This protocol was designed to treat the subset of Hodgkin's disease patients who are at highest risk for treatment failure. From the previous study of advanced Hodgkin's disease, we have identified patients with Stage IIIB, IVB, IVA (marrow) and massive mediastinal Hodgkin's disease as having lower response rates and survival. In order to improve the efficacy of MOPP therapy in this group of patients, the dose-intensity of all drugs has been increased and GM-CSF is given to ameliorate the severe myelotoxic effects of the increased drug doses. To date, 10 of 12 evaluable patients have achieved a complete response. One patient has relapsed. One patient who was an induction failure has since undergone an allogeneic bone marrow transplant and achieved a complete response. The other induction failure is currently undergoing salvage therapy and is too early to evaluate. The one relapsed patient underwent ABMT, but relapsed following a short CR. He is currently receiving other therapy and is too early to evaluate. All evaluable patients are alive and free of disease at this time. No unexpected toxicities have been observed with this treatment.
