[Sequential chemotherapy of malignant non-Hodgkin's lymphoma of high degree of malignancy in stages III and IV].

A sequential combination chemotherapy was used in the treatment of advanced high-grade malignant non-Hodgkins' lymphomas (NHL) from July 1978 to August 1980. The lymphomas were classified according to the Kiel-classification. Cyclophosphamide, vincristine, bleomycin, prednisone (phase A) were followed by a combination of adriamycin, cytosine arabinoside, 6-thioguanine and prednisone (phase B). Patients received four cycles of both combinations. No maintenance therapy was given. 20 patients with centroblastic, lymphoblastic or immunoblastic NHL were included in the study. The overall remission rate was 95% (19 out of 20 patients). 15 (75%) patients entered complete remission. The median duration of complete remission was 28.7 months. The probable survival rate of the patients entering complete remission is 64.5% at two years. Clinical prognostic factors, bone marrow infiltration, extralymphatic organ involvement other than skin and a tumor mass greater than 10 cm in diameter in a single location significantly affected remission induction and survival. All patients with favourable prognosis are still alive in unmaintained complete remission 14 to 38 months after start of treatment. Patients with unfavourable prognosis had a complete response rate of 64% and a median survival of 14.8 months.