CONTINUOUS VERSUS INTERMITTENT PREDNIMUSTINE TREATMENT OF NON-HODGKINS-LYMPHOMA

Seventy-eight patients with advanced non-Hodgkin's lymphomas were rand omized for treatment with prednimustine (Sterecyt) in two different sc hedules: either receiving continuous treatment at a dosage of 60 mg da ily, or intermittent two-week courses with 200 mg daily for five days. The aim of the study was to compare efficacy and side effects of the two different schedules. Forty patients received continuous, and 38 pa tients intermittent treatment. Objective response was achieved in 66% of 71 evaluable patients, equally distributed between the two treatmen t arms. The 10-year survival rate was 20% (SE = 6%; continuous treatme nt) and 11% (SE = 5%; intermittent treatment), respectively (logrank p = 0.26). Median time to response, duration of response and time to pr ogression showed no significant difference between the treatment group s. Median time on treatment was longer for patients treated continuous ly, probably due to more easily performed dose adjustments in such pat ients. There was a significant decrease of the white blood cell counts in patients who received prednimustine continuously compared with tho se treated according to the intermittent schedule (p = 0.02). No signi ficant differences were found regarding the thrombocyte levels. The re sponse rate was closely related to haematological toxicity (p = 0.01). Our results suggest that prednimustine in non-Hodgkin's lymphomas has similar effectiveness both in daily treatment and in a two-weekly int ermittent schedule. Continuously given treatment may be easier to gove rn and, thereby, allow for higher treatment intensity. With respect to toxicity, daily doses of approximately 30-40 mg in previously untreat ed patients may be recommended.