Cyclophosphamide, Vincristine, Methotrexate with Leucovorin Rescue, and Cytarabine (COMLA) Combination Sequential Chemotherapy for Advanced Diffuse Histiocytic Lymphoma

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Abstract
Combination sequential chemotherapy using cyclophosphamide, vincristine, methotrexate with leucovorin rescue, and cytarabine (COMLA) was administered to 42 previously untreated patients with advanced diffuse histiocytic lymphoma. Patients (23) achieved a complete remission as determined by strict clinical restaging criteria. The observed median duration of survival for the complete responders is longer than 33 mo. Eight patients achieved a partial response, with a median survival longer than 21 mo. Eleven patients showed no response, with a median survival of 5 mo. Toxicity was acceptable. None of the responders have shown CNS relapse. There was no difference in response rates between patients with stage III or IV lymphoma or between asymptomatic or symptomatic patients. The COMLA program produces a high rate of complete and durable remissions and should be considered as an initial form of management of patients with advanced diffuse histiocytic lymphoma.