Cis-dichlorodiammineplatinum (cis-platinum) and etoposide (VP-16) in malignant lymphoma--an effective salvage regimen.

Response rates in malignant lymphoma after failure of first-line therapy are generally poor. Twenty-five patients with non-Hodgkin's lymphoma (NHL) unresponsive to standard combination chemotherapy were treated with cis-platinum/VP-16. All were heavily pretreated, 29% having received three or more different drug regimens. Seventeen patients were evaluable for response. There were five complete remissions (CR) (29%) and four partial remissions (PR) (24%), giving an overall response rate of 53% (36% of all patients treated). The duration of CR was 12-48 weeks. Median survival for responders was 25 weeks (15-95), compared with only 5 weeks (4-17) for non-responders (P = 0.002). Toxicity included nausea and vomiting, alopecia, minor renal impairment, and myelosuppression. This was sometimes severe: WBC less than 1.0 X 10(9)/l in three patients (18%) and platelets less than 50 X 10(9)/l in five patients (29%). The response rate for this combination is superior to that reported for either cisplatinum or VP-16 alone in similar patients (PR only 26% and 20%-30%, respectively). Further investigation is required to define the role of these drugs in the first-line treatment of poor-prognosis NHL.