Experiences in the Treatment of Neoplastic Disease with Nitrogen Mustard *

The reintroduction of poison gas in warfare by the Germans in 1915 stimulated experimental studies, both in the clinic and in the animal laboratory, on the effect of these agents upon various body structures. Between 1919 and 1921 several reports1'5,6,78 appeared describing the changes produced by mustard gas. The recent world conflict stimulated further research relating to the properties of the old gases and of new derivatives that might be used in combat. In the course of these studies evidence was incidentally uncqvered which suggested that one of the derivatives had potentialities for effective therapeutic use in malignant disease. Owing to security restrictions imposed by the war, the results of these latter studies were kept secret until April 1946 when an article by Gilman and Philips2 appeared in Science describing the biological actions and therapeutic applications of the nitrogen mustards. Later that year two other reports3' 4 were published relating the accumulated experience of several investigators in the use of this drug in 126 cases of neoplastic disease and allied disorders of the hematopoietic system. The purpose of this communication is to record the results obtained in treating a group of similar diseases at the Tumor Clinic of the Yale University School of Medicine. The series to be presented is admittedly small. Its chief usefulness probably lies in the fact that it may be added to other series and, by increasing the total number of observations, make possible a more accurate statistical analysis of the whole. The trends observed in this small series compare favorably with those noted by other investigators. During the past three years 16 patientst with neoplastic disease have been treated with a nitrogen mustard derivative, methyl-bis