustard treatment. DSB induction and repair were normal in all the NER mutants, including XPF and ERCC1. The XRCC2, XRCC3, and XRCC5 mutants also showed normal induction kinetics. The XRCC2 and XRCC3 homologous recombination mutants were, however, severely impaired in the repair of DSBs. These results define a role for XPF and ERCC1 in the excision of ICLs, but not in the recombinational components of cross-link repair. In addition, homologous recombination but not nonhomologous end joining appears to play an important role in the repair of DSBs resulting from nitrogen mustard treatment.
Topics: Alkylating Agents; Animals; CHO Cells; Cell Line; Cell Survival; Comet Assay; Cricetinae; Cross-Linking Reagents; DNA Repair; Dose-Response Relationship, Drug; Electrophoresis, Gel, Pulsed-Field; Kinetics; Mechlorethamine; Models, Genetic; Mutagenesis, Site-Directed; Recombination, Genetic; Rhodamines; Time Factors
PubMed: 11027268
DOI: 10.1128/MCB.20.21.7980-7990.2000 -
Skin Therapy Letter Mar 2023Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma (CTCL), representing almost 50% of all lymphomas arising in the skin. There is an unmet need...
Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma (CTCL), representing almost 50% of all lymphomas arising in the skin. There is an unmet need in the treatment of MF in Canada, as current available therapies for early-stage MF are limited, without topical agents previously indicated. Chlormethine gel is a topical antineoplastic agent with phase II clinical trial and real-world data demonstrating safety and efficacy as a treatment option for adults with MF. Skin-related side effects such as dermatitis can be managed through appropriate strategies. The use of chlormethine gel can be considered for patients with stage IA and IB MF-CTCL as it provides an easily administered, skin-directed treatment option that fills an unmet need in Canada.
Topics: Adult; Humans; Mechlorethamine; Skin Neoplasms; Mycosis Fungoides; Lymphoma, T-Cell, Cutaneous; Skin
PubMed: 37054720
DOI: No ID Found -
Canadian Medical Association Journal Mar 1964Chemotherapy of solid tumours is considered with respect to cell vulnerability, toxicity, tissue penetrability, tumour disruption and anatomical location. Chemotherapy...
Chemotherapy of solid tumours is considered with respect to cell vulnerability, toxicity, tissue penetrability, tumour disruption and anatomical location. Chemotherapy to date has dealt primarily with the first two factors. Even when the cell is vulnerable to the agent used and host toxicity can be controlled, the other factors can lead to treatment failures. It is suggested that combinations of cytotoxic agents may be of more value than single agents. Timing and dosage are also considered. It is recommended that terminal cases and extremely toxic patients not be submitted to chemotherapy. In 78 patients with bronchogenic carcinoma, to whom nicotinic acid was given as a possible aid to tissue penetrability by nitrogen mustard, there was some indication that further similar studies might be of some value. Specific cases are summarized to illustrate the importance of various factors in the treatment of individual patients.
Topics: Breast Neoplasms; Cyclophosphamide; Fluorouracil; Humans; Mechlorethamine; Neoplasms; Thiotepa; Toxicology; Triethylenemelamine; Vinblastine
PubMed: 14127380
DOI: No ID Found -
The Journal of Investigative Dermatology Nov 1975Progressive repigmentation occurred in vitiliginous skin of two patients topically treated with aqueous solutions of mechlorethamine. Hairless mice were found to provide...
Progressive repigmentation occurred in vitiliginous skin of two patients topically treated with aqueous solutions of mechlorethamine. Hairless mice were found to provide what seems to be a satisfactory cutaneous system for evaluating potential melanogenic properties of topically applied test compounds.
Topics: Administration, Topical; Aged; Animals; Female; Humans; Male; Mechlorethamine; Melanins; Mice; Mice, Inbred Strains; Middle Aged; Mycosis Fungoides; Skin Neoplasms; Skin Pigmentation; Vitiligo
PubMed: 1194712
DOI: 10.1111/1523-1747.ep12608217 -
Proceedings of the National Academy of... Feb 2001Mass spectrometry and fluorescent probes have provided direct evidence that alkylating agents permeate the protein capsid of naked viruses and chemically inactivate the...
Mass spectrometry and fluorescent probes have provided direct evidence that alkylating agents permeate the protein capsid of naked viruses and chemically inactivate the nucleic acid. N-acetyl-aziridine and a fluorescent alkylating agent, dansyl sulfonate aziridine, inactivated three different viruses, flock house virus, human rhinovirus-14, and foot and mouth disease virus. Mass spectral studies as well as fluorescent probes showed that alkylation of the genome was the mechanism of inactivation. Because particle integrity was not affected by selective alkylation (as shown by electron microscopy and sucrose gradient experiments), it was reasoned that the dynamic nature of the viral capsid acts as a conduit to the interior of the particle. Potential applications include fluorescent labeling for imaging viral genomes in living cells, the sterilization of blood products, vaccine development, and viral inactivation in vivo.
Topics: Animals; Aphthovirus; Aziridines; Capsid; Drosophila melanogaster; Mechlorethamine; RNA Viruses; Rhinovirus; Spectrometry, Mass, Electrospray Ionization
PubMed: 11226229
DOI: 10.1073/pnas.051598298 -
Blood Mar 1979
Review
Topics: Acid Phosphatase; Adrenal Cortex Hormones; Adult; Aged; Bone Marrow; Female; Humans; Leukemia, Hairy Cell; Liver; Lymph Nodes; Male; Mechlorethamine; Mercaptopurine; Middle Aged; Radiography; Spleen; Splenectomy
PubMed: 367468
DOI: No ID Found