Hodgkin's Lymphoma: Results of ABVD Chemotherapy in 40 Patients with Advanced or Bulky Disease

During 1980-1986, 40 patients with advanced Hodgkin's disease or bulky disease were treated with six cycles of ABVD chemotherapy, and adjuvant radiotherapy was added to sites of bulky disease when required. Twenty-seven of the 40 patients (67.5%) were treated with ABVD as primary therapy and 13 (32.5%) received it as salvage therapy after initial failure. Twenty-seven patients (67.5%) had advanced stages 3 or 4 disease, while 13 (32.5%) had stage 2 with bulky mediastinal disease (more than 30% chest diameter). Only 7.5 % of the patients had no response to ABVD while 75% achieved CR and 17.5% PR. Seventy-four per cent of the patients with advanced stages 3 and 4 achieved CR and 15% reached PR, with only two failures to ABVD. The median survival for the entire group is currently more than 41 months, with a median disease-free interval (DFI) of 27.5 months for all treated patients. The results compare favorably with those reported from other major centers dealing with larger series of patients. New approaches for future treatment employing alternating shorter courses of MOPP/ABV are discussed, and the importance of radiotherapy for bulky disease is emphasized.