MACOP-B                                           lymphoma(94,95)
 _________________________________________________________________
  methotrexate.... 400 mg/sqm IV at weeks 2, 6, and 10: with 

                   100 mg/sqm given IV bolus and with remaining 
                   300 mg/sqm infused over 4 h.
  leucovorin...... 15 mg orally every 6 h times 6 started 24 h 
                   after methotrexate bolus.
  adriamycin...... 50 mg/sqm IV at weeks 1, 3, 5, 7, 9, and 11.
  cytoxan......... 350 mg/sqm IV at weeks 1, 3, 5, 7, 9, and 11.
  vincristine..... 1.4 mg/sqm (maximum 2 mg/sqm) IV at weeks: 2, 
                   4, 6, 8, 10, and 12.
  prednisone...... 75 mg/day orally, dose tapered over the last 15 
                   days.
  bleomycin....... 10 U/sqm IV at weeks: 4, 8, and 12.
  FREQUENCY....... Regimen described is a single cycle.


  reference...
    Klimo P.  Connors JM. MACOP-B chemotherapy for the treatment 
    of diffuse large-cell lymphoma. Annals of Internal Medicine.  
    102(5):596-602, 1985 May. 
  abstract...
    Between April 1981 and May 1984, 61 patients with advanced 
    diffuse large-cell lymphoma completed treatment with MACOP-B 
    (methotrexate with leucovorin rescue, doxorubicin, 
    cyclophosphamide, vincristine, prednisone, and bleomycin), an 
    innovative pilot chemotherapy program emphasizing weekly 
    treatment, antibiotic prophylaxis, daily corticosteroid 
    treatments, and brief duration (12 weeks). Fifty-one patients 
    (84%) achieved a complete response and 10 patients (16%) had a 
    partial response. Over a median follow-up after treatment of 
    23 months, the actuarial overall survival for the entire group 
    has been 76%; for complete responders the relapse-free 
    survival has been 90%. Toxicity was modest with one 
    treatment-related death and seven episodes of serious 
    infection. The most frequent toxicity was mucositis. Thus, 
    MACOP-B is an effective treatment for large-cell lymphoma that 
    can be delivered in 12 weeks with an acceptable incidence of 
    toxicity. This regimen can achieve results similar and 
    possibly superior to those of other presently used regimens of 
    longer duration. 

  reference...
    Klimo P.  Connors JM. Updated clinical experience with 
    MACOP-B. Seminars in Hematology.  24(2 Suppl 1):26-34, 1987 
    Apr. 
  abstract...
    This paper summarizes our experience with MACOP-B chemotherapy 
    (methotrexate, doxorubicin, cyclophosphamide, vincristine, 
    prednisone, bleomycin) in 125 patients with advanced stage, 
    diffuse, large cell non-Hodgkin's lymphoma referred to the 
    Cancer Control Agency of British Columbia between April 1981 
    and June 1986. Complete response (CR) was achieved in 105 
    patients (84%), partial response (PR) in 18 patients (14.4%) 
    and primary treatment failure occurred in two patients (1.6%). 
    Fifteen of the PRs and both nonresponders succumbed to their 
    disease. Of the 105 CRs, 23 patients (21%) suffered a relapse; 
    14 of the relapsers eventually died from their lymphoma, five 
    are in second CR, three are receiving further therapy, and one 
    has histologic evidence of asymptomatic, low-grade lymphoma. 
    Three deaths were unrelated to lymphoma. Overall toxicity was 
    acceptable, with only six treatment-related deaths (4.8%). The 
    incidence of nonfatal systemic proven or suspected infections 
    was 10%. Mucocutaneous side effects remain the most frequent 
    toxicity of the MACOP-B protocol. More than half of the 125 
    patients received at least a portion of MACOP-B from community 
    oncologists. The results of treatment with MACOP-B remain at 
    least comparable to the best reported in the literature, yet 
    they have been achieved with less toxicity, over shorter 
    periods of time, and with diminished socioeconomic impact on 
    patients. However, improvement on these results is necessary 
    both in terms of efficacy and toxicity. A new variant of 
    MACOP-B is now being tested and our preliminary experience has 
    been encouraging.