mesna and Acute-Disease

Ifosfamide has previously been shown to be active as a single agent and in combination with doxorubicin, etoposide, and teniposide in pediatric solid tumors and adult acute leukemia. The authors performed a dose-escalation trial of ifosfamide with a fixed dosage of etoposide, with mesna uroprotection, in children with multiply recurrent acute leukemia.. Chemotherapy was administered daily for 5 days. Etoposide 100 mg/m2 was followed by ifosfamide at an initial dosage of 1.6 g/m2. The ifosfamide was escalated in 20% increments to the maximum tolerated dosage in cohorts of three patients. Mesna 400 mg/m2 was given immediately before the ifosfamide and then at 3 and 6 hours after ifosfamide in the initial patients. Subsequent patients were treated with mesna 400 mg/m2 just before ifosfamide, and then every 2 hours to a total dosage equal to the ifosfamide dosage.. Forty-four heavily pretreated patients were entered on study. Forty were evaluable for toxicity and 36 for response as well. The maximum tolerated dosage of ifosfamide was 4.0 g/m2/d for 5 days (20 g/m2/course). Overall, 10 patients achieved complete remission, and 3 achieved partial remission. Remissions were brief, although four patients went on to bone marrow transplant while in remission. One patient is still alive.. The combination of etoposide and ifosfamide with mesna uroprotection showed promising activity in children with multiply recurrent acute leukemia.

Topics: Acute Disease; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow; Bone Marrow Transplantation; Child; Drug Tolerance; Etoposide; Humans; Ifosfamide; Leukemia, Myeloid; Mesna; Neoplasm Recurrence, Local; Neutropenia; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Remission Induction; Urinary Tract

Topics: Acute Disease; Adult; Aged; Chronic Disease; Clinical Trials as Topic; Humans; Laryngectomy; Male; Mercaptoethanol; Mesna; Middle Aged; Rhinitis, Atrophic; Sinusitis

Topics: Acute Disease; Child; Diagnosis, Differential; Drug Hypersensitivity Syndrome; Female; Humans; Mesna; Protective Agents; Sepsis

Topics: Acute Disease; Adolescent; Base Sequence; Biomarkers; Bone Marrow Purging; Bone Marrow Transplantation; Busulfan; Cell Separation; Child; Child, Preschool; Clinical Protocols; Combined Modality Therapy; Cyclophosphamide; Drug Resistance; Evaluation Studies as Topic; Genetic Markers; Genetic Vectors; Hematopoietic Stem Cells; Humans; Immunologic Factors; Infant; Informed Consent; Interleukin-2; Kanamycin Kinase; Leukemia, Myeloid; Mesna; Molecular Sequence Data; Phosphotransferases (Alcohol Group Acceptor); Recombinant Fusion Proteins; Remission Induction; Research Design; Retroviridae; Safety; Transplantation, Autologous

A patient with severe chronic asthma, who had become refractory to conventional antiasthma drugs, is described. As a last resort, therapeutic bronchoalveolar lavage was performed using beta-stimulant, steroid, and mucolytic solutions. The patient, who had had asthmatic attacks almost every day prior to lavage, showed a dramatic and sustained improvement in his condition. It is suggested that therapeutic bronchoalveolar lavage may be useful in chronic asthmatics who have become refractory to conventional treatment because of mucus plugging of their bronchi.

Topics: Acute Disease; Adult; Albuterol; Asthma; Bronchoalveolar Lavage Fluid; Drug Therapy, Combination; Humans; Male; Mesna; Methylprednisolone Hemisuccinate

In 125 allogeneic bone marrow transplant recipients conditioned with cyclophosphamide (CY) with or without total body irradiation (TBI), three different protocols for prevention of CY urotoxicity have been used. The three protocols consisted of forced alkaline diuresis alone and then in combination with mesna (sodium 2-mercaptoethane sulfonate) at a low or high dose (60-90% and 150% of the CY dose, respectively). Hemorrhagic cystitis (HC) occurred in 21 patients: there were four immediate episodes without subjective symptoms which healed within a week after starting CY and 20 late episodes, starting between 17 and 51 (median 27) days. There was no correlation between the occurrence of HC and the different protocols used for prevention of urothelial toxicity. Late HC, however, except in one patient, always appeared together with acute graft-versus-host disease (GVHD) and the severity of the HC correlated with the severity of the GVHD (p less than 0.001). When acute GVHD commenced the HC started within 24 hours in three patients and in 11 patients when the dose of prednisolone given for an ongoing GVHD was reduced. In four other patients CY was not used for conditioning, but mustargen or melphalan in combination with TBI. In this group no urothelial protection was used. One of these patients developed a severe HC together with a grade II GVHD. Adenovirus and cytomegalovirus infections were not associated with HC.

Topics: Acute Disease; Bone Marrow Transplantation; Cyclophosphamide; Cystitis; Diuresis; Epithelium; Graft vs Host Disease; Hemorrhage; Humans; Mesna