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Combination sequential chemotherapy in advanced reticulum cell sarcoma
Author(s) -
Levitt Martin,
Marsh John C.,
Deconti Ronald C.,
Mitchell Malcolm S.,
Skeel Roland T.,
Farber Leonard R.,
Bertino Joseph R.
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(197203)29:3<630::aid-cncr2820290316>3.0.co;2-q
Subject(s) - medicine , vincristine , cyclophosphamide , neutropenia , chemotherapy , methotrexate , cytarabine , gastroenterology , surgery , combination chemotherapy
Based on studies of the chemotherapy of human leukemia and late stage animal neoplasms which may be kinetically analogous to disseminated reticulum cell sarcoma, a therapy program was devised using sequential cyclophosphamide‐vincristine followed by weekly methotrexate‐cytosine arabinoside. Each cycle of therapy consisted of cyclophosphamide 1.5 g/m 2 on day 0 and vincristine 1.4 mg/m 2 on days 1, 8, and 15; subsequently, 8 weekly doses of IV cytosine arabinoside 300 mg/m 2 and oral methotrexate 120 mg/m 2 over 24 hours were given followed by “Leucovorin rescue.” Fifteen patients received 3 such cycles with intervening 2‐week recovery periods. Nine patients achieved complete remission, and 6 had a partial response. Median remission duration was 10 months. Median survival from onset of disease was 15+ months and from beginning of therapy was 14+ months. Five of 7 patients who have relapsed are dead. Toxic manifestations included neutropenia below 1000/mm 3 in 10 patients; of these, there were recurrent episodes of sepsis in one. Alopecia occurred in 10, and reversible neurotoxicity in 8 patients.