Before the introduction of combination chemotherapy, more than 95% of patients with advanced HL succumbed to their disease within 5 years. Thus, remission rates in excess of 50% achieved with MOPP (mechlorethamine, vincristine, procarbazine, and prednisone) were a major breakthrough in oncology (J Clin Oncol 4:1295–1306, 1986; Ann Intern Med 92:587–595, 1980). MOPP was successfully introduced almost 40 years ago and used for many years for advanced stage disease, resulting in long-term remission of nearly 50% (J Clin Oncol 4:1295–1306, 1986; Ann Intern Med 104:739–746, 1986). It was then replaced by ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine), after a series of large multicenter trials had investigated ABVD vs. alternating MOPP/ABVD or MOPP alone (Ann Intern Med 104:739–746, 1986; J Clin Oncol 21:607–614, 2003; J Clin Oncol 5:27–37, 1987).