RICHARD S. STEIN, M.D.
To the editor: Although Fisher and associates (1) have proclaimed ProMACE (prednisone, methotrexate, doxorubicin, cyclophosphamide, and epipodophyllotoxin VP-16)-MOPP (mechlorethamine, vincristine sulfate, procarbazine, and prednisone) as a "substantial improvement in the treatment of diffuse aggressive lymphomas as compared with previously used regimens," a careful rereading of their paper suggests that this may not be the case.
Their discussion compares the 48% continuous disease-free survival achieved with other regimens, such as COMLA (cyclophosphamide, vincristine, methotrexate, and cytarabine), with the 75% complete remission rate and 65% survival rate achieved with ProMACE/MOPP. However, survival is not disease-free survival. Fisher and associates report a 74%
STEIN RS. Chemotherapy for Diffuse Aggressive Lymphomas. Ann Intern Med. ;101:397–398. doi: 10.7326/0003-4819-101-3-397
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Published: Ann Intern Med. 1984;101(3):397-398.
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