title: Combination chemotherapy for advanced non-Hodgkin's lymphoma of unfavourable histology.
abstract: Thirty previously untreated adults with diffuse histiocytic and diffuse undifferentiated lymphoma were treated with a combination of adriamycin, vincristine, prednisolone, and L-asparaginase. Complete remission was achieved in 11 out of 12 cases with stage III and 7 out of 18 cases with stage IV disease (P less than 0.005). Bone marrow infiltration, clinical central nervous system involvement, and massive intra-abdominal disease all influenced the prognosis adversely. Complete remission was followed by cranial irradiation and intrathecal methotrexate, and maintained with weekly cyclophosphamide and methotrexate and daily 6-mercaptopurine. The duration of remission was significantly longer for patients with stage III disease (the median of which has not been reached), than for patients with stage IV disease (P = 0.007). Survival was significantly longer for patients in whom complete remission was achieved than for those in whom it was not (P = 0.001), and also for patients with stage III than for those with stage IV disease (P = 0.02).
mesh_terms: D000293:Adolescent; D000328:Adult; D001215:Asparaginase / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004317:Doxorubicin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011239:Prednisolone / Q000627:therapeutic use*; D011379:Prognosis; D013997:Time Factors; D014750:Vincristine / Q000627:therapeutic use*
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D011239:Prednisolone; D001215:Asparaginase