Uracil mustard revisited

BACKGROUND. A patient with diffuse large cell lymphoma who had a complete r esponse lasting 35 years following a 3-day course of uracil mustard stimula ted a recall review of patients treated with this oral alleviating agent. METHODS. Records of patients treated with uracil mustard between 1958 and 1 970 were reviewed. A current histologic review according to the Internation al Formulation was performed when possible. Total doses of uracil mustard w ere similar to those of mechlorethamine, although there were variations in the dose schedule. RESULTS. Employing criteria used over 25 years ago to evaluate patients' re sponses, the overall regression rate for 94 non-Hodgkin lymphoma patients w as 69.2% (complete response [CR] 23.4%). Of 62 patients with Hodgkin diseas e, 69.4% responded (CR 9.7%). For 39 patients with chronic lymphatic leukem ia, the combined complete and partial response rate was 74% (CR 7.7%). Thro mbocytopenia was the primary toxicity. CONCLUSIONS. Uracil mustard is an unmarketed, inexpensive oral alkylating a gent that has been effective in the treatment of patients with lymphoma, ch ronic lymphatic leukemia, and thrombocythemia. Perhaps it should be reevalu ated. Cancer 1999;85:2265-72. (C) 1999 American Cancer Society.