A new anthracycline analog, epirubicin (4'-epi-Adriamycin) was evaluated at 
eleven institutes in a phase II clinical study in patients with malignant 
lymphoma. Epirubicin was administered intravenously mainly with using the 
following two regimens; 50 to 60 mg/m2 every three weeks and 40 mg/m2 weekly. A 
total of 46 cases were entered into the study and 41 cases were evaluable. 
Clinical responses, complete plus partial remissions, were observed in 27 cases 
(65.9%) with 8 of these showing complete remission. There was no significant 
difference of response between the two regimens. Response rates taking into 
account previous chemotherapy were 90.9% (10/11) in previously nontreated cases, 
61.9% (8/13) in cases previously treated with non-anthracyclines and 52.9% 
(9/17) in cases treated with anthracyclines. The major adverse effect was bone 
marrow suppression; leukopenia was observed in 83.8%, anemia in 60.5% and 
thrombocytopenia in 15.4%. Other adverse effects frequently observed were 
anorexia (59.0%), nausea-vomiting (48.8%) and alopecia (55.6%). These adverse 
effects seemed milder than those produced by doxorubicin. The results indicated 
that epirubicin seemed to be a markedly useful drug against malignant lymphoma.