Non-Hodgkin's lymphoma. A four-drug regimen suitable for elderly patients with advanced disease

Twenty-eight patients with non-Hodgkin's lymphomas considered unsuitable for doxorubicin containing combination chemotherapy were given the four-drug combination chlorambucil, mitoxantrone, procarbazine and prednisolone every 3 weeks. The median age of the patients was 69 years and 15 had received prior treatment. Non-haematological toxicity was WHO grade I or II in all cases. Five patients had grade 4 neutropenia of which 3 were associated with fever and one was fatal. The complete response rate was 32% and the overall response rate 61%. The actuarial survival of the 17 responding patients at 12 months was 68%. This outpatient regimen produced good compliance among elderly patients, and modest toxicity with acceptable response rate and survival for the study population.