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When uncomplicated neutropenia during doxorubicin (Adriamycin), bleomycin, vinblastine and dacarbazine (ABVD) chemotherapy for the treatment of Hodgkin's lymphoma is encountered, it is unclear whether or not treatment should be modified. In the present study, we determined the incidence of neutropenia, febrile neutropenia, and the relationship of febrile neutropenia to grade III/IV neutropenia and dose modification, in a large university patient population. We reviewed the charts of patients diagnosed with Hodgkin's lymphoma between 1 January 1990 and 31 December 2002 who were treated with ABVD chemotherapy, and seen at the University of Iowa with complete diagnosis, staging, and treatment dosing records. Adequate data was available on 894 treatments in 81 patients with Hodgkin's lymphoma treated with ABVD chemotherapy. Grade III/IV neutropenia was present on the scheduled day of treatment in 187 (20.9%) treatments in 64 (79%) patients. Grade III/IV neutropenia was most common at cycle 1 day 15. Febrile neutropenia developed nine times in eight patients, and eight episodes of febrile neutropenia developed when the treatment-day absolute neutrophil count (ANC) > or =1000. Dose delay of >4 days and/or dose reduction to

Until recently, the monitoring of elections in a sovereign country by outside actors was extremely rare. The United Nations (UN) had significant experience in conducting plebiscites and elections in dependent territories but did not monitor an election in a formally independent country until 1989 when it reluctantly became involved in the Nicaraguan electoral process. At the regional level, the Organization of American States (OAS) occasionally sent small delegations to witness elections in member states, but these missions were too brief to permit any real observation of the processes, and failed to criticize fraud.1 Since the 1980s election-monitoring has become increasingly common in transitional elections from authoritarian to democratic rule. Non-governmental organizations (NGOs), domestic and international, were the first to become involved in election-monitoring in the 1980s followed by international and regional organizations like the UN, the OAS and the Organization for Security and Cooperation in Europe (OSCE) in the 1990s. Election-monitors played a crucial role in transitional elections held in the Philippines (1986), Chile (1989), Panama (1989), Nicaragua (1990) and Haiti (1990). In addition, elections began to form a crucial element of UN ‘peacebuilding’ strategies in countries torn apart by civil strife such as Namibia (1989), Cambodia (1993) and El Salvador (1994).