MOPP regimen mechlorethamine

Nitrogen mustard is clinically used for the treatment of lymphomas and some forms of lung cancer. The major indication for mechlorethamine is Hodgkin s disease as a part of the MOPP regimen (mechlorethamine + vincristine (oncovin) + procarbazine + prednisone). The usual dose consists of 6 mg/m2 on days 1 and 8. This drug has pronounced hematological toxicity (myelo-suppression). 

The chemotherapy of advanced Hodgkin s disease is one of the best examples of successful combination chemotherapy. Combination therapy with the MOPP regimen (mechlorethamine, Oncovin [vincristine sulfate], procarbazine, prednisone), alternating with ABVD (Adriamycin [doxorubicin hydrochloride], bleomycin, vinblastine, dacarbazine), has resulted in cure rates of 50 to 60%. 

The major indication for mechlorethamine is Hodgkin s disease the drug is given in the MOPP regimen (mechlorethamine, vincristine, procarbazine, prednisone see Chapter 55). Other less reactive nitrogen mustards are now preferred for the treatment of non-Hodgkin s lymphomas, leukemias, and various solid tumors. 

Therapeutic applications Mechlorethamine is used primarily in the treatment of Hodgkin s disease as part of the MOPP regimen (Mechlorethamine, Oncovin, Prednisone, Procarbazine), and is also useful in the treatment of some solid tumors. 

Procarbazine is an alkylating agent that is used in the treatment of Hodgkin s disease in regimens such as MOPP (chlormethine (mechlorethamine), vincristine (Oncovin), procarbazine, and prednisolone) and BEACOPP (bleomycin, etoposide, doxorubicin (Adriamycin), cyclophosphamide, vincristine, procarbazine, and prednisone) (1). It is also used to treat glioblastoma multiforme. 

Clinical use Mechlorethamine is best known for use in the MOPP regimen (see below) for Hodgkin s disease. 

More recently, a German study compared a dose-escalated regimen of BEACOPP (with filgrastim support) with standard-dose bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone, gemcitabine (BEACOPP) and COPP alternating with ABVD (C—cyclophosphamide instead of mechlorethamine for MOPP).18 The escalated BEACOPP was... 

One of the initial combination chemotherapy regimens introduced in the early 1960s that was shown to produce cures in advanced Hodgkin s disease was the MOPP (mechlorethamine, vincristine [Oncovin], procarbazine, and prednisone) regimen (see Table 129-6)P MOPP chemotherapy has been a mainstay of treatment for patients with stage III and IV advanced Hodgkin s disease. According... 

Ever since MOPP therapy was created and the efficacy confirmed, researchers tried to modify the regimen in an attempt to improve efficacy and decrease toxicity. Some MOPP variations include MVPP (vinblastine substituted for vincristine), CVPP (cyclophosphamide substituted for mechlorethamine), and ChlVPP (chlorambucil substituted for mechlorethamine, and vinblastine substituted for vincristine) were attractive alternatives to MOPP because they offered equal efficacy and differing or less severe toxicities. The various combination chemotherapy regimens appear to produce initial complete response rates in over 80% of the patients treated, and result in a 55% to 65% cure rate for advanced Hodgkin s lymphoma. 

Mechlorethamine HCl (Mustargen) was formerly used primarily in the combination chemotherapy regimen MOPP (mechlorethamine, vincristine [Oncovin], procarbazine, and prednisone) in patients with Hodgkin s disease. It is given by intravenous bolus administration in doses of 6 mg/m on days 1 and 8 of the 28-day cycles of each course of treatment. It has been largely replaced by cyclophosphamide, melphalan, and other more stable alkylating agents. It also is used topically for treatment of cutaneous T-cell lymphoma as a solution that is rapidly mixed and applied to affected areas of skin. 

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