[Treatment for advanced malignant lymphoma in patients with compromised bone marrow--a combination therapy using pepleomycin, vincristine and high-dose adrenocorticoids (POP regimen)].

: It is often very frustrating for clinicians when in cases where Hodgkin's disease or non-Hodgkin's lymphoma is relapsing rapidly, sufficient doses of cytotoxic agents and/or radiation therapy cannot be given because of cytopenia due either to previous treatment or to bone marrow infiltration by the lymphoma. We have been treating such patients with a combination chemotherapy consisting of vincristine 0.25 mg/day i.v. push daily for 4 days, pepleomycin 5 mg/day s.c. by continuous infusion daily for 4 days, and prednisolone 1 g/day p.o. or methylprednisolone 1 g/day d.i.v. every other day for 4 days POP combination) administered every 2 to 3 weeks until an improvement in cytopenia occurs. Twelve patients with advanced non-Hodgkin's lymphoma, including 8 T-cell lymphoma patients, entered this pilot study when they were cytopenic or had been treated with cytotoxic agents or radiation therapy immediately prior to POP therapy. All patients responded and experienced more than 50% tumor reduction associated with improved general condition. Untoward effects included transient glycosuria, mild decline of serum immunoglobulin levels, herpes zoster and temporary aggravation of cutaneous or oral fungal infection in each of one to two patients. Since this treatment is switched to other forms of treatment when bone marrow function has recovered, duration of the response cannot be determined. The survival time was rather short because of poor general condition and aggravation of concurrent active pulmonary infection before the start of treatment. This treatment is sufficient effective, however, to be tried on patients with active lymphoma, not necessarily associated with poor bone marrow function, unless active infection supervention.