Continuous infusion vincristine and bleomycin with high dose methotrexate for resistant non-Hodgkin's lymphoma
✍ Scribed by Dickerman Hollister Jr; Richard T. Silver; Bruce Gordon; Morton Coleman
- Publisher
- John Wiley and Sons
- Year
- 1982
- Tongue
- English
- Weight
- 360 KB
- Volume
- 50
- Category
- Article
- ISSN
- 0008-543X
No coin nor oath required. For personal study only.
✦ Synopsis
Sixteen patients with resistant non-Hodgkin's lymphoma were treated with continuous infusions of vincristine (1-2 mg/m2 daily X 2 days) and bleomycin (0.25 mg/kg bolus dose, then 0.25 mg/kg/daily X 5 days). Responding patients received high dose methotrexate (1500 mg/m2) with citrovorum rescue on days 15, 22, 29, 36. Treatment cycles were repeated every six weeks in responding patients. The response frequency was 50% (three complete and five partial responses). Median response duration was 29 weeks. Major toxicity included stomatitis (63%) and leukopenia (44%). One episode each of possible hypersensitivity pneumonitis and paralytic ileus occurred. Continuous infusions of vincristine and bleomycin should be studied further in less critically ill patients.
Cancer 50:1690-1694. 1982.
HILE DIFFERENT COMBINATIONS Of drugs are ef-W fective for non-Hodgkin's lymphoma (NHL), many patients become refractory to chemotherapy after initial complete or partial response. Additional therapy is hindered by resistance to these drugs at the doses and schedules already employed and by limited bone marrow reserve, preventing more aggressive chemotherapy. Two agents active in N H L are vincristine (VCR) and bleomycin (BLEO). Patients with resistant disease usually have already been treated with one or both of these given as bolus injections in a variety of combination drug regimens. However, because they are only minimally marrow suppressive, VCR and BLEO remain potentially useful if tumor resistance to bolus injection can be overcome by varying the method of administration.
VCR has been given as a continuous infusion in a variety of dose-duration schedules. 1-3 Brief responses have occurred in patients with advanced lymphomas