Biweekly chlorambucil treatment of lymphocytic lymphoma

Forty patients with lymphocytic lymphoma were treated with escalating doses of chlorambucil biweekly starting at a dose of 0.4 mg/kg. Fifty percent of patients achieved a complete remission, usually after 6-12 months of therapy. Overall response rate was 80%. Bone marrow involvement did not indicate an adverse prognosis, with 56.5% achieving a complete remission and an overall response rate of 87%. Hematologic toxicity was mild with only three patients showing moderate granulocyte toxicity and two patients showing moderate platelet toxicity. Severe bone marrow toxicity was not observed. Patients with diffuse lymphocytic tissue histology had the poorest response rates--well differentiated 27.3% and poorly differentiated 33.3%. Nodular lymphocytic lymphomas had the best response rates with the well-differentiated type, having 69.2% complete remission and poorly differentiated types having 60.0% complete remissions. Biweekly chlorambucil is an excellent regimen for nodular lymphocytic lymphomas, comparing favorably to combination chemotherapeutic regimens.