Annals of Hematology

, Volume 88, Issue 7, pp 633–637 | Cite as

Comparison between hybrid MOPPABV and ABVD chemotherapy protocols for Hodgkin’s lymphoma in public hospitals of the largest South American city—a retrospective 14-year study

  • E. M. Souza
  • O. C. G. Baiocchi
  • M. A. Zanichelli
  • A. C. Alves
  • J. S. R. Oliveira
Original Article


The behavior of Hodgkin’s lymphoma (HL) is different in developing countries, perhaps due to differences in epidemiology and population access to health care. We performed a retrospective study comparing the efficacy of mechlorethamine, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, and vinblastine (MOPPABV) versus adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy protocols as first-line therapy for HL in a Brazilian population. A hundred and eighty-six HL patients were retrospectively analyzed regarding their first-line treatment with MOPPABV and ABVD at two public hospitals in São Paulo, Brazil. Eligible patients were either previously untreated or at first relapse after being treated with only radiotherapy with confirmed HL diagnosis. At a median follow-up of 9 years, complete remission is 89.5 and 85.9 (P = 0.3), overall survival 93.8% and 89.6% (P = 0.68), disease-free survival 85.6% and 81.6% (P = 0.41), and relapse ratios 20.9% and 26.4% (P = 0.17) for ABVD and MOPPABV, respectively. Extended-field radiation therapy postchemotherapy was mostly used in the MOPPABV group. There were three cases of secondary neoplasm (colon adenocarcinoma, myeloid chronic leukemia, and non-Hodgkin’s lymphoma), all associated with MOPPABV. ABVD and MOPPABV protocols as first-line treatment for HL resulted in similar therapeutic outcomes and did not influence overall survival, disease-free survival, and relapse ratio. MOPPABV was related to a higher risk of secondary malignancy and, therefore, ABVD should be considered a better option for HL therapy. These findings corroborate recent data in literature.


Hodgkin’s Lymphoma Chemotherapy Overall survival 


  1. 1.
    Ayres MMA Jr (2005) Bioestatistica—Aplicações estatísticas nas áreas das ciências bio-médicas. Instituto de Desenvolvimento sustentável Mamirauá 45:124–175Google Scholar
  2. 2.
    Bonadonna G, Zucali R, Monfardini S, De Lena M, Uslenghi C (1975) Combination chemotherapy of Hodgkin’s disease with Adriamycin, bleomycin, vinblastine and imidazole carboxide versus MOPP. Cancer 36:252–259 doi:10.1002/1097-0142(197507)36:1<252::AID-CNCR2820360128>3.0.CO;2-7 PubMedCrossRefGoogle Scholar
  3. 3.
    Bonadonna G, Valagussa P, Santoro A (1986) Alternating non-cross resistant combination chemotherapy with ABVD or MOPP in stage IV Hodgkin’s disease: A report of eight year results. Ann Intern Med 104:739–746PubMedGoogle Scholar
  4. 4.
    Canellos GP, Anderson JR, Propert KJ, Nissen N, Cooper MR, Henderson ES et al (1992) Chemotherapy of advanced Hodgkin’s disease with MOPP, ABVD, or MOPP alternating with ABVD. N Engl J Med 327:1478–1484PubMedGoogle Scholar
  5. 5.
    Carbone PP, Kaplan HS, Musshoff K (1971) Report of the committee on Hodgkin’s disease staging. Cancer Res 31:1860–1861PubMedGoogle Scholar
  6. 6.
    Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM et al (1999) Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI sponsored International Working Group. J Clin Oncol 17:1244–1255PubMedGoogle Scholar
  7. 7.
    DeVita VT Jr, Simon RM, Hubbard SM, Young RC, Berard CW, Moxley JH et al (1980) Curability of advanced Hodgkin’s disease with chemotherapy. Ann Intern Med 92:587–595PubMedGoogle Scholar
  8. 8.
    Dores GM, Metayer C, Curtis RE, Lynch CF, Clarke EA, Glimelius B et al (2002) Second malignant neoplasms among long-term survivors of Hodgkin’s disease: a population-based evaluation over 25 years. J Clin Oncol 20:3484–3494 doi:10.1200/JCO.2002.09.038 PubMedCrossRefGoogle Scholar
  9. 9.
    Duggan DB, Petroni GR, Johnson JL, Glick JH, Fisher RI, Connors JM et al (2003) Randomized comparison of ABVD and MOPP/ABV hybrid for the treatment of advanced Hodgkin’s disease: report of an intergroup trial. J Clin Oncol 21:607–614 doi:10.1200/JCO.2003.12.086 PubMedCrossRefGoogle Scholar
  10. 10.
    Engert A, Ballova V, Haverkamp H, Pfistner B, Josting A, Dühmke E, German Hodgkin’s Study Group et al (2005) Hodgkin’s lymphoma in elderly patients: a comprehensive retrospective analysis from the German Hodgkin’s study group. J Clin Oncol 23:5052–5060 doi:10.1200/JCO.2005.11.080 PubMedCrossRefGoogle Scholar
  11. 11.
    Glick JH, Young ML, Harrington D, Schilsky RL, Beck T, Neiman R et al (1998) MOPP/ABV hybrid chemotherapy for advanced Hodgkin’s disease significantly improves failure-free and overall survival: the eight year results of the intergroup trial. J Clin Oncol 16:19–26PubMedGoogle Scholar
  12. 12.
    Goldie JH, Coldman AJ, Gudauskas GA (1982) Rationale for the use of alternating non-cross-resistant chemotherapy. Cancer Treat Rep 66:439–447PubMedGoogle Scholar
  13. 13.
    Hasenclever D, Diehl V (1998) A prognostic score for advanced Hodgkin’s disease. N Engl J Med 339:1506–1514 doi:10.1056/NEJM199811193392104 PubMedCrossRefGoogle Scholar
  14. 14.
    Hebel JR, Mccarter RJ (2006) Study guide to epidemiology and biostatistics. Jones and Bartlett, SudburyGoogle Scholar
  15. 15.
    Hoppe RT (1980) Radiation therapy in the treatment of Hodgkin disease. Semin Oncol 7:144–154PubMedGoogle Scholar
  16. 16.
    Klimo P, Connors JM (1985) MOPP/ABV hybrid program: combination chemotherapy based on early introduction of seven effective drugs for advanced Hodgkin’s disease. J Clin Oncol 3:1174–1182PubMedGoogle Scholar
  17. 17.
    Longo DL, Young RC, Wesley M, Hubbard SM, Duffey PL, Jaffe ES et al (1986) Twenty years of MOPP chemotherapy for Hodgkin’s disease. J Clin Oncol 4:1295–1306PubMedGoogle Scholar
  18. 18.
    Ng AK, Bernardo MVP, Weller E, Backstrand K, Silver B, Marcus KC et al (2002) Second malignancy after Hodgkin disease treated with radiation therapy with or without chemotherapy: long-term risks and risk factors. Blood 100:1989–1996 doi:10.1182/blood-2002-02-0634 PubMedCrossRefGoogle Scholar
  19. 19.
    Rosenberg SA, Kaplan HS (1985) The evolution and summary results of the Stanford randomized clinical trials of the management of Hodgkin’s disease: 1962–1984. Int J Radiat Oncol Biol Phys 11:5–22PubMedGoogle Scholar
  20. 20.
    Specht L, Gray RG, Clarke MJ, Peto R (1998) Influence of more extensive radiotherapy and adjuvant chemotherapy on long-term outcome of early-stage Hodgkin’s disease: a meta-analysis of 23 randomized trials involving 3,888 Patients. J Clin Oncol 16:830–843PubMedGoogle Scholar
  21. 21.
    Spector N, Costa MA, Pulcheri W, Salgado RC, Nucci M, Andrade CA et al (1993) C-MOPP/ABV yields good results in a public hospital population with Hodgkin disease in Brazil. Cancer 71:2823–2827 doi:10.1002/1097-0142(19930501)71:9<2823::AID-CNCR2820710923>3.0.CO;2-6 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • E. M. Souza
    • 1
  • O. C. G. Baiocchi
    • 1
    • 3
  • M. A. Zanichelli
    • 2
  • A. C. Alves
    • 1
  • J. S. R. Oliveira
    • 1
  1. 1.Departamento de Oncologia Clínica e ExperimentalFederal University of São Paulo (UNIFESP), Universidade Federal de São PauloSão PauloBrazil
  2. 2.Brigadeiro State Hospital of São Paulo, Hospital Estadual Brigadeiro (HEB)São PauloBrazil
  3. 3.São PauloBrazil

Personalised recommendations