MOPP therapy

This is present in mechlorethamine (Mustargen), which is used in patients with Hodgkin s disease and other lymphomas, usually in combination with other drugs, such as in MOPP therapy (mechlorethamine, Oncovin [vincristine], procarbazine, and prednisone). It may cause bone marrow depression. 

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. 

Longo DL, Young RC, Wesley M, et al. Twenty years of MOPP therapy for Hodgkin s disease. J Clin Oncol 1986 4 1295-306. 

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%. 

MOPP-(Combined therapy with nitrogen mustard, vincristine, procarbazine, and prednisone) (and other combined therapies)... 

Items 11-12 A 23-year-old man with Hodgkin s disease was treated unsuccessfully with the MOPP regimen. He subsequently underwent a successful course of therapy with the ABVD regimen. 

The anticancer drug most commonly associated with pulmonary toxicity is bleomycin. If pulmonary dysfunction with infiltration developed, the drug would be discontinued. High-dose steroids and empiric antibiotic therapy would also be indicated. Note that procarbazine (not listed), used in the MOPP regimen for Hodgkin s lymphoma, may also cause cough and pleural effusions. The answer is (A). 

Protective Posture. What was the level of mission-oriented protective posture (MOPP) Was there face mask or suit damage Did the face mask fit adequately When was the filter changed How well trained was the soldier in using the appropriate protective posture, in making clinical observations, and in choosing appropriate therapy Were other factors present (eg, consumption of alcoholic beverages, exposure to other chemicals, psychiatric status) ... 

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