Thirty-one patients in first (n = 25) or second (n = 6) relapse of Hodgkin disease were eligible and evaluable. APE chemotherapy was well-tolerated, with the major toxicity consisting of short duration, grade 3/4 hematopoietic toxicity. The CR/PR response rate was 68% (42% CR, 26% PR). Allowing subsequent stem cell transplantation in some patients, 4-year EFS and OS were 27% +/- 8% and 49% +/- 9%, with 8-year EFS and OS of 23% +/- 9% and 34% +/- 10%.

APE is an efficacious regimen with minimal toxicity. Novel regimens are necessary to: (1) re-induce remission, (2) treat newly diagnosed patients, and (3) augment therapy in patients with slow response to standard regimens. This regimen had minimal toxicity and an excellent response rate that facilitated long term survival, often in conjunction with transplantation. The Children's Oncology Group is using a similar regimen to augment therapy for slow responders on a current Hodgkin disease trial.