[A case of bilateral renal metastases from non Hodgkin's malignant lymphoma]

A patient with bilateral renal metastases from non Hodgkin's malignant lymphoma originating in the aortocaval abdominal lymph nodes was treated with chemotherapy. Initially, methotrexate (20 mg/m2), vincristine (0.6 mg/m2), cyclophosphamide (500 mg/m2), adriamycin (20 mg/m2), and bleomycin (30 mg/m2) were given on day 1, cisplatinum (50 mg/m2) was given on day 2, and prednisolone (20 mg/body) was given from day 1 to 3 (MVP-CAB regimen). Since the patient was 74 years old and had slight renal dysfunction, for the first and second courses of this therapy, methotrexate and cisplatinum were administered at 60% of the usual dose and the other 4 anticancer agents at 70% of the usual dose. Only prednisolone was given at the full dose. From the third course the 6 anticancer agents were used at 70% of the normal dose. Administration was performed every 4 weeks until the third course, and every 8 weeks after the fourth course (total number of cycles of MVP-CAB: 8 cycles). A marked improvement of the general state and a reduction of the tumor size were noted following treatment. Since regrowth of the residual tumor occurred, as second line chemotherapy cytosine arabinoside (100 mg/m2) on day 1, ifosfamide (1 g/m2) on day 1 to 2, etoposide (100 mg/m2) plus prednisolone (20 mg/body) on day 1 to 3 were administered (AraC-VIP regimen). The timing of administration was similar to that of the MVP-CAB regimen. More than 50% tumor reduction was obtained with this regimen. The total survival time since the beginning of chemotherapy is 2 years to date.