Pilot study of two adriamycin-based regimens in patients with advanced malignant lymphomas

Forty-two patients with advanced malignant lymphomas, all of whom had failed at least one prior course of chemotherapy, were treated with one of two new combination chemotherapy regimens to determine patient tolerability. Twenty-seven patients received regimen 1, after which this study was discontinued, and subsequently 15 additional patients were treated with regimen 2. Regimen 1 (BAP) consisted of BCNU and adriamycin administered iv on Day 1 and prednisone administered orally on Days 1--5 with cycles repeated at 21-day intervals. Regimen 2 (VAP) consisted of VP-16-213 given iv on Days 1 and 2, adriamycin given iv on Day 3, and prednisone given on Days 3--7 in a schedule designed to produce cell cycle synchronization; cycles were repeated at 21--28-day intervals. Both regimens were, in general, well tolerated. Reversible bone marrow depression was the major toxic reaction observed. Nine of 27 patients treated with regimen 1 and five of 15 patients treated with regimen 2 experienced objective tumor regressions. Tolerable dosage levels of both regimens have been defined for future clincial trials.