Combination chemotherapy with CHOP (cyclophosphamide, Adriamycin, vincristine, and prednisone) and HOP (Adrimycin, vincristine, and prednisone, was used as treatment for patients with pathologically staged, advanced non-Hodgkin's lymphoma. Among 204 evaluable patients treated on CHOP there were 71% complete remissions with 92% overall responses. Among the 216 evaluable patients on HOP there were 61% complete remissions and 88% responses. Complete remission rates among patients with histiocytic lymphoma were comparable to those of patients with lymphocytic disease. Patients with nodular lymphoma had higher rates of complete remission than their counterparts with diffuse lymphoma. This was noted with both CHOP (78% vs. 67%) and HOP (67% vs. 60%) induction therapy. Rapid responses were common, as more than 14% of complete remissions and 66% of overall responses were achieved with the first course of treatment. Patients in complete remission have been maintained with either cyclophosphamide, vincristine, and prednisone (COP) or arabinosyl cytosine, vincristine, and prednisone (OAP). After 1 year, 86% of patients on COP and 80% on OAP are projected to be free of disease.

Fifty (5%) of 1039 patients with non‐Hodgkin's lymphomas registered on two Southwest Oncology Group clinical trials between 1972 and 1977 developed evidence of central nervous system (CNS) lymphoma. Thirty‐nine patients (3.7%) had leptomeningeal involvement, 10 patients (1%) had focal cerebral involvement and 2 patients (0.1%) had spinal cord compression. Cytologic examination of the cerebrospinal fluid (CSF) was the most reliable diagnostic technique. Patients with diffuse histologies and those with nodular histiocytic lymphoma had the highest incidence of CNS disease. Diffuse histiocytic lymphoma accounted for 22 patients with CNS involvement. Lymphoblastic lymphoma, convoluted type, was found in 6 patients, although in none was the diagnosis established prospectively. Patients who developed CNS lymphoma usually had extranodal disease and systemic symptoms at initial staging (90% stage IV, 54% “B” symptoms). The most commonly involved extranodal sites included the bone marrow (56%), gastrointestinal tract (26%), skin (18%), and lung (14%). CNS lymphoma was observed at all times during the clinical course but was most common in patients with active, poorly controlled disease. In 13 patients (26%), however, CNS lymphoma was the first sign of relapsing lymphoma. Median survival after recognition of CNS lymphoma was 2 months. The incidence of CNS disease was similar for 5 remission induction regimens employed, but maintenance chemotherapy with vincristine, prednisone and parenteral cytosine arabinoside appeared to substantially reduce the incidence of late CNS relapse (1 of 90 patients) compared to maintenance treatment with oral cyclophosphamide in place of cytosine arabinoside (9 of 90 patients, p = 0.02). This study indicates that there is a subgroup of patients with readily identifiable clinical and pathologic features who might benefit from prophylactic therapy to prevent CNS lymphoma.

The immunoglobulins are made up of heavy and light polypeptide chains (1, 2). There are three major classes of immunoglobulin (gamma globulins) that are commonly identified in normal human serum: the IgG (yG-, or 7 S y2-globulin), the IgA (yA-, ylA-, or /32A-globulin), and the IgM (yM-, YlM-, 12M-, or 18 S -yi-macroglobulin)

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One hundred thirty two patients with disseminated malignant melanoma were treated using a combination of BCNU, vincristine and imidazole carboxamide. A response rate of 23% was observed, while 16% had stable disease. The patients' median survival was 42 months from diagnosis and 5.3 months from the onset of treatment. These results are not significantly different from therapy with imidazole carboxamide alone. Patients on this study were observed to have a significant reduction in the number of lymphocytes in their peripheral blood (mean 1800/mm3, median 1550/mm3). Patients with lymphopenia prior to the onset of therapy (86%) had a similar response rate but a shorter median survival (4.4 months vs. 7.8 months, P = .03) than patients with normal lymphocyte levels. These findings are compatible with recent observations on the importance of host immunocompetence in patients with malignant melanoma. Eosinophil levels were not closely correlated with response, although among patients with eosinophil counts of greater than 300/mm3 (22%), a slightly higher response rate (29%) was observed (P = .13). Eosinophilia did not influence patient survival.