Abstract
Seventeen patients with advanced, previously treated Hodgkin's disease received therapy with a combination of streptozotocin 500 mg/m^2^ /day i.v. days 1β5, CCNU 100 mg/m^2^ orally day 1, adriamycin 45 mg/m^2^ i.v. day 1, and bleomycin 15 mg/m^2^ i.m. days 1 and 8 at 28βday intervals (SCAB). The overall response rate was 59% with six patients (35%) achieving complete remission and four patients (24%) entering partial remissions. No maintenance therapy was given and the median duration of complete remission was 8+ months (range 2+β18+ months), while the median duration of partial remission was only 2 months (range 2β3 months). The median duration of survival from the start of therapy for the complete responders was 16+ months (range 5+β25+ months) while the median survival for the partial and nonresponders was only 5 months (range 2β13 and 3β11+ months, respectively). Toxicity was a major problem with this drug combination. Myelosuppression occurred regularly and was severe after 25% of courses. There were two death directly related to drugβinduced myelosuppression. Other serious toxicities included bleomy cinβinduced pulmonary toxicity in three patients, with one death; renal tubular dysfunction secondary to streptozotocin in three patients; hepatic dysfunction in three patients and severe weight loss in three patients. SCAB has proven to be an active although toxic combination which is not crossβresistant to MOPPβtype regimens. Alterations in drug dosages and scheduling are being evaluated in an effort to ameliorate toxicity and preserve efficacy.