Premium
High‐dose cyclophosphamide therapy for malignant disease. Toxicity, tumor response, and the effects of stored autologous marrow
Author(s) -
Buckner C. D.,
Rudolph R. H.,
Fefer A.,
Clift R. A.,
Epstein R. B.,
Funk D. D.,
Neiman P. E.,
Slichter S. J.,
Storb R.,
Thomas E. D.
Publication year - 1972
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197202)29:2<357::aid-cncr2820290215>3.0.co;2-m
Subject(s) - medicine , leukopenia , hematocrit , cyclophosphamide , gastroenterology , surgery , toxicity , bone marrow , chemotherapy
Twenty‐five patients with disseminated malignant disease received single or multiple courses of cyclophosphamide (CY) 60 to 120 mg/kg. Stored autologous marrow was infused following 120 mg/kg of CY in 6 instances. One patient received 240 mg/kg of CY over a 4‐day period followed by autologous marrow infusion. Patients receiving 60 mg/kg showed a moderate leukopenia (mean nadir of 500/mm 3 ), anemia (mean hematocrit decline of 8.2 vol%) and variable thrombocytopenia that ranged from no change to 34,000/mm 3 with a mean nadir of 127,000/mm 3 . Increasing the dose to 120 mg/kg produced leukopenia to below 500 cells/mm 3 with a mean nadir of 120 cells/mm 3 . Thrombocytopenia was severe with a mean nadir of 37,000/mm 3 . Hematocrit values in this group fell by 15.2 vol%. Infectious complications occurred following 1 of 10 courses at 60 mg/kg and 18 of 35 courses at 120 mg/kg. In the latter group, there were 7 episodes of septicemia including one death from pseudomonas septicemia. A second patient, with cerebral metastases, died of a CNS hemorrhage. The patient receiving 240 mg/kg died as a consequence of myocardial necrosis. The infusion of autologous marrow had no apparent effect on hemopoietic recovery or infectious complications. Of the responding patients, 3 had ovarian carcinoma, 3 had testicular tumors, 1 had adenocarcinoma of the bowel, and 1 had an undifferentiated malignancy.