Nineteen patients with generalized lymphoma were treated with large intermittent intravenous doses of cyclophosphamide. Five patients experienced a complete response, and 2 had a partial response. The median duration of complete response was 22 months. Toxicity was not intolerable. Published results of response rates in lymphoma to various chemotherapeutic agents are summarized, Factors which contribute to survival in patients with lymphoma are discussed. It is suggested that further evaluation of large intermittent doses of cyclophosphamide be made in view of the favorable results.
T HAS BEEN OVER A DECADE SINCE THE SYNTHE-I sis of cyclophosphamide (Cytoxan*) was announced, and the drug has become a useful agent in the treatment of a variety of human neoplasms. Experience with the murine L1210 leukemia10 and AKR lymphoma2 systems indicated that large intermittent doses of Cytoxan possess greater therapeutic activity and a wider margin of safety than daily treatment at maximally tolerated doses. Bergsagell recently demonstrated that several single doses of u p to 2 g/m2 intravenously of Cytoxan were tolerated without progressive hematopoietic toxicity when the agent was administered every 17-24 days to patients with lung cancer for as long as 36 weeks. I n the therapy of Burkitt's lymphoma, it has been shown that daily oral or weekly parenteral doses of Cytoxan are not as effective as single large doses of 40 mg/kg (1500 mg/m2) in inducing long-term remi~sion.~ The present report presents the clinical and therapeutic data from 19 patients with malignant lymphoma treated with large intermittent intravenous doses of Cytoxan. METHOD All patients were referred to the National Cancer Institute's Baltimore Cancer Research Center with a confirmed diagnosis of malig-From the Medical Service of the Baltimore Cancer