1988 Volume 29 Issue 5 Pages 688-693
(2''R)-4'-O-tetrahydropyranyladriamycin (THP) is a new anthracycline with effect equal or superior to that of adriamycin, and with less toxicities in experimental animals. Clinical phase I and II studies confirmed its effect on non-Hodgkin's lymphomas (NHL); cardiotoxicity was minial. We incorporated THP in one of the two regimens for an alternating, presumably non cross-resistant chemotherapy for NHL, which consisted of THP 40 mg/m2 iv D1, cyclophosphamide 500 mg/m2 iv D1, vincristine 1 mg/m2 iv D1 & 8, prednisolone 60 mg/m2 po D1-5 (THP-COP). The other regimen consisted of N4-behenoyl ara-C 100 mg/m2 iv D1-5, VP-16 60 mg/m2 iv D1-5, methotrexate 200 mg/m2 iv D8 & 15, and prednisolone 40 mg/m2 po D1-5 (BHAC-VMP). Three courses of THP-COP were administered first, followed by three courses of BHAC-VMP. After complete remission (CR) these two regimens were administered alternately for a total of 12 courses or until relapse. Twenty patients have been entered and all were evaluable: M/F, 12/8; mediun age 57.5 yr (22∼79); clinical stage II 3, III 8, IV 9; histology, follicular medium cell sized 3, and diffuse 17 (small cell 1, medium cell sized 6, mixed cell 2, large cell 7, lymphoblastic 1).
Sixteen patients achieved CR, among whom 8 only after 1 course of THP-COP. The median remission duration and survival were 7.5 (1∼30) months and 11.5 (3∼31) months, respectively. All 11 patients with stage II and III, and 5 out of 9 stage IV patients achieved CR. Side effects included myelosuppression, mild gastrointestinal symptoms, neurotoxicity, hair loss and others which were all tolerable; no cardiotoxicity was observed within total dose of THP up to 530 mg/m2. THP-COP was quite effective as a CR-inducer in NHL. A longer observation, however, is necessary for evaluation of effectiveness of the alternating non-cross resistant chemotherapy as a whole on survival.
