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Fifty-nine consecutive previously untreated adult patients with acute lymphoblastic leukemia (ALL) were entered onto a prospective single-arm trial of doxorubicin, vincristine, prednisone, and asparaginase (HOP-L) induction therapy followed by CNS prophylaxis and 3 years of maintenance therapy. Consolidation therapy was not administered. The study population included a large number of older (greater than 50 years) patients. Seventy-five percent of patients achieved complete remission. With a median follow-up of 6 years, the median duration of complete remission is greater than 4 years, with 53% of patients expected to remain in remission at both 3 and 5 years. Overall, median survival duration is 27.9 months, with 45% and 35% of all patients expected to survive 3 and 5 years, respectively. Multivariate analysis identified patients with T-cell disease and mediastinal masses (P less than .001) and those with low values of lactic dehydrogenase (LDH) (P = .057) as being at greatest risk of relapse. Therapy was well tolerated by patients under age 35, but older patients suffered appreciable mortality. We conclude that this treatment program is effective therapy for adult ALL, yielding a large proportion of durable remissions despite the exclusion of consolidation therapy.

Razoxane (ICRF-159) was administered to 11 patients with Stage IV nodular sclerosing Hodgkin's lymphoma. A weekly schedule was employed with a starting dose of 1000 mg/m2 in divided doses. The dose was escalated up to 2000 mg/m2 weekly as tolerated. One objective partial remission was observed. The toxicity of the program was quite tolerable. Further trials of razoxane in this situation are not recommended.

Nine patients with extensive small-cell lung cancer were treated with a kinetically scheduled combination of cyclophosphamide, methotrexate by infusion, Adriamycin, and vincristine. There were two partial responses. No complete responses were noted. All patients progressed within 25 weeks of the initiation of therapy. In contrast to previously reported success with a similar kinetic schedule, we have found it to be ineffective in patients with extensive disease. Higher-dose therapy may be necessary to achieve better results in extensive small-cell lung cancer.