Lymphoma Information Network - MOPP Chemotherapy

Lymphoma Information Network - Hodgkin's Disease and the Non-Hodgkin's Lymphomas

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MOPP, developed in the mid 1960's, was the first combination chemotherapy regimen for treating Hodgkin's lymphoma (disease) with a high success rate. It has been used alone or in combination (in part or total) with ABVD chemotherapy. Studies over the last few years seem to indicate ABVD is just as effective with fewer long term effects. MOPP may now be used as a "salvage" chemotherapy after relapse or where the patient has allergies, lung or heart problems which do not allow use of ABVD.

MOPP is even used for animal lymphomas.

Regimen Drugs:

The following are the drugs used in the regimen. Select a drug to see a page and pertinent information:

Mustargen (generic name mechlorethamine, MSD, mustine or nitrogen mustard)
Vincristine (also called Oncovin or VCR)
Procarbazine (also called Matulane or possibly Natulan)
Prednisone (sometimes called Deltasone or Orasone)

Before starting the regimen:

Read information on each drug. You should discuss your treatment thoroughly with your doctor/medical team. Items to mention include if you are pregnant, have a history of of health problems prior to treatment.

This regimen may cause permanent sterility (shown to be more severe than ABVD). You may want to discuss with your medical team options such as sperm banking. The harvesting of ova is a rapidly evolving field - please ask about the latest information if you wish to pursue this option.

This regimen may also cause hair loss. The patient may wish to consider wigs or head coverings such as hats & scarves. Skin sensitivity caused by procarbazine may make sun protection a necessity.

Administration:

MOPP may be administered in cycles of 4 weeks. A common treatment regimen is for 6 cycles. The exact number of cycles given is dependent on the treatment prescribed by the medical team.

Mustargen and Vincristine are usually administered by intravenous drip (into the vein). If burning or pain occurs from a drug you may want to ask the administrator (often a nurse trained in chemotherapy administration) to slow down the drug infusion. Procarbazine and prednisone are pills taken by mouth over a period of several days.

The doses are determined by square meters of body area. I have seen different dosing in the references below so I refrain from selecting one - please refer to qualified medical personnel for exact dosing.

Drugs that may be given with MOPP are:

Zofran or Kytril - for nausea
Zantac - to help stomach upset

If you feel side effects while receiving the drugs in the medical facility notify the staff. Common discomforts are chills (which can be remedied by a warm blanket) and frequent urination. Burning or red streaks at the IV site should be noted immediately.

Items to consider while on this regimen:

Ask about drinking more fluids. Also some regimen drugs may cause constipation which should be closely monitored. Your doctor may prescribe a laxative to help.
Ask your medical team about which pain relievers to take while on this regimen - some drugs thin the blood which is not recommended while on chemotherapy.
Procarbazine interacts with some foods! See the page on this drug and ask your doctor for more information.
Prednisone may cause several mood and body altering effects. Read the prednisone page and speak to your medical team on coping with the effects.

Side Effects:

These drugs can cause nausea, vomiting, and loss of appetite. There are medications your doctor may prescribe such as Zofran or Kytril that may lessen chemotherapy induced nausea.
Fatigue is common during chemotherapy treatment. Proper rest and pacing oneself may be helpful.
The drugs will make your hair tend to fall out (alopecia) - you might consider headcoverings.
Treatments can be delayed if the patient has a low white blood cell count (neutropenia). Blood counts can be raised by drugs such as Granulocyte Colony-Stimulating Factor (G-CSF, brand name NeupogenŽ) - a drug used to stimulate the production of granulocytes in the bone marrow.
For support, see the Surviving Lymphoma section

Long Term:

As noted above, infertility is an important issue to consider.
Treatment with this protocol has a slight chance of causing secondary leukemia. According to NCI (1/99), the risk of acute myelogenous leukemia is approximately 3%, with the peak incidence occurring 5-9 years after therapy.

Latest Studies: (new)

A 2003 study confirms ABVD should be the standard treatment over MOPP/ABD in advanced Hodgkin's (article)

Resources for Information on MOPP:

Tirgan Oncology page on MOPP (US)
MOPP information from Li's Site (US)
Chemotherapy Regimens for Hodgkin's from
Medicine On Line
Information on peripheral neuropathy
Books on Lymphoma Treatment including chemotherapy

Reference:

Hodgkin's Disease, Peter M. Mauch (Editor), James O. Armitage (Editor), Volker Diehl (Editor), June 1999. Very recent and complete with articles on all aspects of diagnosis, treatment, etc. Written for medical professionals and expensive but worth it if you are an avid researcher of information on Hodgkin's.

Disclaimer: This information is general in nature. Please consult with a doctor or the literature provided with the drugs if you need specific information on a drug. The author is not responsible for missing or inaccurate information and the reader assumes full responsibility for their actions. As always, please consult with medical personnel before undertaking any medical treatment.

For more information on Adult Hodgkin's Disease, please see the following pages: :

For more information on Childhood Hodgkin's Disease, please see the following pages:

Childhood Hodgkin's Disease: Chemotherapy

Childhood Hodgkin's Disease: Treatment

Childhood Lymphoma: Resources

Childhood Bone Marrow and Stem Cell Information Page

Childhood Hodgkin's Disease: Diagnosis

Childhood Hodgkin's Disease: Introduction

The Main Page - gateway to support and more

The Lymphoma Information Network

This page is a work in progress - if you have more complete information, references, or other information please contact the author. The author is not in the medical field and does not warrant the correctness of the material on this page or the sites linked - please take online information and consult with your own medical team to make informed decisions.

Hodgkin's Chemotherapy - MOPP