Delivery and funding are provincial matters in Canada.

The following article is one of a series that deal with the provision of health care services around the world. Other countries in the series include Germany, Italy, Japan, Mexico, the Netherlands, and the United States. Countries scheduled for coverage in the series include Austria, France, Singapore, Spain, and the United Kingdom. The countries are described using a grid of characteristics so that comparisons may be made more easily. All of the analyses, along with further comparative data, will be gathered into a freestanding book to be published later in the year. Dr. Mendoza serves as editor for the project.

BEAM autografting in lymphoma--experience at one centre.

Since December 1987, we have examined the use of high-dose chemotherapy and unpurged bone marrow rescue in 31 patients with advanced or refractory lymphoma. Twenty-one patients had Hodgkin's disease (HD) and 10 had Non-Hodgkin's lymphoma (NHL). At ABMT, 22 patients had relapsed or resistant disease. All patients, excluding 3 early deaths, engrafted. There was no relationship between cell numbers harvested, CFU-GM and bone marrow recovery. The mean times to 0.5 x 10(9)/l neutrophils and 50 x 10(9)/l platelets were 20 d and 43 d respectively. However, 5 patients with HD had a significantly slower platelet recovery time of up to 203 days (p = 0.05). Disease-free survival was 72% for HD and 40% for NHL at 40 months. Relapsed or refractory disease at ABMT, bulky disease, extensive salvage therapy and Karnofsky scores below 80% were all associated with a poorer outcome. The most striking observation has been the dramatic radiological response of some patients with advanced/refractory disease.

Combination chemotherapy including bleomycin in the treatment of advanced Hodgkin's disease.

Fifty-six patients with advanced Hodgkin's disease were treated with a combination of nitrogen mustard, a vinca alkaloid (vincristine or vinblastine), procarbazine, prednisone and bleomycin, given in repeated cycles. Complete remission was achieved in 33 out of 53 evaluable patients (62,5%). The complete remission rate in patients who had received prior radiation therapy alone (65%) was similar to that in previously untreated patients (73%). Patients who had previously received combination chemotherapy, either alone or together with radiation therapy, responded less well to this regimen of therapy, with a complete remission rate of less than 40%. The complete remission rate was not influenced by the histological subtype of the Hodgkin's disease. Twenty-three of the 33 responders (70%) remain in continuous complete remission. The median for this group has not been reached but will be in excess of 24 months. Major bleomycin toxicity was not encountered in this study. Lung function was monitored throughout but no consistent changes were encountered. The degree of haematological toxicity caused by treatment was no greater than would have been expected without bloemycin. Although the results obtained with the 5-drug combination were satisfactory, the follow-up to date does not suggest that the addition of bleomycin to the convention 4-drug regimen has significantly affected the outcome.