Twenty-eight patients with non-Hodgkin’s lymphoma (NHL) were treated with a combination of (2XXX-R)-4′-o-tetrahydropyranyladriamycin (pirarubicin, THP), cyclophosphamide, vincristine, and prednisolone (VEP-THP therapy). Eleven (45.8%) of twenty-four evaluable patients achieved complete response (CR). CR rate (52.8%) was higher in the intermediate-grade histology group than in high- or low-grade group. Toxicity was generally acceptable although leukopenia less than 2,000/ul was observed in 17 (60.7%) of 28 patients. Clinical signs of cardiotoxicity were not observed and alopecia was mild. Therefore, VEP-THP therapy is useful as a first-line chemotherapy in the treatment of NHL, particularly for the patients with intermediate-grade histology. Higher CR rate and longer relapse-free survival can be expected by administering a greater dose of THP or employing a schedule of fractionated low do