Phase II study of aziridinylbenzoquinone in refractory lymphoma

Aziridinylbenzoquinone (AZQ), an alkylating agent with lipophilic properties allowing CNS penetration, has been studied in a phase II trial in patients with refractory lymphoma. Thirty-five patients (ages, 24-84 years) have been treated using AZQ at a dose of 30 mg/m2 every 3 weeks. Nine patients (26%) have responded (complete responses for 14+, 12+, 4, 3, and 3 months; partial responses for 7, 2, 2, and 2 months). Seven of the nine responses were seen in patients with diffuse histologies, particularly diffuse histiocytic lymphoma. One of two patients with CNS lymphoma responded completely. Complete remissions were observed only in patients receiving not more than one prior chemotherapeutic protocol. The drug was well-tolerated. Neutropenia was brief and acceptable. However, cumulative thrombocytopenia occurred even in patients without prior nitrosourea therapy and necessitated significant dosage reductions with subsequent cycles. AZQ appears active in lymphomas, especially in diffuse histiocytic lymphoma. The possibility of using AZQ in CNS lymphoma should be further explored.