Background: This analysis was undertaken to assess the relationship between the dose intensity of initial chemotherapy and outcome in a large cohort of patients with advanced Hodgkin lymphoma (HL) treated in a randomised controlled trial, in which detailed dose data were collected prospectively. Patients and methods: Three hundred eighty patients randomised to receive standard ABVD who underwent at least 2 cycles of treatment were studied. With a median follow up of 6.9 years, progression-free survival (PFS) from the end of cycle 2 was analysed according to dose intensity (DI) during those cycles. Results: During the first 2 cycles, 25% of patients received more than 97% of planned DI, 37% received between 86% and 97% and 38% received less than 86%. DI during the first 2 cycles was correlated with DI during the remainder of the course, but there was no evidence that early DI influenced PFS (hazard ratio 0.87, 95% CI 0.67-1.11; p=0.265). Multivariate analysis also failed to confirm the influence of early DI on PFS or overall survival (OS). Conclusion: At the range of DI delivered in a multicentre trial using conventional therapy, there is no clear evidence that early DI influences outcome. This should be tested in a prospective study.