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Retrospectively, 41 Iranian patients with Mediterranean abdominal lymphoma (MAL) were studied; 21 patients had received anthracycline-based protocols, and 20 patients had been treated with regimens lacking anthracyclines. The study groups were comparable with respect to several factors, including age, performance status, histology of lymphoma, stage of disease, and the average relative dose intensity of their protocols. Our first group had a complete remission (CR) rate of 62%, mean disease-free interval (DFI) of 16.3 months and a 71% overall survival at 30 months. The second group showed a CR rate of 40%, mean DFI of 11.2 months, and a 35% overall survival at 30 months. The differences were significant in survival (P=. 012) and DFI (p<. 001). The incidence of serious toxicities and complications was similar.