peplomycin and Leukemia

A 60-year-old man with adult T cell leukemia had been suffering from intractable hypercalcemia resistant to saline hydration, intravenous administration of furosemide, elcatonin, prednisolone and phosphate, and also hemodialysis. Since there was one report suggesting that bleomycin could act as an anticalcemic agent, peplomycin, a new derivative of blerivative of bleomycin, was given at a dose of 10 mg/day by continuous intravenous infusion for 3 days and rapid normalization of serum calcium and creatinine levels resulted. The mechanism of this antihypercalcemic effect is not clear, but peplomycin directly inhibit bone resorption.

Topics: Bleomycin; Deltaretrovirus; Humans; Hypercalcemia; Leukemia; Male; Middle Aged; Peplomycin; Retroviridae Infections; T-Lymphocytes

Peplomycin containing combination chemotherapy with cyclophosphamide, hydroxy-daunomycin, oncovin and prednisone (CHOP-P) was performed in one patient with ATL and 8 patients with advanced diffuse lymphoma. CHOP-PM combination chemotherapy plus MTX was applied to 6 patients resistant to CHOP-P regimen. The overall complete remission rate was 53%, and 67% in non-T cell type and 50% in T cell type. However, only one patient out of 4 ATL patients showed complete response. Toxicities such as transient fever, myelotoxicities, G-I tract symptoms, hair loss and interstitial pneumonitis, were observed. Only in one out of 4 patients suspected drug-induced pneumonitis by peplomycin was observed. This regimen including peplomycin is considered to be one of the useful combination chemotherapies for diffuse lymphoma, especially non-T cell type and some of T cell type, except ATL.

Topics: Adult; Aged; Antibiotics, Antineoplastic; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cyclophosphamide; Doxorubicin; Drug Therapy, Combination; Female; Humans; Leukemia; Lung; Lymphoma; Male; Middle Aged; Peplomycin; Prednisone; Radiography; T-Lymphocytes; Vincristine