Uracil-chlorethamine in the Treatment of Lymphoma

Abstract

Twenty-four patients with advanced lymphoma were treated with uracil-chlorethamine. The starting dose was 2 to 3 mg by mouth daily until maximum therapeutic effect or severe hematologic toxicity developed. This period of time ranged from 20 to 185 days (median 30) for a total dose ranging from 0.7 to 5.1 mg/kg (median 1.3). Maintenance treatment was given to 13 patients at the dose of 1 mg per day for 5 to 7 days per week. In the induction phase, therapeutic effects were obtained in 13 out of 24 (54 %), all pretreated patients. However, complete or incomplete remissions were observed in only 5 out of 24 (21 %) cases. Severe, although reversible, hematologic toxicity (i. e. blood leukocytes < 1000 and/or platelets < 50.000/mmc) was observed in 5 out of 24 cases. It was not strictly dose-related and it was often unpredictable. Altogether, as remission inducer, uracil-chlorethamine appeared to be moderately active and not easy to handle. On the other hand the drug proved able to maintain or improve a remission (induced by the same or other agents) for periods of time up to 24 months (median 6), with minimal or no toxicity.