Treatment of Hodgkin's Disease in Children with Vamp (Vinblastine, Adriamycin, Methotrexate, Prednisone) and Vepa (Vinblastine, Etoposide, Prednisone, Adriamycin)
Abstract
Treatment of Hodgkin's disease in children should be directed at maximizing cures and minimizing the long-term effects of alkylating agents, anthracyclines, and bleomycin. In this study methotrexate and etoposide were wed in the VAMP/VEPA regimens to treat 60 clinically staged pediatric patients with Hodgkin's disease.
Twenty-nine patients with stages I-IIA received Sour courses of VAMP plus low-dose radiotherapy. Thirty-one IIA bulky disease and IIB-NB patients received four or six courses of VEPA plus low-dose radiotherapy.
There were 6 partial remissions after the completion of chemotherapy and all of these patients relapsed but 4 were successfuly salvaged with ABMT: Two patients have died. The 3. 1-year overall survival rate is 97% (100% VAMP: 94% VEPA) and the event-free survival rate is 88% (97% VAMP 77% VEPA).
These results suggest that VAMP is a reasonable treatment for low stages of Hodgkin's disease, but more advanced disease is not adequately treated by VEPA and low-dose radiotherapy.