No abstract available.
Sarcoma, Kaposi* ; Vinblastine*

No abstract available.
Cyclophosphamide* ; Doxorubicin* ; Drug Therapy* ; Sarcoma* ; Vinblastine*

We treated 11 patients with advanced transitional cell carcinoma of upper urinary tract with adjuvant M-VAC chemotherapy and their median survival time was compared with 9 patients without M-VAC chemotherapy as e historical group. The total number of cycles per each patient ranged from 1 to 5 with a mean of 3.4. Of these patients, 8 patients could be evaluated for response and 4 patients were responded (2 complete and 2 incomplete. response rate 50%). The median duration of response was 26 months for complete responders and 4.5 months for incomplete responders. The median duration of survival for all chemotherapy group, complete responders, progression and historical control group were 22, 23+, 14 and 21 months. respectively. Median survival was 22 months in all 11 patients. 23+ months in clinical responders, 14 months in progression and 21 months in historical control group. Although overall survival was not prolonged significantly in chemotherapy than the historical control group, M-VAC was effective in small proportion of patients (CR: 2/8). The duration of survival of the patients with complete remission was prolonged significantly.
Carcinoma, Transitional Cell* ; Doxorubicin* ; Drug Therapy* ; Humans ; Urinary Tract* ; Vinblastine*

PURPOSE: We wanted to compare the efficacy and toxicity of chemotherapy with methotrexate, vinblastine, adriamycin, cisplatin(M-VAC) versus gemcitabine and cisplatin(GC) for patients with advanced or metastatic urothelial carcinoma. MATERIALS AND METHODS: Forty-nine patients diagnosed with advanced urothelial cell carcinoma and who were started on chemotherapy were divided into two groups. All of them had a 0-1 Eastern Cooperative Oncology Group performance status. 19 patients received M-VAC chemotherapy and 30 patients received the GC regimen. Among them, the subjects who completed more than 3 cycles of their recommended formula (13/19 for M-VAC, 28/30 for GC) were included in this study. They were evaluated for their overall response rate, the 5-year survival rate, toxicities and the drop-out rate. RESULTS: The overall response rate and median survival period of the M-VAC and G-C groups were 38%(5/13 cases) and 46%(13/28 cases), and 16.7 months and 43.9 months, respectively. The 5-year survival rates in the two groups were 10% in the M-VAC group and 46% in the G-C treated group(p=0.013). The main hematologic complication was leukopenia and this occurred in 10/19 patients and more than grade 3 leukopenia was noted in 4/10 patients in the M-VAC group and in 19/30 patients and more than grade 3 was noted in 10/19 patients in the GC group.The common non-hematologic side effects between the two groups were nausea/vomiting(84.2% vs 47.7%), alopecia(47.4% vs 26.7%), diarrhea(15.8% vs 16.7%), and nephrotoxicity(15.8% vs 6.7%), respectively. The drop-out rates were 31.6% in the M-VAC group and 6.7% with the GC group. CONCLUSIONS: For patients with a good performance status with advanced or metastatic urothelial carcinoma, GC chemotherapy is more effective and it has more tolerable toxicities than does the M-VAC regimen.
Doxorubicin ; Drug Therapy* ; Humans ; Leukopenia ; Methotrexate ; Survival Rate ; Vinblastine

Histopathologic study was performed to observe the effects of M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin), widely used for advanced bladder cancer and its metastatic lesion, on the visceral organs of the experimental animal. M-VAC was used intraperitoneally throughout the study and the following results were obtained : 1. There were severe adhesions of visceral organs in all of experimental groups, compared with the control group. 2. Compared with the control group(15.0%), significant increase of incidence in renal cystic changes in experimental group(89.6%) was observed. The lesions were similar to polycystic kidney type I and considered to be irreversible. Therefore, ultrasonography of the kidney during the M-VAC regimen may be clinically worthwhile. 3. Portal triaditis ( 27.5% ) and fatty metamorphosis of the liver(24.1%) were observed significantly in the experimental group but they were limited, localized changes and thought to be reversible. Deterioration in hepatic function may not be seriously considered.
Animals* ; Doxorubicin* ; Incidence ; Kidney ; Polycystic Kidney Diseases ; Ultrasonography ; Urinary Bladder Neoplasms ; Vinblastine*

PURPOSE: Forty percent of the newly diagnosed bladder cancer patients are over the age of 70 years, but it is said that over 75% of them are excluded from active programs of management. This study was to evaluate the usefulness of M-VAC(methotrexate, vinblastine, adriamycin and cisplatin) chemotherapy for invasive bladder cancer patients over the age of 70 years compared with that of patients under the age of 70 years. MATERIALS AND METHODS: Sixty patients with invasive bladder cancer were treated with M-VAC chemotherapy. We divided the patients into group 1- 20 patients over the age of 70 years and group 2- 40 patients under the age of 70 years. We compared cycle length, toxicity and clinical response of M-VAC chemotherapy in group 1 with those of group 2. RESULTS: The Karnofsky performance score was 85.5% in group 1 and 96.3% in group 2. The cycle length needed for 2 cycle of M-VAC chemotherapy was 67.2(range, 56-92) days in Group 1 and 61.5(range, 56-78) days in Group 2(p>0.05). Hematologic toxicities had not significant difference between two groups. Vomiting and stomatitis occurred more common in group 1. In 3 patients of group 1, the serum creatinine level rose to more than 3 mg/dl. The clinical response was 50% in Group 1 and 67% in Group 2(p>0.05). CONCLUSIONS: The bladder cancer patients over the age of 70 years had much more toxicity, longer cycle length and lower response rate, but these differences had not statistical significance. These results suggest that M-VAC chemotherapy in patients over the age of 70 years will achieves the therapeutic effects when the patients have a good physical condition and toxicities to chemotheraphy are monitored closely.
Aged* ; Creatinine ; Doxorubicin ; Drug Therapy* ; Humans ; Stomatitis ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Vinblastine ; Vomiting

Of the 11 advanced bladder cancer patients who received M-VAC (Methotrexate, Vinblastine, Doxorubicin and Cisplatin) combination chemotherapy, complete and partial remission were observed in 63.6%. Of the 17 advanced bladder cancer patients who received MAC (Methotrexate, Doxorubicin and Cisplatin) combination chemotherapy, complete and partial remissions were observed in 17%. Complete remission was achieved in 18.2% of the patients clinically, pathologically in M-VAC group and 5.9% in MAC group. Partial remission was occurred in 46.5% of the patients in M-VAC group and 41.2% in MAC group. All metastatic sites including the bone and liver, lung were well responded in M-VAC group, but poorly responded in MAC group. Toxicity was significant but tolerable.
Doxorubicin ; Drug Therapy, Combination* ; Humans ; Liver ; Lung ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Vinblastine

Patients with advanced urothelial tumors that relapse or persist following conventional therapy have poor prognosis. Management of the patients with recurrent local or disseminated urothelial tumors presents a difficult clinical problems. In 1985 Sternberg et al reported 71% of significant tumor regression and 50% of complete clinical remission with M-VAC (methotrexate, vinblastine, doxorubicin and Cisplatin) combination chemotherapy for treatment of advanced urothelial transitional cell carcinomas. Herein, we have experienced 13 cases of M-VAC combination chemotherapy in advanced urothelial tumors. Complete and partial remission was in achieved 46.2 per cent of the patients clinically, while 15.4 percent had a minor response and 38.4 per cent had progression with median survivals of 11.5, 8.5 and 7.4 months. Toxicity was significant. 15.4 per cent of the patients having experienced nadir sepsis, 30.8 per cent mucositis and 7.6 per cent cardiac toxicity. Median cycle length varied from 31.6 to 41.7 days for the first and 5th cycle respectively. This regimen has been efficacious in selected patients with advanced urothelial tumors.
Carcinoma, Transitional Cell ; Doxorubicin* ; Drug Therapy, Combination ; Humans ; Mucositis ; Prognosis ; Recurrence ; Sepsis ; Vinblastine*

Three cases of hisiocytic medullary reticulosis occurring in children aged 6 years, 9 years and 14 years, are described. In all children the diagnosis was based on anemia, granulocytopenia, thrombocytopenia and marked erythrophagocytosis by bone marrow and lymph node atypical histiocytes. They all showed immediate remission with combined chemotherapy of vinblastine and prednisolone, but Case 1 eventually died at 6 months after onset of this rapidly progressive, fatal illness and Case 2, 3 are alive 14 months after onset of their illness.
Agranulocytosis ; Anemia ; Bone Marrow ; Child ; Diagnosis ; Drug Therapy ; Histiocytes ; Humans ; Lymph Nodes ; Prednisolone ; Thrombocytopenia ; Vinblastine

PURPOSE: To evaluate the hematologic toxicity of gemcitabine and cisplatin (GC) in patients with advanced transitional cell carcinomas. MATERIALS AND METHODS: From 25 patients, with advanced transitional cell carcinomas, 8 had previously received M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) chemotherapy for a metastatic disease, and were scheduled to receive gemcitabine, 1,000mg/m2, intravenously, over 30 minutes, on days 1, 8 and 15, and cisplatin, 70mg/m2, over 1 hour, on day 2 of a 28-day cycle. The hematological toxicities of each cycle were evaluated. RESULTS: The main hematological toxicities were thrombocytopenia (grade 3 in 24% and grade 4 in 16% of patients), leukopenia (grade 3 in 14% of patients) and anemia (grade 3 in 12% of patients). Four of the patients that experienced grade 4 thrombocytopenia had a tendency for recurring grade 4 thrombocytopenia during the GC chemotherapy. However, there was no evidence of bleeding. CONCLUSIONS: The most severe hematological toxicity of the GC chemotherapy was thrombocytopenia. The careful observation of the patients that experience grade 4 thrombocytopenia is recommended.
Anemia ; Carcinoma, Transitional Cell ; Cisplatin* ; Doxorubicin ; Drug Therapy ; Hematology ; Hemorrhage ; Humans ; Leukopenia ; Thrombocytopenia ; Vinblastine