Between 1967 and 1977, 48 patients with Hodgkin's disease under 16-yearsold were treated with MOPP chemotherapy alone at the Uganda Cancer Institute because radiotherapy facilities are not available. Thirty-eight percent had early stage disease (stages I-IIIA). Prolonged first remissions were achieved in 74% of 42 complete responders. Of 11 patients who relapsed, 5 had prolonged second remissions induced by MOPP. Three patients were lost to follow-up and 15 of the remaining 45 died: 12 of these from progressive Hodgkin's disease, 2 from unrelated causes and 1 from Burkitt's lymphoma after 4 months remission from Hodgkin's disease. Acturial survival for all patients is 67% (75% for stages I-IIIA and 60% for stages IIIB -1V). Treatment complications included Herpes roster and gynaecomastia. The latter is probably related to gonadal dysfunction. All stages of childhood Hodgkin's disease can be successfully managed with MOPP chemotherapy alone.
Cancer 42:787-792, 1978.
ODGKIN'S DISEASE CAN be divided into H three and possibly four epidemiological varietie~.~,'~ Type 1, characterized by high rates in children and a preponderance of those histologic types associated with poor prognosis, is found in developing countries with suboptimal socioeconomic conditions. Type I1 is found in rural areas of Western countries and the incidence rate is intermediate between I and 111. Type I11 is seen in the urban populations of Europe and North America and is characterized by high rates in young adults and a preponderance of those histologic subtypes associated with a good outcome. Type IV is observed in Asia and shows low incidence rates at all ages. Epidemiologic type I has been reported from South America. Lebanon and East A f r i ~a .