Adriamycin, the 14-hydroxylated derivative of the anti-leukemic drug daunorubicin, was administered to 33 patients with non-Hodgkin's lymphoma and 10 with Hodgkin's disease. Eighteen received adriamycin alone in a dose of 60 to 75 mg/sq m intravenously every 3 weeks. All 18 had been responsive initially but had become refractory to extensive combination chemotherapy. With adriamycin, five complete and four partial remissions were observed for a median duration of more than 7 months, with five patients still in remission. Sixteen patients who had proven refractory to initial combination chemotherapy or who had extensive bone marrow involvement including frank leukemic transformation received adriamycin in combination with cytosine arabinoside, vincristine, and prednisone. Four complete and four partial remissions were observed for a median duration of 2.5 months, with four patients still responding. In a third regimen, nine patients with minimal or no previous chemotherapy received adriamycin combined with cyclophosphamide, vincristine, and prednisone. All nine responded; seven complete and two partial remissions were observed for a median duration of more than 8 months, with six patients still in complete remission. For the 16 patients with complete remissions on all three regimens, the median duration of response is now more than 11 months. In the patients with non-Hodgkin's lymphoma, the response rate was similar in the different histological subtypes. Major side effects included nausea, alopecia, and myelosuppression, with the last side effect most pronounced in the combination with arabinosylcytosine. Our studies suggest that adriamycin is a new, effective agent in the treatment of patients with advanced malignant lymphoma. The response rate with the combination of adriamycin, cyclophosphamide, vincristine, and prednisone is particularly encouraging in non-Hodgkin's lymphoma, and this regimen is currently being further pursued in a larger multiinstitutional study.
Presented in part at the National Meeting of the American Federation for Clinical Research, Atlantic City, N. J., April 1972. Supported by Grants CA 05831, CA 10379, and CA 03754 from the National Cancer Institute, Bethesda, Md.