Cerebellar toxicity with high-dose cytosine arabinoside
| Autor: | Peter A. Cassileth, J. D. Hines, David J. Adelstein, Roger H. Herzig, R Brown, Hillard M. Lazarus, G P Herzig, S. N. Wolff, S. E. Strandjord, Peter F. Coccia |
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| Rok vydání: | 1987 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Adolescent Lymphoma Gastroenterology chemistry.chemical_compound Cerebellar Diseases Internal medicine medicine Humans Child Aged Leukemia business.industry Incidence (epidemiology) Cerebellar function Age Factors Cytarabine Infant Middle Aged Total body irradiation medicine.disease Surgery Regimen nervous system Oncology chemistry Child Preschool Toxicity Female business Cytosine |
| Zdroj: | Journal of Clinical Oncology. 5:927-932 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.1987.5.6.927 |
| Popis: | CNS dysfunction, especially impaired cerebellar function, is the dose-limiting toxicity associated with high-dose cytosine arabinoside, which precludes doses of greater than 48 g/m2. Four hundred eighteen patients between the ages of 2 and 74 years with leukemia or lymphoma received 36 to 48 g/m2 cytosine arabinoside either alone or with anthracycline antibiotics, 4'-(9-acridinylamino) methane sulfon-m-anisidine (m-AMSA), or total body irradiation. In only 35 of 418 patients (8%) did severe cerebellar toxicity develop; it was irreversible or fatal in four (1%) patients. The age of the patient was a critical factor in the incidence of severe cerebellar toxicity. Patients greater than 50 years old had a statistically significant greater incidence of cerebellar toxicity compared with younger patients (26/137, 19%, v 9/281, 3%; P less than .0005, chi 2). Neither the diagnosis, disease status, sex, nor the regimen altered the incidence of severe cerebellar toxicity (when corrected for age). A second course of high-dose cytosine arabinoside, administered to 62 patients, did not increase the incidence of severe cerebellar toxicity, which occurred in five (8%) of these patients. Two of the five patients had severe toxicity with the initial course. Of the 60 patients with no antecedent cerebellar dysfunction, three (5%) had severe toxicity with the second course: one of 41 patients were less than 50 years old; two of 19 patients were greater than or equal to 50 years. Since the occurrence of severe cerebellar dysfunction is greatly affected by age, reduced doses of high-dose cytosine arabinoside should be given to patients greater than 50 years old, and methods for reducing the cerebellar toxicity should be investigated in these patients. |
| Databáze: | OpenAIRE |
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