I am writing in response to a grossly inaccurate statement recently published in Cancer. Van Scott et al., in an otherwise excellent article (Cancer 36:1613-1618, 1975) stated: "the prognosis of systemic mycosis fungiodes (MF) is similar to that of non-Hodgkin's lymphoma in general, i.e., unchanged by chemotherapy." The reference is to an article by Aisenberg which was outdated originally and clearly not relevant to the present situation.
Previous studies that we, and others, have reported's2 have shown excellent complete response rates in widespread nodular lymphoma with mean duration of complete remission of greater than 3 years.21a Of even greater importance is the demonstration by DeVita et al.' that histiocytic lymphoma is curable by chemotherapy. Recent evidence suggests that the percentage of patients who may be cured may be improved with newer regimens.'-'
Dr. Van Scott's pessimism regarding chemotherapy in non-Hodgkin's lymphoma cannot be justified, although I would share his feelings that visceral MF does very poorly. I am frankly unaware of any reported cases of MF with prolonged survival after visceral disease is detected. However, the potential value of appropriate chemotherapy should not be discounted on the basis of reported failures with traditional regimens. We are presently treating a 19-yearold man who presented with classical MF and developed extensive pulmonary disease (biopsy-proven). On the COMLA regimen,s~E effective in histiocytic lymphoma, pulmonary disease totally resolved and only minimal active skin disease persists. Follow-up is minimal, but if this response persists, further evaluation of such aggressive regimens would appear warranted.