Hodgkin's Disease - Other Treatments

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Introduction	Staging and Treatment Guidelines	Immunotherapy
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Other Treatments

Chemotherapy uses drugs to kill cancer cells. The drugs are called cytotoxic medications. Chemotherapy is referred to as bodywide, or systemic, therapy because the drugs travel throughout the entire body.

Cytotoxic drugs may be taken by mouth or given by injection. Treatment may be administered at a medical center, doctor's office, or even a patient's home. Some patients receiving chemotherapy may need to remain in the hospital for several days so the effects of the drug can be monitored.

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Patients may receive up to 8 cycles of chemotherapy, depending on the stage. A cycle is usually 28 days and consists of several doses of drug administration followed by a period of rest.

Specific Drugs and Drug Combinations Used in Hodgkin's Disease

A number of chemotherapy regimens have proven to be effective. Different drugs in each regimen may need to be taken orally or by injection. Toxicity varies depending on the combination. Researchers are investigating the use of chemotherapy regimens used alone, taken in alternate cycles with another regimen, or as hybrids (combining one or two drugs from one regimen with drugs from another).

The following are regimens that are very effective in the treatment of Hodgkin's disease.

ABVD [doxorubicin (Adriamycin), bleomycin, vinblastine, dacarbazine] is now the first choice for most patients who need chemotherapy. It is the most effective and least toxic regimen available to date. Unlike MOPP, for example, it does not pose a significant risk for leukemia or infertility.
MOPP and MOPP-ABV. The introduction of MOPP [mechlorethamine (Mustargen), vincristine (Oncovin), procarbazine, prednisone] in the 1960s resulted in dramatic reductions in mortality rates from HD. A hybrid of MOPP and ABV [doxorubicin (Adriamycin), bleomycin, vinblastine] has often been used for advanced HD. MOPP can cause infertility and carries a 3% risk for leukemia, however.
BEACOPP (bleomycin, etoposide, Adriamycin, cyclophosphamide, vincristine, procarbazine, and prednisone). This regimen is proving to be very effective, particularly in advanced stages, with studies reporting remission rates of over 90% in patients with advanced Hodgkin's. The risk of long-term side effects, such as leukemia, requires longer follow-up.
Stanford V (Seven drugs administered over a shorter time but more frequently than MOPP or ABVD). Mechlorethamine (Mustargen), doxorubicin (Adriamycin), vinblastine (Velban), vincristine (Oncovin), bleomycin (Blenoxane), etoposide (VP-16), prednisone by mouth every other day. This regimen is proving to be effective for extensive and advanced HD, although it is not known whether it is superior to more standard regimens, such as ABVD.