Treatment of Hodgkin's disease in children with VAMP (vinblastine, adriamycin, methotrexate, prednisone) and VEPA (vinblastine, etoposide, prednisone, adriamycin)

Pediatr Hematol Oncol. 1999 Mar-Apr;16(2):141-8. doi: 10.1080/088800199277461.


Treatment of Hodgkin's disease in children should be directed at maximizing cures and minimizing the long-term effects of alkylating agents, anthracyclines, and bleomycin. In this study methotrexate and etoposide were used in the VAMP/VEPA regimens to treat 60 clinically staged pediatric patients with Hodgkin's disease. Twenty-nine patients with stages I-IIA received four courses of VAMP plus low-dose radiotherapy. Thirty-one IIA bulky disease and IIB-IVB patients received four or six courses of VEPA plus low-dose radiotherapy. There were 6 partial remissions after the completion of chemotherapy and all of these patients relapsed, but 4 were successfully salvaged with ABMT. Two patients have died. The 3.1-year overall survival rate is 97% (100% VAMP, 94% VEPA) and the event-free survival rate is 88% (97% VAMP, 77% VEPA). These results suggest that VAMP is a reasonable treatment for low stages of Hodgkin's disease, but more advanced disease is not adequately treated by VEPA and low-dose radiotherapy.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Disease-Free Survival
  • Dose-Response Relationship, Radiation
  • Doxorubicin / administration & dosage
  • Female
  • Hodgkin Disease / drug therapy*
  • Hodgkin Disease / mortality
  • Hodgkin Disease / radiotherapy
  • Humans
  • Male
  • Methotrexate / administration & dosage
  • Prednisolone / administration & dosage
  • Procarbazine / administration & dosage
  • Retrospective Studies
  • Survival Rate
  • Vincristine / administration & dosage


  • Procarbazine
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisolone
  • Methotrexate

Supplementary concepts

  • VAMP protocol
  • VAP-cyclo protocol