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ICML: ChlVPP/EVA hybrid chemotherapy effective against Hodgkin's disease By Tim Allmark and Claudia Orellana LUGANO, SWITZERLAND -- June 21, 2002 -- The ChlVPP/EVA hybrid chemotherapy regimen is effective for previously untreated Hodgkin’s disease, according to a prolonged follow up study. The results were presented here last week at the 8th International Conference on Malignant Lymphoma (ICML) Researchers led by Dr. John Radford from the Manchester Lymphoma Group, Christie Hospital in Manchester, United Kingdom followed-up 701 patients with previously untreated Hodgkin’s disease who were in stage I/II (plus mediastinal bulk and/or B symptoms) or stage III/IV and who participated in one of two consecutive randomized phase III trials In the first trial, the researchers randomly assigned 415 patients to treatment with eight cycles of on the following treatments: · ChlVPP/EVA hybrid. Chlorambucil 6 mg/m² , procarbazine 90 mg/m², prednisone 50 mg on days 1-7, etoposide 75-100 mg/m² intravenously (IV) on days 1-5, vincristine 1.4 mg/m² IV on day 1, vinblastine 6 mg/m² IV, and adriamycin 50 mg/m² IV both on day 8 of a 28 day cycle · MVPP. A 42 day cycle with mustine 10 mg IV, vinblastine 10 mg IV on days 1 and 8; procarbazine 150 mg on days 1-14; and prednisone 50 mg on days 1-14) In the second trial the investigators randomly assigned 282 patients to one of the following: · six cycles of ChlVPP/EVA hybrid · VAPEC-B (11 weekly cycles). Adriamycin 35 mg/m² IV on weeks 1, 3, 5, 7, 9, and 11; cyclophosphamide 350 mg/m² IV on weeks 1, 5, and 9; etoposide 75-100 mg/m² on weeks 3, 7, and 11; vincristine1.4 mg/m² IV, bleomycin 10,000IU/m², both on weeks 2, 4, 6, and 8; and prednisone 50 mg daily to week 6, then tail to zero over ten days, plus prophylactic ketoconazole/co-trimoxazole during the entire treatment. In both trials, patients received consolidation radiotherapy upon completion of chemotherapy to sites of initial bulk or residual abnormality, based on computed tomography (CT) scanning. Treatment with ChlVPP/EVA hybrid resulted in better free from progression (FFP) and overall survival (OS) rates than either VAPEC-B or MVPP. Moreover, according to pooled data from both trials, incidences of secondary acute myeloblastic leukaemia (AML) or myelodysplastic syndrome (MDS) among those treated with ChlVPP/EVA hybrid was 1 percent at five years and 1.6 percent at 10 years. Similarly, the incidence of other second malignancies was 2.5 percent at five years and 4.9 percent at ten years in this group. "It is clear that ChlVPP/EVA hybrid has a substantial advantage over the two regimes it was compared with in these to trials," said Dr. Radford. "These are very promising results for the patients, especially when considering the low incidence of secondary AML and MDS". E-mail this page to a friend or colleague! To print, use this version