phosphorus-radioisotopes and Cystitis

The frequent side effects of Hydroxy-Urea and the non-exceptional risk of leukemia and cancer in Polycythemia Vera treated for a long time by Hydroxy-Urea allow to conclude that Hydroxy-Urea is not an innocent drug. In a prospective trial of 150 patients with a median follow up of nine years, Hydroxy-Urea given alone induced side effects in 29% of patients necessitating to stop treatment in half of cases. The percentage of leukemia or myelodysplasia is 6.7% with an actuarial risk of leukemic transformation of 10% at 13 years. In an other prospective trial in 181 aged patients Hydroxy-Urea was given as maintenance therapy after 32P treatment. The median follow-up in that study is also of nine years. Side effects are observed in 13% of cases. A two fold increase of the leukemic risk was observed in the maintenance arm of the trial: 11 versus 19% at ten years, 14 vs 30% at 12 years, 16 vs 35% at 15 years because of the leukemogenic effect of Hydroxy-Urea in maintenance therapy we stopped including new patients in this arm of the trial.

Topics: Aged; Alopecia; Combined Modality Therapy; Cystitis; Erectile Dysfunction; Female; Fever; Follow-Up Studies; Humans; Hydroxyurea; Incidence; Leg Ulcer; Leukemia; Lymphoma, Non-Hodgkin; Male; Middle Aged; Neural Tube Defects; Phosphorus Radioisotopes; Pipobroman; Polycythemia Vera; Prospective Studies; Risk; Safety; Stomatitis, Aphthous

The prevention of recurrences of bladder cancer was attemped in 48 patients by means of the combined intravesical instillation of thio-tepa and urokinase and in 28 patients through the instillation of thio-tepa alone. The recurrence rates of both therapies for the postoperative 18 months were 7.9 and 32.6 per cent, respectively, indicating a significant drop in the recurrence rate in the group subjected to the combined therapy. No significant difference was found between the 2 instillation groups in terms of the blood transmission of 32-P thio-tepa. Serious leukopenia was found in 2 of the 48 patients receiving the combined instillation therapy but we concluded that this was not attributable to the use of urokinase.

Topics: Adolescent; Adult; Aged; Carcinoma, Transitional Cell; Cystitis; Drug Therapy, Combination; Endopeptidases; Female; Hemorrhage; Humans; Leukopenia; Male; Middle Aged; Neoplasm Recurrence, Local; Phosphorus Radioisotopes; Thiotepa; Urinary Bladder Diseases; Urinary Bladder Neoplasms; Urokinase-Type Plasminogen Activator