Assuntos
Granuloma/complicações , Granuloma/diagnóstico , Leucemia Linfocítica Crônica de Células B/complicações , Pneumonia por Pneumocystis/complicações , Pneumonia por Pneumocystis/diagnóstico , Pseudolinfoma/complicações , Idoso , Anti-Infecciosos Urinários/uso terapêutico , Atovaquona , Biópsia , Diagnóstico Diferencial , Quimioterapia Combinada , Granuloma/tratamento farmacológico , Humanos , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Naftoquinonas/uso terapêutico , Pneumonia por Pneumocystis/tratamento farmacológico , Pneumonia por Pneumocystis/patologiaRESUMO
PURPOSE: The goals of this study were to define the efficacy and toxicity of doxorubicin and dose-escalated cyclophosphamide (Cy) along with granulocyte colony-stimulating factor (G-CSF) in the treatment of hormone-refractory prostate cancer (HRPC), to determine the maximal-tolerated dose (MTD) of Cy in this regimen, and to evaluate the impact of prior pelvic irradiation (XRT) on MTD and toxicity. PATIENTS AND METHODS: Thirty-five patients were treated every 21 days with fixed-dose doxorubicin (40 mg/m2) and Cy 800 to 2,000 mg/m2 (in a cohort dose-escalation schema) along with G-CSF. RESULTS: Five of 15 patients (33%) with measurable disease obtained an objective response. Sixteen of 35 patients (46%) had a greater than 50% decrease in prostate-specific antigen (PSA) level (95% confidence interval [CI], 28.8% to 63.4%). Ten of 35 patients (28.6%) had a greater than 75% decrease in PSA level. The median survival time was 11 months. The median survival duration of patients with a greater than 50% decrease in PSA level was 23 months, versus a median survival time of 7 months in patients without a PSA response (P = .02). Although 33% of cycles were associated with grade 4 neutropenia, febrile neutropenia occurred in only 7.8% of all cycles. Thrombocytopenia and anemia were rare. Nonhematologic toxicity was minimal. Patients who had received prior pelvic XRT had a lower Cy MTD, but their hematologic toxicity was not appreciably different. CONCLUSION: This is a well-tolerated, active regimen for the treatment of HRPC. Toxicity was not different in patients with prior pelvic XRT, although these patients had a lower MTD.
Assuntos
Adenocarcinoma/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Neoplasias da Próstata/tratamento farmacológico , Adenocarcinoma/mortalidade , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Ciclofosfamida/administração & dosagem , Ciclofosfamida/efeitos adversos , Relação Dose-Resposta a Droga , Doxorrubicina/administração & dosagem , Doxorrubicina/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/mortalidade , Análise de SobrevidaRESUMO
A radioimmunoassay was developed to discriminate immunoglobulin (Ig) classes specific for the J-5 mutant of Escherichia coli (serotype O:111-B4). Adult horses were periodically inoculated IM with a nonviable suspension of the J-5 mutant emulsified in Freund's incomplete adjuvant. Before and after the horses were inoculated, sera were collected sequentially and examined by radioimmunoassay. Rabbit anti-(horse) Ig and [125I]protein A served as the indicator system. Antigen-specific IgM, IgG, and IgA were observed to follow a classic immune response. The radioimmunoassay offers a valuable tool for the discrimination of circulating, antigen-specific Ig in the horse.