[Combination chemotherapy in malignant lymphoma. Results of long-term follow-up].
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Biomedical subjects
Publications and source records attributed to H Ueoka.
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Six patients with hepatocellular carcinoma (HCC) and 9 patients with metastatic liver carcinoma (MLC) (4 with stomach cancer, 4 with pancreas cancer and 1 with colon cancer) were treated with rapid hepatic artery infusion of adriamycin. Partial response was obtained in 3 patients (44%) with HCC and 2 patients (22%) with MLC. The median survival time was 6 months in HCC patients and 8 months in MLC patients. Patients with elevated serum alkaline phosphatase or those with ascites were poorly prognostic. Myelosuppressive toxicity was seen frequently, but, no life-threatening complications occurred. Other toxicities were generally mild and well tolerated. These results indicated that hepatic artery infusion of adriamycin is a useful treatment modality in the management of both HCC and MLC.
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A system useful for the collection and analysis of a large number of abnormal karyotypes and for studies on the relationship between cytogenetic abnormalities and clinical features of diseases is reported. The program is based on the disintegration and rearrangement of abnormal karyotypes recorded according to the 1978 International System for Human Cytogenetic Nomenclature (ISCN).
A phase II study of mitoxantrone (MIT) was performed in 21 patients with hematologic malignancies refractory to combination chemotherapy including anthracyclines. MIT was administered intravenously at doses of 8 to 13 mg/m2 on day 1 for 12 malignant lymphoma patients, and 1 to 3.3 mg/m2 on day 1 through 5 for 7 acute leukemia patients and 2 malignant lymphoma patients. Four malignant lymphoma patients (2 each of Hodgkin's disease and non-Hodgkin's lymphoma) achieved partial response lasting 19, 14, 8+, and 4 weeks, respectively. Although no definite response was obtained in acute leukemia patients, a marked cytoreduction was observed in 2 patients. Myelosuppression was a major toxicity, however, life-threatening toxicities were not observed in this study.
Eighteen patients with advanced non-Hodgkin's lymphoma other than the diffuse histiocytic type were treated with a combination of adriamycin, vincristine, ifosfamide and prednisolone (AVIP). The objective response rate was 83% (15/18); 61% (11/18) achieved complete remission. The median duration of complete remission was 11 months ranging from 2 to 39+ months. Eleven of the 18 patients are still alive during the median follow-up time of 13 months. The median survival was 14+ months for complete responders, and 9.5 months for partial and nonresponders. A myelosuppressive toxicity was well tolerated. AVIP offers some hope as treatment of advanced non-Hodgkin's lymphoma.
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A phase I study of a new anthracycline antibiotic, aclacinomycin A, was performed in a total of 15 patients with advanced malignancy to determine the maximum-tolerated dose. The gastrointestinal toxicity which occurred was not dose-related and was not severe. Epilation and stomatitis were extremely minimal. Both hepatic dysfunction and hematologic toxicity were dose-limiting. A recommended dose for phase II study was determined to be 2.5--3.0 mg/kg (approximately 100--120 mg/m2) given in 3-week intervals. Objective response was observed in two patients with malignant lymphomas.
BACKGROUND: We investigated the feasibility and efficacy of high-dose chemotherapy consisting of ifosfamide, carboplatin and etoposide (HD-ICE) facilitated by autologous peripheral blood progenitor cell transplantation (ABPCT) for the treatment of small-cell lung cancer (SCLC). PATIENTS AND METHODS: Eleven patients aged 44 to 63 years old (5 with extensive disease [ED] and 6 with limited disease [LD]) were entered into this study. Induction chemotherapy consisted of 3 to 4 cycles of cisplatin and irinotecan for ED-SCLC, and cisplatin and etoposide for LD-SCLC. Patients with LD-SCLC received concurrent chest radiotherapy along with the first cycle of induction chemotherapy. After induction therapy, peripheral blood progenitor cells (PBPC) were collected following G-CSF administration during a recovery phase from high-dose etoposide (1,500 mg/m2). Eight patients (4 with ED and 4 with LD) with adequate organ function were treated with HD-ICE (15 g/m2 ifosfamide, 1,200 mg/m2 carboplatin and 1,500 mg/m2 etoposide) followed by ABPCT. RESULTS: Hematologic recovery was rapid and non-hematological toxicities were acceptable without treatment-related mortality. In ED-SCLC, all of the 4 patients achieved complete response (CR) or near CR but developed a relapse of the disease. In LD-SCLC, 2 of 4 patients with LD-SCLC are alive in continuous CR for 18 and 21 months after the beginning of induction therapy. CONCLUSIONS: Despite a limited number of patients and short follow-up time, these preliminary results indicate that marrow-ablative therapy (HD-ICE) supported by ABPCT is feasible in the treatment of elderly patients with LD- and ED-SCLC.