Title |
Amifostine (WR-2721), a cytoprotective agent during high-dose cyclophosphamide treatment of non-Hodgkin's lymphomas: a phase II study
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Published in |
Brazilian Journal of Medical and Biological Research, July 2000
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DOI | 10.1590/s0100-879x2000000700009 |
Pubmed ID | |
Authors |
C.A. De Souza, G. Santini, G. Marino, S. Nati, A.M. Congiu, A.C. Vigorito, E. Damasio |
Abstract |
Clinical trials indicate that amifostine may confer protection on various normal tissues without attenuating anti-tumor response. When administered prior to chemotherapy or radiotherapy, it may provide a broad spectrum of cytoprotection including against alkylating drugs. The mechanism of protection resides in the metabolism at normal tissue site by membrane-bound alkaline phosphatase. Toxicity of this drug is moderate with hypotension, nausea and vomiting, and hypocalcemia being observed. We report a phase II study using amifostine as a protective drug against high-dose cyclophosphamide (HDCY) (7 g/m2), used to mobilize peripheral blood progenitor cells (PBPC) and to reduce tumor burden. We enrolled 29 patients, 22 (75. 9%) affected by aggressive and 7 (24.1%) by indolent non-Hodgkin's lymphoma (NHL), who were submitted to 58 infusions of amifostine and compared them with a historical group (33 patients) affected by aggressive NHL and treated with VACOP-B followed by HDCY. The most important results in favor of amifostine were the reduction of intensity of cardiac, pulmonary and hepatic toxicity, and a significant reduction of frequency and severity of mucositis (P = 0. 04). None of the 29 patients died in the protected group, while in the historical group 2/33 patients died because of cardiac or pulmonary toxicity and 2 patients stopped therapy due to toxicity. Amifostine did not prevent the aplastic phase following HDCY. PBPC collection and hematological recovery were adequate in both groups. The number of CFU-GM (colony-forming units-granulocyte/macrophage) colonies and mononuclear cells in the apheresis products was significantly higher in the amifostine group (P = 0.02 and 0.01, respectively). Side effects were mild and easily controlled. We conclude that amifostine protection should be useful in HDCY to protect normal tissues, with acceptable side effects. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 30 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 6 | 20% |
Student > Bachelor | 5 | 17% |
Student > Master | 4 | 13% |
Researcher | 4 | 13% |
Student > Ph. D. Student | 4 | 13% |
Other | 5 | 17% |
Unknown | 2 | 7% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 15 | 50% |
Pharmacology, Toxicology and Pharmaceutical Science | 3 | 10% |
Agricultural and Biological Sciences | 3 | 10% |
Psychology | 2 | 7% |
Biochemistry, Genetics and Molecular Biology | 1 | 3% |
Other | 2 | 7% |
Unknown | 4 | 13% |