ABSTRACT
Ten previously untreated patients with gastric cancer were treated with etoposide, 120 mg/m2 intravenously (i.v.) on days 4, 5, and 6, Adriamycin, 20 mg/m2 i.v. on days 1 and 7, and cisplatin, 40 mg/m2 i.v. on days 2 and 8 (EAP). Etoposide, 240 mg/m2 on days 4, 5, and 6, was administered orally instead of intravenously in alternating cycles, and pharmacokinetic studies were performed in those who had previously undergone gastrectomy or who had tumor infiltrating the stomach to determine oral bioavailability. Nine patients had advanced measurable gastric cancer, and one patient had an elevated carcinoembryonic antigen after surgery for synchronous gastric and colon cancer. The median age was 54 years (range 38-69), and the median Eastern Cooperative Oncology Group (ECOG) performance status was 2 (range 0-3). Nine of 10 patients had poorly differentiated adenocarcinoma. Twenty-four cycles were administered to 10 patients, and hematologic data were available for 23 courses. ECOG grade 4 neutropenia and thrombocytopenia developed in 19 (83%) and 8 (53%) courses, respectively. Thirteen courses (54%) were complicated by fever requiring parenteral antibiotics. Two patients (20%) died due to neutropenic sepsis. The profound myelotoxicity observed in our study prompted us to terminate the investigation prior to completing accrual. The oral bioavailability of etoposide was 21% and 36% in the two patients who had had prior gastrectomy.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Stomach Neoplasms/drug therapy , Adenocarcinoma/blood , Adenocarcinoma/surgery , Administration, Oral , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Biological Availability , Cisplatin/administration & dosage , Cisplatin/adverse effects , Combined Modality Therapy , Doxorubicin/administration & dosage , Doxorubicin/adverse effects , Drug Evaluation , Etoposide/administration & dosage , Etoposide/adverse effects , Etoposide/pharmacokinetics , Female , Gastrectomy , Humans , Male , Middle Aged , Neutropenia/chemically induced , Stomach Neoplasms/blood , Stomach Neoplasms/surgery , Thrombocytopenia/chemically inducedABSTRACT
Two patients with hairy cell leukemia (HCL) who failed alpha-2a-interferon and one who failed beta-ser-interferon were treated with 2'-deoxycoformycin (DCF), 4 mg/m2, by intravenous bolus infusion every 2 weeks. All three patients achieved a complete response, continuing for 9+, 14+, and 15+ months. Treatment was discontinued when complete remission was diagnosed. DCF-induced remission has not been previously reported after beta-ser-interferon failure. These patients, as well as 12 others in the literature reviewed herein, demonstrate the efficacy of DCF in HCL patients unresponsive to alpha, beta, and gamma interferon.
Subject(s)
Interferon Type I/therapeutic use , Interferon-alpha/therapeutic use , Interferon-beta , Leukemia, Hairy Cell/drug therapy , Pentostatin/therapeutic use , Adult , Humans , Interferon alpha-2 , Interferon beta-1a , Interferon beta-1b , Leukemia, Hairy Cell/blood , Male , Middle Aged , Pentostatin/administration & dosage , Pentostatin/toxicity , Recombinant Proteins/therapeutic use , Remission InductionABSTRACT
Hemophilia A and von Willebrand's disease are hereditary disorders associated with qualitative and quantitative abnormalities of clotting factor VIII. A major clinical feature is excessive or abnormal bleeding often necessitating the use of transfusions of pooled blood products to achieve hemostasis. Exposure to blood products places the recipient at risk for infection by the hepatitis B virus or the human immunodeficiency virus. A synthetic analog of arginine vasopressin, 1-desamino-8-D-arginine vasopressin, has been shown to increase the plasma levels of factor VIII coagulant activity and von Willebrand's factor, and clinically to improve abnormal bleeding, obviating the need to use blood products.
