title: Vancouver hybrid: preliminary experience in the treatment of Hodgkin's disease in childhood and adolescence.
abstract: OBJECTIVE
  To describe our preliminary experience with 19 young patients with newly diagnosed Hodgkin's disease who received the Vancouver hybrid chemotherapeutic regimen.
  
  
  METHODS
  We summarized the characteristics of our 19 study patients, the treatment administered (between June 1988 and June 1992), and the outcome.
  
  
  RESULTS
  The Vancouver hybrid, which consists of mechlorethamine, vincristine sulfate (Oncovin), procarbazine hydrochloride, prednisone, doxorubicin hydrochloride (Adriamycin), bleomycin, and vinblastine sulfate (MOPP/ABV), was based on the hypothesis of preventing drug resistance by early introduction and alternation of all active agents and was aimed at decreasing the severity and frequency of treatment-related complications. Of our 19 patients with Hodgkin's disease (age range, 6 to 20 years) treated with this regimen, 2 had clinical stage I disease, 10 had stage II, 6 had stage III, and 1 had stage IV. Only two patients had systemic symptoms, and nodular sclerosis was the most common histologic feature. Patients were given four to eight cycles of chemotherapy, depending on the clinical stage of disease. In addition, 10 patients received irradiation, including 6 of 9 patients with bulky disease. In all patients, complete remission was achieved. After a median follow-up of 3.3 years, only two patients had had a relapse; both underwent autologous bone marrow transplantation and were alive and well with no evidence of disease at last follow-up. The treatment was well tolerated, and delivery of treatment was excellent. The only severe toxicity was myelosuppression; 8 patients experienced a total of 15 episodes of fever and neutropenia that necessitated hospitalization and antibiotic therapy, but no systemic infections were confirmed during 104 cycles of therapy.
  
  
  CONCLUSIONS
  The MOPP/ABV hybrid is an effective and well-tolerated therapy in most young patients with Hodgkin's disease. Long-term monitoring is needed to evaluate late effects.
authors.affiliation: Section of General Pediatrics and Pediatric Hematology/Oncology, Mayo Clinic Rochester, MN 55905.
authors.forename: S P
authors.initials: SP
authors.lastname: Khan
authors.forename: G S
authors.initials: GS
authors.lastname: Gilchrist
authors.forename: C A
authors.initials: CA
authors.lastname: Arndt
authors.forename: W A
authors.initials: WA
authors.lastname: Smithson
authors.forename: M G
authors.initials: MG
authors.lastname: Chen
authors.forename: P J
authors.initials: PJ
authors.lastname: Schomberg
authors.forename: J M
authors.initials: JM
authors.lastname: Matsumoto
authors.forename: W M
authors.initials: WM
authors.lastname: O'Fallon
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000009:adverse effects / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D002648:Child; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008466:Mechlorethamine / Q000009:adverse effects / Q000627:therapeutic use; D009367:Neoplasm Staging; D009503:Neutropenia / Q000139:chemically induced; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D011344:Procarbazine / Q000009:adverse effects / Q000627:therapeutic use; D011829:Radiation Dosage; D012008:Recurrence; D012074:Remission Induction; D016019:Survival Analysis; D014747:Vinblastine / Q000009:adverse effects / Q000627:therapeutic use; D014750:Vincristine / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D001761:Bleomycin; D011344:Procarbazine; D008466:Mechlorethamine; D014750:Vincristine; D014747:Vinblastine; D004317:Doxorubicin; D011241:Prednisone