Hodgkin's Disease - Other Treatments

Other regimens continue to be tested for effectiveness and safety in both early and late stage HD. They include the following:

ChlVPP (chlorambucil, vinblastine, procarbazine, and prednisone). Studies are showing that it is effective in specific patients. For example, it is proving to be to beneficial and less toxic for children. In one 2002 study, a hybrid regimen using ChlVPP and another regimen containing doxorubicin improved response compared to ChlVPP alone for elderly patients.
VAPEC-B (vincristine, doxorubicin, prednisolone, etoposide, cyclophosphamide, and bleomycin). This is a short-course regimen that might be useful in some patients, although it is not as effective as others.

text continues below

Regimens with fewer toxic effects, such as ChlVPP and others, are being tested in children and adolescents in early stages, with some showing promise. Certain drugs, such as etoposide, cause less injury to male reproductive organs and can be substituted for more toxic drugs, notably procarbazine.

Specific regimens are also being studied for elderly patients.

Drugs Used with Relapsed or Previously Untreatable HD. For patients who relapse or have only partial remissions other drugs, called salvage chemotherapy, may be needed or high-dose chemotherapy may be used in combinations with stem cell transplantation.

Common regimens include the following:

BEAM [carmustine (BCNU), VP-16, cytosine arabinoside, and melphalan] is used with stem cell transplantation. (An alternative regimen known as mini-BEAM uses lower doses and is used without stem cell transplantation.)
CBV [cyclophosphamide, carmustine (BCNU), etoposide (VP-16)] is used with stem cell transplantation.

Other drugs or combinations are showing promise for relapsing or previously untreatable Hodgkin's and including the following:

ASHAP [doxorubicin (Adriamycin), methylprednisolone (Solumedrol), high-dose cytosine arabinoside, and cisplatin (platinum)]
DHAP (dexamethasone, cytarabine, cisplatin)
GEM-P (gemcitabine, cisplatin and methylprednisolone)

Drugs that have shown some effectiveness in combinations for relapsed or progressive HD in children and adolescents include cisplatin plus regimens with high-dose cytarabine, ifosfamide, carboplatin, and etoposide and ifosfamide plus vinorelbine. Gemcitabine has shown promise as a single drug in patients with relapsed Hodgkin's disease.

Sequential High-Dose Chemotherapy. A promising approach called sequential high-dose chemotherapy employs few drugs given at the highest possible doses and administered at intervals of1 to 3 weeks.