ACOMLA                                               lymphoma(83)
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  adriamycin...... 40 mg/sqm IV day 1.
  cytoxan......... 1,000 mg/sqm IV day 1.
  vincristine..... 2.0 mg IV on days 1, 8, and 15.
  methotrexate.... 120 mg/sqm IV weekly for 7 weeks starting at 3 
                   weeks (i.e. on days 22, 29, 36, 43, 50, 57, 64, 
                   and 71).
  cytarabine...... 300 mg/sqm IV administered 1 h after each dose 
                   of methotrexate.
  leucovorin...... 25 mg orally beginning 24 h after each 
                   methotrexate dose and repeated every 6 hours 
                   times 6.
  FREQUENCY....... Repeat cycle every 3 months for three cycles 
                   total.

  reference...
    Newcomer LN.  Cadman EC.  Nerenberg MI.  Chen M.  Bertino JR.  
    Farber LR. Prosnitz LR. Randomized study comparing 
    doxorubicin, cyclophosphamide, vincristine, methotrexate with 
    leucovorin rescue, and cytarabine (ACOMLA) with 
    cyclophosphamide, doxorubicin, vincristine, prednisone, and 
    bleomycin (CHOP-B) in the treatment of diffuse histiocytic 
    lymphoma. Cancer Treatment Reports.  66(6):1279-84, 1982 Jun. 
  abstract...
    Two combination chemotherapy programs, ACOMLA (doxorubicin, 
    cyclophosphamide, vincristine, methotrexate and leucovorin 
    rescue, and cytarabine) and CHOP-B (cyclophosphamide, 
    doxorubicin, vincristine, prednisone, and bleomycin), were 
    evaluated in 29 prospective randomized patients with advanced 
    diffuse histiocytic lymphoma. A complete response was achieved 
    in 13 of the 15 patients (87%) treated with CHOP-B and in nine 
    of the 14 patients (64%) treated with ACOMLA. The overall 
    complete response rate was 75%. Two patients treated with 
    ACOMLA and none of the CHOP-B-treated patients have relapsed. 
    Median followup is 32 months for ACOMLA patients and 26 months 
    for CHOP-B patients. Actuarial freedom from relapse at 2 years 
    is 49.9% for ACOMLA and 93.3% for CHOP-B (P = 0.04). Toxicity 
    was substantial, with eight nonfatal episodes of sepsis and 
    three drug-related deaths. There have been no central nervous 
    system relapses. Although patients treated with CHOP-B have a 
    better response rate, the small numbers of patients treated to 
    date preclude definitive conclusions.