Modified cyclophosphamide, vincristine, methotrexate, leucovorin, and cytarabine (COMLA) in intermediate- and high-grade lymphoma: an effective short-course regimen.

Twenty-one patients with intermediate- and high-grade lymphomas were treated with modified cyclophosphamide, vincristine, methotrexate, leucovorin, and cytarabine (COMLA). This regimen utilizes the drugs used in COMLA in similar doses, but cyclophosphamide is given twice as frequently, cytarabine is given by continuous infusion, and the total duration of therapy is reduced to 16 weeks. Complete remission rates were 80% in patients with intermediate-grade lymphomas and 67% in patients with high-grade lymphomas. Persistent complete remission rates were 60% and 33%, respectively, with a median follow-up of 26 months for surviving patients. This regimen was myelotoxic, but there were no toxic deaths. Modified COMLA is a relatively nontoxic regimen producing excellent results in intermediate-grade lymphomas.