MOPP regimen vincristine

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. 

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... 

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. 

Procarbazine, an antineoplastic agent (2 to 4 mg/kg/day for the first week) in combination with other antineoplastic agents (MOPP regimen—nitrogen mustard, vincristine, procarbazine, prednisone), is indicated in the treatment of stage III and IV Hodgkin s disease. Procarbazine inhibits the synthesis of protein RNA and DNA (see also Figure 15). 

The cell cycle-specific drugs used in standard treatment protocols for Hodgkin s disease are bleomycin and the vinca alkaloids. Vinblastine is used in the ABVD regimen, and vincristine (Oncovin) is used in the MOPP regimen. The answer is (E). 

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... 

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. 

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. 

Clinical use Vincristine is a component of the MOPP and COP combination dmg regimens and is used in acute leukemias, lymphomas, Wilms tumor, and choriocarcinoma. Vinblastine is a component of the ABVD regimen for Hodgkin s disease and is used for other lymphomas, neuroblastoma, testicular carcinoma, and Kaposi s sarcoma. 

Registered trademark of Merck. Used in combination chemotherapeutic regimens, i.e., MOPP mustine (Mustargen), vincristine (Oncovin),procarbazine,prednisone (not to be confused with other MOPP and NBC protection clothing). 

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