Long-term Survival of Patients with Hodgkin's Disease: Treatment With Cyclophosphamide, Vinblastine, Procarbazine, and Prednisone

Thirty-eight patients with advanced Hodgkin's disease were treated with a combination of cyclophosphamide, vinblastine, procarbazine, and prednisone (CVPP); the minimum period of observation for surviving patients was five years. Twenty-eight patients (74%) achieved complete remission; in 17 (61%), remissions lasted at least five years. Twenty-five (66%) of the 38 patients survived more than five years from the initiation of CVPP. There were no differences in either rates or duration of response when evaluation was performed for multiple pretreatment clinical features. However, survival was adversely influenced by advanced age, nodular sclerosis histologic subtype, and pretreatment bone marrow involvement. Two patients died, in remission, of overwhelming viral infections, and acute nonlymphocytic leukemia developed in one patient. In another patient, aseptic necrosis of the heads of both femora developed. Our data suggest that treatment with CVPP may result in long-term disease-free survival for patients with advanced Hodgkin's disease.