Mitoxantrone-containing combination chemotherapy in patients with non-Hodgkin's lymphoma]

Thirty-one patients with advanced non-Hodgkin's lymphoma were entered in a trial of a four-drug combination of mitoxantrone, cyclophosphamide, vincristine, and prednisolone (MCOP). This trial was intended to test the efficacy of substituting mitoxantrone for adriamycin in the CHOP combination, and to evaluate tumor response in patients who had received anthracycline antibiotic therapy. Of 31 patients, 25 were fully evaluated for tumor response and toxicity. There were 7 responses (4 complete, 3 partial) among 9 patients who had received radiation alone or chemotherapy not containing anthracycline antibiotics, whereas there were 7 responses (3 complete, 4 partial) in 16 patients who had been given anthracycline-containing chemotherapy. Median duration of response was 11+ weeks (range; 5 to 43+ weeks). The major toxicity was myelosuppression, although patients tolerated this well. This study suggested that mitoxantrone is not fully cross-resistant with anthracycline antibiotics and that MCOP is an effective regimen in patients with previously treated non-Hodgkin's lymphoma. However, when salvage chemotherapy for CHOP-failure is intended, cyclophosphamide and vincristine in MCOP should be further substituted by other agents such as etoposide and cis-platinum.