Treatment of advanced non-small cell lung cancer with cisplatin, 5-fluorouracil, and mitomycin C.

Thirty patients with advanced non-small cell lung cancer (NSCLC) were treated with cisplatin (P), mitomycin C (M), and 5-fluorouracil (5-FU) chemotherapy. Twelve patients (40%) achieved major responses to therapy (11 partial, one regression). The median duration of partial response was 20 weeks. Median survival for the entire group was 29 weeks. Toxicity with this combination was moderate, with myelosuppression being the most significant toxic effect. Acute hematologic toxicity was generally mild, with 74% of patients having a leukocyte nadir greater than or equal to 2000/microliter and 67% with a platelet count nadir of greater than or equal to 100,000/microliter. There were, however, two toxic deaths during periods of treatment-induced cytopenia, 40% of patients developed significant anemia necessitating blood transfusions, and 33% had episodes of prolonged neutropenia. Nonhematologic toxicities were generally mild, although one patient developed a cardiac arrest of unclear etiology during day 4 of cycle 3 of treatment and died, for a total treatment mortality rate of 10% (three of 30). This drug combination produced a response rate comparable to those noted with other two or three drug cisplatin-based regimens in NSCLC but does not appear to offer any substantial advantage given its moderate toxicity, short duration of response, and necessity for substantial hospitalization.

Malignant lymphoma presenting in the orbit: a clinicopathologic study of a rare immunoglobulin-producing variant.

Malignant lymphoma with orbital presentation and associated serum paraproteinemia has seldom been reported in the literature. We report two such cases of lymphoplasmacytic type, one of which was also associated with amyloidosis. Both cases were studied with immunohistologic and one with electron microscopic techniques with results that confirmed that the neoplastic cells were producing the abnormal serum immunoglobulin.

Ancillary measures in treatment of myeloma. Use of immune serum globulin, fluoride, or androgen.

We reviewed the efficacy of three agents advocated as ancillary therapy in myeloma patients. Intramuscularly administered immune serum globulin (gamma globulin) was ineffective in preventing infection. Hemoglobin level was improved in some myeloma patients receiving androgens. However, the response rate and the degree of leukopenia or thrombocytopenia were not superior with androgen-melphalan-prenisone combination therapy, as compared with those resulting from the two-drug combination without androgen. A controlled study evaluating androgen plus melphalan has not been done. The long-term administration of fluoride, supplemented by calcium and androgen, induced radiologically apparent bone fluorosis, but strengthening of lytic bone was not observed. Neither objective nor subjective benefit was demonstrated in a controlled study comparing the effects of fluoride (without calcium supplement) with those of the placebo.