[Usefulness of recombinant human erythropoietin on predeposit autologous blood transfusion in patients undergoing radical prostatectomy].

The usefulness of recombinant human erythropoietin (rHuEPO) on autologous blood transfusion was investigated in 18 patients undergoing radical prostatectomy (mean age 67.4 years). A total of 800 ml blood was deposited by two donations of 400 ml each, concomitant with subcutaneous administration of 24,000 U rHuEPO at each donation. All patients completed two successive donations with no adverse effects. The mean hemoglobin concentration was 13.7 g/dl before the donation and 13.0 g/dl on the day of operation. The decrease in hemoglobin was effectively prevented in 12 patients (66.7%) with rHuEPO, when compared with the predicted decrease in the absence of recovery from anemia. During radical prostatectomy, no homologous blood transfusion was required in 16 of 18 patients (88.9%). In conclusion, predeposit autologous blood transfusion with rHuEPO is useful for diminishing the risks associated with homologous blood transfusions.

[Glutathione chemoprotection therapy against CDDP-induced neurotoxicity in patients with invasive bladder cancer].

We studied the efficacy of glutathione in the prevention of CDDP-induced neurotoxicity. Nine patients with muscle-invasive bladder cancer were treated with intra-arterial THP and CDDP chemotherapy plus radiotherapy. Glutathione was given at a dose of 1,500 mg/m2 before CDDP administration and at a dose of 600 mg/body on days 2 to 4. The CR rate of 9 patients was 89%, and 2 of the 9 patients developed grade 1 neurotoxicity. These patients were then compared with 15 patients treated with the same regiment but without glutathione. The two groups did not differ in CR rate (89% vs 87%), but the incidence of neurotoxicity of patients with glutathione was significantly lower than that of patients without glutathione (22% vs 73%).

Preliminary results of bladder preservation by concurrent intraarterial chemotherapy and radiotherapy for muscle-invasive bladder cancer.

BACKGROUND: We previously reported favorable results of intraarterial doxorubicin chemotherapy in combination with low-dose radiotherapy for locally-advanced bladder cancer. We have now designed a new intraarterial chemotherapy regimen to achieve a higher tumor response rate while preserving a functional bladder. METHODS: Twenty-one patients with muscle-invasive bladder cancer (T2,10; T3,7; T4,4) were treated with concurrent intraarterial chemotherapy and radiotherapy after an initial complete transurethral resection. Induction therapy consisted of concomitant pirarubicin (THP; 15 mg/m2/day on days 1 to 3), cisplatin (CDDP; 25 mg/m2/day on days 8 to 10) and irradiation (2 Gy/session on days 1 to 3 and 8 to 10). Maintenance treatment consisted of THP administered at 20 or 30 mg with or without 50 mg CDDP every month for 2 years. RESULTS: Nineteen of the 21 patients (90.5%) achieved a complete response (CR). One of these 19 relapsed with lung metastases 24 months after treatment and was treated surgically. The 2 patients who did not achieve a CR died of cancer, while the remaining 19 patients are alive with preservation of a functional bladder. CONCLUSION: These findings suggest that a higher tumor response rate with bladder preservation for patients with muscle-invasive bladder cancer is achieved by intraarterial THP/CDDP chemotherapy plus radiotherapy.