Stop-flow in mediastinum and thorax for resistant lymphoma.
Hepatogastroenterology
; 47(32): 378-82, 2000.
Article
en En
| MEDLINE
| ID: mdl-10791194
ABSTRACT
BACKGROUND/AIMS:
Management of patients with heavily pretreated malignant lymphoma failing frontline treatment and salvage high-dose chemotherapy and autologous peripheral stem cell rescue, is problematic. A pilot study was conducted to evaluate isolated thoracic perfusion of drugs by means of stopflow technique.METHODOLOGY:
Six patients were enrolled in the study; diagnoses included 4 advanced Hodgkin's disease, 1 primary mediastinal B-cell lymphoma, and 1 anaplastic large cell lymphoma. Patients were aged 18-37 years; 4 presented with bulky mediastinum. They had never achieved a complete response since all had progressed from front-line treatment, and 3 had even failed salvage high-dose chemotherapy with autologous peripheral stem cell rescue. Cisplatin (100 mg/m2) and melphalan (35 mg/m2) were used. Carmustine (100 mg/m2) were added to these 2 drugs and cytarabine (2000 mg/m2) in patients not previously treated by carmustine, etoposide, cytarabine, and melphalan. Epidoxorubicin (70 mg/m2) was added in patients who previously received a suboptimal dosage of antracycline. Drugs were delivered monthly via aortic perfusion performed by means of Aigner's stop-flow technique.RESULTS:
Overall 13 cycles of perfusional chemotherapy were administered with a median number of 2 cycles. During the procedures there were no technical, hemodynamic, or vascular complications, and no deaths occurred during surgery. After 1 month, 6 (100%) objective responses after isolated thoracic perfusion were recorded, 3 (50%) of which were complete. Tolerance to therapy was excellent. Hematological toxicity was mild and transfusional support was needed only in one course. At the last follow-up, 2 patients are alive (1 complete response and 1 very good partial response, maintained).CONCLUSIONS:
This new therapeutical approach seems very active in recurrent/refractory malignant lymphoma and may play an important role in this setting.
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Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_lymphomas_multiple_myeloma
/
6_other_malignant_neoplasms
/
6_other_respiratory_diseases
Asunto principal:
Enfermedad de Hodgkin
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Quimioterapia del Cáncer por Perfusión Regional
/
Protocolos de Quimioterapia Combinada Antineoplásica
/
Linfoma de Células B
/
Linfoma de Células B Grandes Difuso
/
Neoplasias del Mediastino
Límite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Hepatogastroenterology
Año:
2000
Tipo del documento:
Article
País de afiliación:
Italia