Based on studies of the chemotherapy of h u m a n leukemia and late stage animal neoplasms which may be kinetically analogous to disseminated reticulum cell sarcoma, a therapy program was devised using sequential cyclophosphamidevincristine followed by weekly methotrexate-cytosine arabinoside. Each cycle of therapy consisted of cyclophosphamide 1.5 g/mz on day 0 and vincristine 1.4 mg/m? on days 1, 8, and 15; subsequently, 8 weekly doses of IV cytosine arabinoside SO0 mg/mz and oral methotrexate 120 mg/mz over 24 hours were given followed by "Leucovorin rescue.'' Fifteen patients received 3 such cycles with intervening 2-week recovery periods. Nine patients achieved complete remission, and 6 had a partial response. Median remission duration was 10 months. Median survival from onset of disease was 15+ months and from beginning of therapy was 14+ months. Five of 7 patients who have relapsed are dead. Toxic manifestations included neutropenia below lOOO/mm3 in 10 patients; of these, there were recurrent episodes of sepsis i n one. Alopecia occurred in 10, and reversible neurotoxicity in 8 patients.
HILE IMPROVED CHEMOTHERAPY FOR
Hodgkin's disease has recently led to an improved prognosis,6 disseminated reticulum cell sarcoma has continued to be viewed with pessimism by many physicians. Although