A 6-DRUG REGIMEN (MAPECO) FOR INTERMEDIATE OR HIGH-GRADE NON-HODGKINS-LYMPHOMA

Forty-eight patients with intermediate and high-grade NHL were treated with an intensive weekly six-drug regimen of methotrexate, doxorubici n, prednisolone, etoposide, cyclophosphamide and vincristine (MAPECO) between 1982-1988 and now have a median follow-up of 4.8 years. Ninete en of these patients received an intensified derivative of this regime n with the incorporation of bleomycin. Histological sub-type showed in termediate grade in 28 and high grade in 20 patients. Forty-five patie nts received the 4 planned cycles, and all patients achieved an object ive response, of whom 36 (75%) entered complete remission. At 5 years, the actuarial survival of the 48 patients was 50%. Of the 36 patients achieving complete remission, the relapse-free survival at 5 years wa s 62%. The 5-year time to treatment failure was 48% for the whole grou p and 40% for the 22 stage III + IV patients. Histological sub-type ha d no effect on survival and time to failure curves. Neutropenic fever occurred in 15 patients and grade 3/4 mucositis was seen in 25. The MA PECO combination is an effective intensive regimen with acceptable tox icity for intermediate and high-grade lymphoma.