Combination sequential chemotherapy in advanced reticulum cell sarcoma

Abstract

Based on studies of the chemotherapy of human leukemia and late stage animal neoplasms which may be kinetically analogous to disseminated reticulum cell sarcoma, a therapy program was devised using sequential cyclophosphamide-vincristine followed by weekly methotrexate-cytosine arabinoside. Each cycle of therapy consisted of cyclophosphamide 1.5 g/m2 on day 0 and vincristine 1.4 mg/m2 on days 1, 8, and 15; subsequently, 8 weekly doses of IV cytosine arabinoside 300 mg/m2 and oral methotrexate 120 mg/m2 over 24 hours were given followed by “Leucovorin rescue.” Fifteen patients received 3 such cycles with intervening 2-week recovery periods. Nine patients achieved complete remission, and 6 had a partial response. Median remission duration was 10 months. Median survival from onset of disease was 15+ months and from beginning of therapy was 14+ months. Five of 7 patients who have relapsed are dead. Toxic manifestations included neutropenia below 1000/mm3 in 10 patients; of these, there were recurrent episodes of sepsis in one. Alopecia occurred in 10, and reversible neurotoxicity in 8 patients.