Chemotherapy of malignant lymphoma

Between January 1976 and December 1980, 16 patients with advanced Hodgkin's Disease and 70 patients with Stage III and Stage IV Non-Hodgkin's lymphoma were treated with combination chemotherapy, 12 patients with Hodgkin's disease were treated with nitrogen mustard, vinblastine, procarbazine (MVPP). 4 patients received MVPP. 4 patients received MOPP (O = vincristine). 69% of the patients showed disease remission. 25% of the patients achieved complete remission. 58 patients with advanced non-Hodgkin's lymphoma were treated with the quadruple drug combination of cyclophosphamide, vincristine, procarbazine and prednisolone (COPP). 21% of the patients with non-Hodgkin's lymphoma developed a frankly leukaemic transformation which complicated management. Response rate to COPP therapy was 44% for all patients. 43% of the patients showed no response to treatment. Of the patients who showed disease remission with COPP, 52% achieved a complete remission. Percentage survival at 2 years for all patients was 14% compared with 47% for patients with complete remission. Using the Rappaport classification for histological subtype in non-Hodgkin's lymphoma, 61% of diffused poorly differentiated lymphoma showed disease remission compared to 47% remission in diffused histiocytic lymphoma. Only 33% of lympho-blastic lymphoma responded to COPP. Patients with leukaemic transformation did not respond to COPP. 9 of 15 patients with a leukaemic phase showed partial remission with combination chemotherapy. Majority of patients on combination chemotherapy showed evidence of drugs toxicity both in the Hodgkin's group and the non-Hodgkin's group. Major drug toxicities were myelosuppression and neurotoxicity.