dinoprost and Neutropenia

Six patients with incurable malignancies were originally treated with vitamin E, 3200 IU/day for fourteen days, followed by the same dose of vitamin E daily plus LCV (20 mg/m2 i.v. bolus daily x 5) with 5FU (425 mg/m2 i.v. bolus immediately following LCV). The same schedule of LCV and 5FU was repeated 4 weeks later, then every 5 weeks indefinitely. When 3 of the first 6 had grade 3/4 toxicity, six more patients were treated on the identical drugs and schedule. Seven of twelve total patients had one or more grade 3/4 toxicities. Neutropenia, abdominal pain, and diarrhea were most common. No patient had a documented response, though seven patients did have stable disease. Though the combination of vitamin E and chemotherapy was toxic, this trial demonstrated maximal therapeutic doses of vitamin E can be combined with standard 5FU and LCV, without significantly increasing the side effects of the chemotherapy itself.

Topics: Abdominal Pain; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Diarrhea; Dinoprost; Dose-Response Relationship, Drug; F2-Isoprostanes; Female; Fluorouracil; Humans; Infusions, Intravenous; Leucovorin; Male; Middle Aged; Neoplasms; Neutropenia; Vitamin E

Bone marrow cells were collected from normal dogs, normal dogs made neutropenic with cyclophosphamide, and 11 dogs affected with cyclic hematopoiesis (CH) on 3 consecutive days of separate 12- to 14-day cycles. The mononuclear marrow cells from both groups of control dogs and from the CH dogs on each of 12-cycle days were cultured for 2.5 hr in serum-free media. The amounts of prostaglandins (PGF2 alpha and PGE) and cyclic GMP (cGMP) measured in the media were found to vary with the cycle in the CH dog. PGF2 alpha was highest as the dogs recovered from the neutropenia and lowest 4 days before the onset of the next neutropenic episode. Cyclic GMP was lowest 4-5 days before the onset of neutropenia, then dramatically increased as the neutropenic period approached. Cyclic GMP was highest when PGF2 alpha was lowest. Normal dogs, made neutropenic with a single dose of cyclophosphamide, had elevations of PGF2 alpha but not PGE or cGMP during the recovery period of active granulopoiesis.

Topics: Agranulocytosis; Animals; Bone Marrow Cells; Cells, Cultured; Cyclic AMP; Cyclic GMP; Cyclophosphamide; Dinoprost; Dogs; Hematopoiesis; Neutropenia; Periodicity; Prostaglandins; Prostaglandins E; Prostaglandins F