V. J. HARVEY, M.D.; P. I. THOMPSON, M.B., Ch.B.
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To the editor: Significant progress has been made in the treatment of diffuse large-cell lymphoma in recent years with the use of several intensive combination chemotherapy programs. In 1985, Klimo and Connors (1) reported a study in 61 patients treated with MACOP-B combination chemotherapy (methotrexate with leucovorin rescue, doxorubicin, cyclophosphamide, vincristine, prednisone, bleomycin) with impressive early results. This regimen was modified several times during its development, including the substitution of bleomycin for methotrexate in patients whose creatinine clearance was less than 60 mL/min.
We are concerned that this modification is potentially dangerous and should not be recommended. It may have
HARVEY VJ, THOMPSON PI. Bleomycin and Mild Renal Failure. Ann Intern Med. ;105:976. doi: 10.7326/0003-4819-105-6-976_1
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Published: Ann Intern Med. 1986;105(6):976.
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