Myocardial ischemia associated with high-dose carmustine infusion

Article Abstract:

Carmustine, also called BCNU, is a powerful anticancer agent which is used for both solid tumors and lymphomas. BCNU has serious side effects, however, including bone marrow suppression, liver toxicity, lung disease, and progressive kidney failure. Recently, attempts to use high doses of BCNU have been combined with autologous bone marrow transplantation. In this procedure, bone marrow taken from the patient is replaced later to supplant the bone marrow that has been crippled by the chemotherapeutic treatment. While this procedure permits the use of higher doses of BCNU, it also results in high rates of other side effects besides bone marrow suppression. While many of the side effects have been well studied, researchers have now found that myocardial ischemia is a side effect which has been previously overlooked. Myocardial ischemia is the inadequate supply of oxygen to the heart muscle resulting from obstructed blood flow. This same phenomenon is common in the form of angina pectoris, and, if the oxygen deprivation is severe enough, may result in a heart attack. The condition most often results from disease of the blood vessels supplying the heart. Three patients receiving infusions of BCNU developed chest pain and racing heart beats during or immediately after the infusion. Electrocardiograms (ECGs) taken of the three cancer patients revealed physiological changes indicative of myocardial ischemia. The oldest of the three patients was 41, and none had previous histories of cardiovascular disease. Angina pectoris is normally treated with drugs which relax the blood vessels to the heart; this treatment proved effective in these cancer patients as well. Myocardial ischemia is known to be a side effect of 5-fluorouracil, which is unrelated in molecular structure to BCNU. Although the cause of the myocardial ischemia in patients treated with high-dose BCNU is not understood, these cases illustrate that this side effect must be considered as a possibility in patients receiving this treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Ischemia, Carmustine

---

A dose-intensive regimen of 5-fluorouracil for the treatment of metastatic colorectal carcinoma

Article Abstract:

While the efficacy of 5-fluorouracil (5-FU) in treating colorectal cancer is limited, the drug still remains the best agent available. Therefore, much of the research into chemotherapy for colorectal cancer concerns developing more effective 5-FU regimens, rather than exploring completely novel chemotherapeutic protocols. Most of the efforts to improve the effectiveness of 5-FU either evaluate additional agents to enhance the action of 5-FU or examine the effects of altering the schedule of 5-FU administration. Variations in the schedule of 5-FU administration not only result in different degrees of effectiveness, but in differing patterns of toxicity as well. In a further attempt to improve the efficacy of 5-FU, the drug was administered to 23 patients with metastatic or inoperable colorectal cancer in a dose-intensive regimen. The dose schedule consisted of a single bolus of 400 to 500 milligrams followed by continuous infusion of 600 to 800 milligrams per meter squared per day over the next four days. After the high-dose infusion, a low dose infusion of 200 to 250 milligrams per meter squared per day was continued over the next 17 to 24 days. Most patients required dose reductions before completing the schedule due to the development of significant toxic effects, including inflammation of the mucous membranes and diarrhea. There were no complete responses and five partial responses. The partial responses were moderately durable, however, lasting from 4 to 10 months. This level of activity is comparable to levels achieved easily with more conservative schedules in combination with other drugs. The dose-intensive regimen, therefore, provides no advantage. The authors suggest that since exploration of the use of 5-FU has been proceeding for 30 years, it is unlikely that any striking improvements remain to be made, and that new advances in the chemotherapeutic treatment of colorectal cancer must come from the development of newer and more effective cytotoxic agents. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Colorectal cancer, Chemotherapy, Fluorouracil

---

Similar abstracts:

• Abstracts: Nosocomial transmission of tuberculosis associated with a draining abscess. Tuberculosis and acquired immunodeficiency syndrome - Florida
• Abstracts: Nosocomial transmission of tuberculosis associated with a draining abscess. part 2 Prevalence of human immunodeficiency virus and hepatitis B virus in unselected hospital admissions: implications for mandatory testing and universal precautions
• Abstracts: Hematologic neoplasia associated with primary mediastinal germ-cell tumors. Case 12-2005: A 30-year-old woman with a mediastinal mass
• Abstracts: Neonatal hepatitis and extrahepatic biliary atresia associated with cytomegalovirus in twins. Asymptomatic congenital cytomegalovirus infection: audiologic, neuroradiologic, and neurodevelopmental abnormalities during the first year
• Abstracts: Toxic shock syndrome associated with use of latex nasal packing. Latex and vinyl examination gloves: quality control procedures and implications for health care workers

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.