MACE-MOPP                                            lymphoma(99)
 _________________________________________________________________
  etoposide....... 120 mg/sqm IV day 1.
  cytoxan......... 650 mg/sqm IV day 1.
  adriamycin...... 25 mg/sqm IV day 1.
  methotrexate.... 500 mg/sqm IV over 12 h on day 15.
  leucovorin...... 50 mg/sqm orally every 6 h times 4 beginning 24 
                   hours after methotrexate. 
  mechlorethamine. 6 mg/sqm IV day 8.
  vincristine..... 1.4 mg/sqm IV day 8.
  prednisone...... 60 mg/sqm/day orally from day 1 to day 14.
  procarbazine.... 100 mg/sqm/day orally from day 8 to day 14.
  FREQUENCY....... Repeat cycle every 28 days.


  reference...
    Fisher RI.  DeVita VT Jr.  Hubbard SM.  Longo DL.  Wesley R.  
    Chabner BA. Young RC. Diffuse aggressive lymphomas: increased 
    survival after alternating flexible sequences of proMACE and 
    MOPP chemotherapy. Annals of Internal Medicine.  98(3):304-9, 
    1983 Mar. 
  abstract...
    A new treatment program was developed in an attempt to 
    increase the complete remission rate and survival of 
    previously untreated patients with advanced stages of diffuse 
    aggressive lymphomas. A flexible number of cycles of ProMACE 
    chemotherapy (prednisone, methotrexate, doxorubicin, 
    cyclophosphamide, and epipodophyllotoxin VP-16) was alternated 
    with a flexible number of cycles of MOPP chemotherapy 
    (mechlorethamine, vincristine sulfate, procarbazine, and 
    prednisone), and finally late intensification with ProMACE 
    therapy was given. The duration of each phase of treatment was 
    determined by the patient's rate of tumor response. Complete 
    remissions were achieved in 55 of 74 patients (74%) with a 
    median duration of follow-up exceeding 2 1/2 years. Only ten 
    of the complete responders (18%) have had relapse. The 
    dose-limiting toxicity is myelosuppression, and eight patients 
    (10%) died from sepsis. Median survival for all patients has 
    not been reached but is predicted to exceed 4 years with 65% 
    of patients alive at 4 years. Previously we achieved a 46% 
    complete remission rate with 38% of all patients alive at 4 
    years; relapse-free survival beyond 2 years was tantamount to 
    cure. Therefore, ProMACE-MOPP chemotherapy represents a 
    substantial improvement in treating patients with diffuse 
    aggressive lymphomas.