levoleucovorin and Nutrition-Disorders

Total parenteral nutrition (TPN) has been suggested as a useful addition to chemotherapy of malignant disease in the hope of decreasing drug toxicity and increasing drug tolerance. In this study, 17 of 36 patients given chemotherapy for advanced diffuse lymphoma were randomly selected to receive TPN. The dose of the chemotherapeutic agents to be administered was decreased according to predetermined toxicity guidelines. A comparison of drug dosage in the group receiving TPN and the group receiving standard nutrition is a measure of drug tolerance in these patients. Drug dosage was evaluable in 15 TPN and 18 standard nutrition patients. No difference in tolerance of any specific drug or total drug dose occurred when all patients in both groups were compared. Similar comparisons in subgroups of malnourished patients and responding patients also revealed no difference. A cycle-by-cycle analysis demonstrated no difference in any phase of therapy. The wbc count, platelet count, and albumin level, on the first day of each cycle, the nadir during cycles and the day of nadir were compared in TPN and standard nutrition patients. No differences were found. This study does not suggest improved drug tolerance in lymphoma patients as a result of TPN support. Further controlled studies are needed to determine which groups of cancer patients might benefit from TPN and how these benefits occur.

Topics: Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Cyclophosphamide; Doxorubicin; Drug Therapy, Combination; Drug Tolerance; Etoposide; Humans; Leucovorin; Leukocyte Count; Lymphoma; Mechlorethamine; Methotrexate; Nutrition Disorders; Parenteral Nutrition; Platelet Count; Prednisone; Procarbazine; Prospective Studies; Random Allocation; Serum Albumin; Vincristine

Interference with any organ system during development leads to permanent damage. Severe disease or starvation during the first four months of extrauterine life lead to a persistent deficiency of cell mediated immunity, which changes the life expectancy and later disease patterns in population groups. Severe intercurrent disease, starvation or trauma later in life lower cell mediated immunity only temporarily.

Topics: Allergy and Immunology; Animals; Child Development; Female; Fetal Diseases; Humans; Immunity, Cellular; Immunologic Deficiency Syndromes; Infant; Infant, Newborn; Leucovorin; Male; Mice; Morbidity; Nutrition Disorders; Pregnancy; Starvation; Thymus Gland