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, 22 of 24 evaluable patients have achieved a complete response. Four patients have 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 underwent ABMT, achieved a CR, but relapsed after two months and died with progressive disease. Four patients have relapsed: one is in second CR following ABMT, one has relapsed following a short CR after ABMT; two others are currently receiving therapy. Twenty-three of 24 evaluable patients are alive: 21 free of disease, two with Hodgkin's disease. No unexpected toxicities have been observed with this treatment.
