This page discusses the use of chemotherapy for the treatment of Hodgkin's disease. For a thorough review of chemotherapy, please see the chemotherapy treatment monograph .

Cancer chemotherapy is the use of drugs to kill cancer cells. Unlike radiation and surgery, which are localized treatments, chemotherapy is a systemic treatment, meaning the drugs travel throughout the whole body. This means chemotherapy can reach cancer cells that may have spread, or metastasized, to other areas.

Hodgkin’s disease typically responds well to chemotherapy. The drugs are given in combination in cycles on multiple days. You may receive six to eight cycles of therapy. Between cycles the doctor will likely check your tumor status. This may involve a physical exam and x-rays or other tests. If the tumor continues to grow, the doctor will make changes to your treatment plan.

Chemotherapy is usually ordered before radiation treatment or if the disease recurs after treatment. Doctors are investigating using combined regimens that include both chemotherapy and radiation.

Successful initial treatment provides the best chance of survival.

Chemotherapy Drugs Used for Hodgkin’s Disease:

The following drugs may be given to treat Hodgkin's disease:

  • Bleomycin
  • Chlorambucil
  • Cyclophosphamide
  • Dacarbazine
  • Doxorubicin (Adriamycin)
  • Etoposide
  • Mechlorethamine
  • Nitrogen mustard
  • Prednisone
  • Procarbazine
  • Vinblastine (Velban)
  • Vincristine (Oncovin)

Combination Therapies

The combination of drugs recommended by your doctor will depend on the known side effects, your general health and age, and your doctor's familiarity with the regimens.

Cycles last four to six weeks. The different standard regimens may be combined.

Common combinations of chemotherapy drugs used to treat Hodgkin's lymphoma include the following:

MOPP, a four-week cycle

  • Nitrogen mustard, given intravenously (IV) on days 1 and 8
  • Vincristine, given by IV on days 1 and 8
  • Procarbazine, taken by mouth on days 1 through 14
  • Prednisone, taken by mouth on days 1 through 14

MVPP, a six-week cycle

  • Nitrogen mustard, given by IV on days 1 and 8
  • Vincristine, given by IV on days 1 and 8
  • Procarbazine, taken by mouth on days 1 through 15
  • Prednisone, taken by mouth on days 1 through 15

ChlVPP, a four-week cycle

  • Chlorambucil, taken by mouth on days 1 through 14
  • Vinblastine, given by IV on days 1 and 8
  • Procarbazine, taken by mouth on days 1 through 14
  • Prednisolone, taken by mouth on days 1 through 14

ABVD, a four-week cycle

  • Doxorubicin, given by IV on days 1 and 15
  • Bleomycin, given by IV on days 1 and 15
  • Vinblastine, given by IV on days 1 and 15
  • Dacarbazine given IV on days 1 and 15

VBM, a four-week cycle, given six times, followed by radiation

  • Vinblastine, given by IV on days 1 and 8
  • Bleomycin, given by IV on days 1 and 8
  • Methotrexate, given by IV on days 1 and 8

Stanford V, a four-week cycle, given three times, followed by radiation to tumors larger than 5 centimeters (cm) in size

  • Doxorubicin, given by IV on days 1 and 15
  • Vinblastine, given by IV on days 1 and 15
  • Nitrogen mustard, given by IV on day 1
  • Vincristine, given by IV on days 8 and 22
  • Bleomycin, given by IV on days 8 and 22
  • Etoposide, given by IV on days 15 and 16
  • Prednisone, taken by mouth every other day

NOVP, a three-week cycle, given three times, followed by radiation

  • Mitoxantrone, given by IV on day 1
  • Vincristine, given by IV on day 8
  • Vinblastine, given by IV on day 1
  • Prednisolone, taken by mouth on days 1 through 5

Effectiveness

The effectiveness of the various regimens is similar. Almost all patients with early-stage disease treated with both chemotherapy and radiation therapy achieve complete remission. Two-thirds of patients with advanced disease respond to chemotherapy when it is given at optimal doses.

Special Considerations

Many of these chemotherapy drugs are likely to cause infertility and premature menopause. If fertility is a concern to you, talk with your doctor about the possibility of storing sperm or eggs before starting therapy. Bleomycin and combinations with bleomycin are more prone to causing lung complications. Life-threatening side effects may delay treatment or result in lower doses.

For more information on chemotherapy, including side effects and how to manage them, please see the chemotherapy treatment monograph .