The treatment of combination chemotherapy‐resistant Hodgkin disease with single‐agent vinblastine

Abstract Vinblastine has been an effective single agent for initial induction therapy of advanced Hodgkin disease. To investigate the efficacy of this drug in combination chemotherapy‐resistant Hodgkin disease, 29 patients with Stage III or Stage IV disease who had previously received MOPP (nitrogen mustard, vincristine, prednisone, procarbazine) or C‐MOPP (cyclophosphamide, vincristine, prednisone, procarbazine) for initial remission induction were treated with vinblastine at the time of relapse, either as the first single agent at relapse (n = 17) or following unsuccessful attempts at reinduction with combination chemotherapy (n = 9) or other single agents (n = 3). Eighteen patients (62%) achieved an objective regression of disease. Two patients (7%) had a complete remission of nine and ten months duration and 16 patients (55%) had a partial remission with a median duration of four months. A response to combination chemotherapy did not predict for a vinblastine response, nor did nodal versus visceral involvement at time of relapse or initial stage of Hodgkin disease. There were no significant differences in age, sex, vinblastine dose, or disease duration between those patients who responded to vinblastine and those who did not. Patients with nodular sclerosis histology responded better to subsequent vinblastine therapy. Hematologic toxicity was moderate with 17 patients developing leukopenia (< 3,000 cells/mm3) and 12 patients developing thrombocytopenia (< 100,000 cells/mm3). The overall response rate of vinblastine in combination chemotherapy‐resistant Hodgkin disease is comparable to vinblastine single‐agent therapy for initial induction and appears not to be cross‐resistant with combinations containing vincristine.