STUART A. GROSSMAN, M.D.
To the editor: The article by Sweet and colleagues in the June issue (1) suggests that cyclophosphamide, vincristine, methotrexate with leucovorin rescue, and cytarabine (COMLA) should be considered "as an initial form of therapy in previously untreated patients with advanced diffuse histiocytic lymphoma." The authors state that the major advantages of this regimen are avoidance of the potential toxicities of bleomycin, doxorubicin, and prednisone and provision of some degree of protection from central nervous system relapse. These are not major advantages and are more than offset by disadvantages of this treatment regimen.
Both bleomycin and doxorubicin can be avoided in
GROSSMAN SA. Treatment for Histiocytic Lymphoma. Ann Intern Med. ;93:640–642. doi: 10.7326/0003-4819-93-4-640_3
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Published: Ann Intern Med. 1980;93(4):640-642.
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