ERYTHROCYTES Favism : Current Problems and Investigations

S 615 These four drugs were given simultaneously in intensive 2-wk periods of each mo for a 6-mo period. Since the simultaneous utilization of combinations ofdrugs may result in antagonism as well as potentiation ofeffect, a control group treated with the same drugs and with the same total dosage over a similar period of therapy, with the drugs used one at a time in a sequential manner, was necessary. Two hundred and forty-seven patients with disseminated Hodgkin’s disease were randomly treated with one of three intensive multiple-agent regimens. Partial or complete response rates of 90% were obtained with each one of these routines. The “MOPP” (mechlorethamine hydrochloride, yincristine sulfate, procarbazine hydrochloride, and prednisone) yielded the longest duration of response but had the highest toxicity. A second group of patients was treated by the ALB schedule. Therapy periods were defined at the first 2 wk of six successive 4 wk periods. Treatment in the first, third, and fifth periods consisted of vincristine sulfate and procarbazine hydrochloride. Treatment in the second, fourth and sixth periods consisted of yinblastine sulfate, chlorambucil, and prednisone. Another group of patients was treated by the sequential SEQ schedule. Drugs were given sequentially as single agents. The drugs were procarbazine hydrochloride taken orally each day for 28 days, followed by prednisone each day for 14 days, then vincristine sulfate iv. weekly for 4 wk, then prednisone taken orally each day for 14 days, then chlorambucil taken orally daily for 28 days, then prednisone taken orally each day for 14 days, then vinblastine sulfate administered intravenously weekly for 4 wk, and finally prednisone orally each day for 14 days. The total amount of each drug given over the 6 mo period was the same as in the ALB schedule. There was no difference in survival rates among patients on the three routines. Major factors associated with good response were female sex and little or no prior therapy. Minor favorable factors were stage III disease, lack of systemic symptoms, former responsiveness to therapy, and age of less than 60 yr. The simultaneous dosage routine was superior in both response rate and lessened toxicity, compared to sequential usage of the same drugs with the same total dosage.-M.G.B. A Decade of Combination Chemotherapy of Ad-. vanced Hodgkin’s Disease. V. T. DeVita, Jr., G. P. Canellos, and J. H. Moxley, Ill. Medical Branch National Cancer Institute, NIH, Bethesda, Md. Cancer 30:1495-1504, 1973. The history and success of combination chemotherapy of advanced Hodgkin’s disease is reported. Early results with combination of drugs for the treatment of acute childhood leukemia in 1963 prompted the first study with a similar philosophy of treatment in Hodgkin’s disease. The agents used at that time were ymca alkaloids, alkylating agents, prednisone and methotrexate. The results were encouraging enough to lead to an expanded program substituting procarbazine for methotrexate. This combined drug program was called MOPP. MOPP therapy has yielded results significantly different from those previously achieved with single agents and has proved that combination chemotherapy in Hodgkin’s disease is the treatment of choice because it produced a higher rate of induction of complete remissions in patients with advanced Hodgkin’s disease (80%) and prolongation of remission duration after all therapy is stopped (36 mo). In comparison to results previously obtained with treatment by the use of single agents, it is definite that there is a doubling or tripling of the complete remission rate and an eight to tenfold increase in remission duration with MOPP therapy. Data from the NCI showed that approximately 70% of the patients with stages III and IV disease who achieved remission with combination chemotherapy between 1964 and 1967, are alive at 5 and 6 yr.-M.G.B. Prognosis and Survival of Patients With Chronic Lymphatic Leukemia. L. Donner, P. Klener, and Z. Roth. Department of Medicine, Charles University, Prague, Czechoslovakia. Cas Lek Cesk 112:710-714,1973. The prognosis and survival time of 208 patients with chronic lymphatic leukemia in the periods 1939-1953 and 1954-1968 were investigated. The survival time was established both from the time of appearance of the first symptoms of the disease and the time at which the diagnosis was made. The geometric means of survival time were obtained and the differences of the mean logarithms of survival time between individual groups under study were evaluated by the t test. The survival of patients aged 35-60 yr in the period 1954-1968 was significantly higher than in the period 1939-1953. There was no difference between the two groups in the survival time of patients aged 6 1-80 yr.L.D. Unusual Coincidence of Polycythemia Vera and Chronic Lymphadenosis. P. Klener and M. Bo anov#{243}. Department of Medicine, Charles University, For personal use only. on November 14, 2017. by guest www.bloodjournal.org From