melphalan and Ascites

Pleural effusion or ascites complicating plasmacytoma is rare and has a poor prognosis. A 70-year-old man was diagnosed as plasma cell leukemia and one course of ranimustine-vindesine, melphalan, and prednisolone followed by melphalan and prednisone (MP) maintained a very good partial response. After MP he was diagnosed to have pleural effusion and ascites as a complication of the plasmacytoma. Low-dose bortezomib caused disappearance of the malignant effusion. The malignant effusions recurred after the end of the second course of bortezomib. High-dose dexamethasone vincristine, doxorubicin, cyclophosphamide, and prednisone yielded no benefit, the patient died of Aspergillus pneumonia.

Topics: Aged; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Ascites; Boronic Acids; Bortezomib; Fatal Outcome; Humans; Leukemia, Plasma Cell; Male; Melphalan; Pleural Effusion, Malignant; Prednisone; Pyrazines; Treatment Failure

Topics: Adenocarcinoma; Ascites; Carcinoma; Cyclophosphamide; Female; Fluorouracil; Humans; Injections, Intravenous; Melphalan; Nitrogen Mustard Compounds; Ovarian Neoplasms; Thiotepa

In a controlled prospective randomized study the regimen doxorubicin (A) 40 mg/m2 + melphalan (M) 0.4 mg/kg was compared with A + M + cisplatin (C) 50 mg/m2 given every four weeks in advanced ovarian cancer, FIGO stage III or IV and with serous or anaplastic histology. From 1981 to 1983, 300 patients entered the study and 295 patients were evaluable for response, toxicity and long-term survival. All patients were followed for at least 10 years. The majority of patients had large residual tumours >2 cm. Patients treated with MAC had a higher response rate compared with patients treated with MA (76% vs. 50%, p < 0.01) and treatment with MAC resulted in significantly more pathological complete responders than MA. There was a significant difference in median duration of response (19 months vs. 13 months, p < 0.006) and in median survival time (26 months vs. 19 months, p = 0.05). After 5- and 10 years a significant difference in progression-free and overall survival was found. The independent prognostic factors in this study were residual tumour after primary surgery, treatment with MAC, tumour grade, ascites, and stage. Objective and subjective side effects were significantly worse with MAC, although tolerable. In conclusion, this study shows that incorporating C into MA improves the duration of progression-free survival and overall survival in women with incompletely resected Stage III or Stage IV ovarian epithelial cancer. A 5- and 10-year survival of 25% and 18%, respectively, is impressive.

Topics: Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Ascites; Cisplatin; Doxorubicin; Female; Humans; Melphalan; Middle Aged; Neoplasm, Residual; Ovarian Neoplasms; Prognosis; Sweden

Ninety-three women with FIGO stage II epithelial ovarian carcinoma underwent comprehensive surgical staging and were randomized prospectively to therapy consisting of either intraperitoneal radioactive phosphorus or oral melphalan. No patient had gross residual disease at the time of randomization. Ten of the forty-five women treated with melphalan experienced severe bone marrow depression at some time during therapy and two women expired from leukemia. Four of the forty-eight women treated with intraperitoneal phosphorus required surgical reexploration for intestinal obstruction or bowel injury. Twenty-one women died of their disease. Survival was not statistically different between the two treatment arms. The 5-year actuarial survival was 78%.

Topics: Adolescent; Adult; Aged; Ascites; Carcinoma, Squamous Cell; Child; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Melphalan; Middle Aged; Neoplasm Staging; Ovarian Neoplasms

Antitumor efficiencies of cytostatics dioxadet, cisplatin, mitomycin C, melphalan, and paclitaxel after a single intraperitoneal or intravenous injection in doses of 1.5, 4, 1.5, 2, and 5 mg/kg, respectively, were studied on the model of transplanted ovarian tumor in 124 rats. The antitumor effects were evaluated by the increase in median survival. Dioxadet, cisplatin, and melphalan injected intraperitoneally significantly prolonged the lifespan median - by 79, 88, and 114%, respectively, and were in fact ineffective, when injected intravenously. Intraperitoneal mitomycin C prolonged lifespan median by just 35%, intravenous - by 152%. Paclitaxel injected intraperitoneally and intravenously prolonged the lifespan median by 45 and 81%, respectively.

Topics: Adenocarcinoma, Papillary; Animals; Antineoplastic Agents; Ascites; Cisplatin; Female; Injections, Intraperitoneal; Injections, Intravenous; Melphalan; Mitomycin; Neoplasm Transplantation; Ovarian Neoplasms; Paclitaxel; Rats; Survival Analysis; Treatment Outcome; Triazines

The Single Cell Gel Electrophoresis (Comet) assay, originally developed to allow visualisation of DNA strand break damage in individual cells, has been adapted to measure DNA interstrand cross-links. DNA interstrand cross-links are formed in cells by a number of commonly used cancer chemotherapy agents and are considered to be the critical lesion formed by such agents. This technique allows the analysis of DNA interstrand cross-link formation and repair at a single cell level, requires few cells, allows the determination of heterogeneity of response within a cell population and is sensitive enough to measure DNA interstrand cross-links at pharmacologically relevant doses. The method can be applied to any in vitro or in vivo application where a single cell suspension can be obtained. The method has also become invaluable in studies using human tissue and can be used as a method for pharmacodynamic analysis in early clinical trials.

Topics: Ascites; Cell Line, Tumor; Comet Assay; Cross-Linking Reagents; DNA; DNA Damage; Humans; Lymphocytes; Melphalan; Staining and Labeling

Nodular regenerative hyperplasia (NRH) of the liver is an infrequent entity that is usually diagnosed after the appearance of clinical signs of portal hypertension such as hepatomegaly, splenomegaly or upper gastrointestinal bleeding due to esophageal varices, which are the most frequently found clinical manifestations in NRH. Ascites is a less frequent finding and has always been described in association with other manifestations of portal hypertension. We describe a new case of NRH with atypical presentation in which ascites was the sole clinical manifestation.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Ascites; Bronchopneumonia; Combined Modality Therapy; Disease Progression; Fatal Outcome; Focal Nodular Hyperplasia; Humans; Hypertension, Portal; Liver Regeneration; Lumbar Vertebrae; Male; Melphalan; Multiple Myeloma; Plasmacytoma; Prednisone; Spinal Neoplasms

A 61-year-old man was transferred from a peripheral hospital with the diagnosis of interstitial lung disease and an unclear mediastinal tumour. At the time of admission the patient had congestive heart disease NYHA class IV.. The echocardiogram showed a small left ventricle with concentric hypertrophy and a left ventricular ejection fraction of 35 %. The myocardium was relatively echo-rich with solid structures inside. Chest X-ray showed a massive rightsided pleural effusion. The abdominal ultrasound demonstrated ascites and hepatomegaly. The bronchoalveolar lavage showed an increased part of CD3 negative and CD16/CD56 positive cells, which were identified as plasma cells by light and electron microscopy. Aspiration and investigation of the bone marrow verified the diagnosis of a IgG multiple myeloma, highly differentiated characterised by monoclonal expression of light-lambda chains. Additionally Bence-Jones-proteins were found in the urine and osteolysis in the x-ray of the skull and the humerus.. Multiple myeloma, IgG-lambda, stage IIA.. Chemotherapy with prednisolone and melphalan was initiated. His general condition increased after administration of the first cycle of chemotherapy.. Cardiopulmonary involvement is seldom seen in multiple myeloma but should be excluded when clinical symptoms are present.

Topics: Antineoplastic Combined Chemotherapy Protocols; Ascites; Bence Jones Protein; Bone Marrow; Bronchoalveolar Lavage Fluid; Humans; Male; Melphalan; Microscopy, Electron; Middle Aged; Multiple Myeloma; Plasma Cells; Pleural Effusion, Malignant; Prednisolone; Tomography, X-Ray Computed

Topics: Abdominal Neoplasms; Antineoplastic Combined Chemotherapy Protocols; Ascites; Cell Division; Cisplatin; Combined Modality Therapy; Female; Fluorouracil; Humans; Hyperthermia, Induced; Infusions, Parenteral; Male; Melphalan; Middle Aged; Mitomycin; Perfusion; Survival Rate

We administered melphalan by the intraperitoneal route to investigate its toxicity and pharmacokinetics. The drug was instilled with 2 litres of fluid and allowed to dwell in the peritoneal cavity for 4 hours. No local toxicity was detected by clinical examination, laboratory tests, or histologic examination. The intraperitoneal route allowed the dose to be increased to approximately three times the maximum dose tolerated intravenously before drug leaking into the systemic circulation produced dose-limiting myelosuppression. The peak peritoneal concentration averaged 93-fold greater than the plasma concentration, and total drug exposure for the peritoneal cavity averaged 63-fold greater than that for plasma. Tumor regressions were observed in patients with ovarian carcinoma and gastrointestinal adenocarcinomas. This study shows that from the pharmacologic point of view, if any portion of the tumor can be reached by intraperitoneal instillation, then there is a very strong rationale for the administration of melphalan by the intraperitoneal route, rather than the oral or intravenous route, for the treatment of tumors confined to the peritoneal cavity.

Topics: Adult; Aged; Ascites; Ascitic Fluid; Bone Marrow Diseases; Colonic Neoplasms; Female; Humans; Infusions, Parenteral; Kinetics; Laparotomy; Male; Melphalan; Middle Aged; Models, Biological; Neoplasms; Ovarian Neoplasms; Pancreatic Neoplasms; Peritoneal Cavity; Stomach Neoplasms

Topics: Animals; Ascites; Cell Division; Cisplatin; Cross-Linking Reagents; DNA, Neoplasm; Drug Resistance; Leukemia L1210; Melphalan; Mice

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Ascites; Chlorambucil; Cobalt Isotopes; Cyclophosphamide; Cystadenocarcinoma; Dactinomycin; Endometriosis; Female; Fluorouracil; Humans; Melphalan; Ovarian Neoplasms; Radiotherapy, High-Energy; Thiotepa; Vinblastine; Vincristine

Topics: Animals; Anti-Bacterial Agents; Antibiotics, Antineoplastic; Antifungal Agents; Antiviral Agents; Ascites; Carcinoma 256, Walker; Carcinoma, Ehrlich Tumor; Cyclophosphamide; Depression, Chemical; Injections, Intraperitoneal; Injections, Subcutaneous; Leukemia, Experimental; Mechlorethamine; Melphalan; Mice; Neoplasms, Experimental; Nitrogen Mustard Compounds; Rats; Sarcoma; Sarcoma 180; Thiotepa; Uracil

Topics: Animals; Ascites; Cricetinae; Cyclophosphamide; Injections, Intraperitoneal; Injections, Subcutaneous; Lethal Dose 50; Melanoma; Melphalan; Neoplasm Transplantation; Neoplasms, Experimental

Topics: Animals; Ascites; Cells, Cultured; DNA; DNA Repair; DNA, Neoplasm; Melphalan; Mustard Compounds; Nucleic Acid Conformation; Rats; Rats, Inbred Strains; Sarcoma, Yoshida; Sulfur Isotopes; Time Factors; Tritium

Topics: Animals; Ascites; Cricetinae; Melanoma; Melphalan; Neoplasms, Experimental; Prognosis

Topics: Animals; Antineoplastic Agents; Ascites; Carcinoma, Ehrlich Tumor; Cyclophosphamide; Electronics, Medical; Mannomustine; Melphalan; Mercaptopurine; Methods; Mice; Sarcoma 180

Topics: Alkylating Agents; Ascites; Cyclophosphamide; Female; Humans; Melphalan; Ovarian Neoplasms; Prognosis; Thiotepa

Topics: Amines; Animals; Antimetabolites; Ascites; Carcinoma; Carcinoma, Ehrlich Tumor; Gallic Acid; Hydrolyzable Tannins; Melphalan; Pharmacology; Protein Biosynthesis; Proteins; Research; Thiotepa

Topics: Alkaloids; Antineoplastic Agents; Ascites; Cyclophosphamide; Electrons; Lymphoma; Mannomustine; Melphalan; Mice; Microscopy; Microscopy, Electron; Neoplasms; Neoplasms, Experimental; Pharmacology; Research