Trofosfamide (TROFO) is an orally taken oxazaphosphorine prodrug. Other metabolic products of TROFO include ifosfamide and cyclophosphamide. In pilot studies with TROFO, significant activity against refractory non-Hodgkin's lymphoma (NHL) and mild toxicity were reported. The prognosis of pretreated elderly patients is extremely poor. Thus, the aim of this trial was to test the activity of single TROFO therapy given orally continuously (c) (3 × 50 mg daily) versus intermittently (i) (300–400 mg daily for 4 days every 21 days) in pretreated elderly patients with refractory NHL. Forty-four patients (25 female, 19 male), median age 69 years (range 65–84) have been accrued to receive either TROFOi or TROFOc. Twenty-seven patients presented with low-grade, 17 with high-grade NHL. All patients had stage III or IV disease, and 12 (27%) were suffering from B symptoms. The majority (41/44, 93%) was heavily pretreated with 2 or more prior regimens (median = 2; range 1–4), 24 had already received other oxazaphosphorine prodrugs. Major responses have been seen in 48% so far, with 3 complete (2 in high-grade) and 18 partial (6 in high-grade) remissions. With TROFOi, responses were seen in 9/21 patients after a median of 3 cycles, with TROFOc in 12/23 patients after a median of 9 weeks. The median duration of response was 4 months in both groups. TROFO was well tolerated in both groups without significant gastrointestinal or renal toxicity, peripheral neurotoxicity or alopecia. Bone marrow toxicity was slightly more pronounced in TROFOc with 57% of WHO grade III leukopenia and/or thrombocytopenia as compared with 43% in TROFOi. Other adverse effects included mild to moderate fatigue, nausea, diarrhea, and vomiting and were seen in a total of 35 patients. TROFO seems to be an active agent in the treatment of elderly pretreated patients with refractory low-grade and high-grade NHL, with responses in about 50% of patients. TROFO is equally effective as TROFOi but is more toxic.
In a phase II study, the combination of the new platinum derivative carboplatin with vincristine and etoposide is associated with a remission rate of 81.8 per cent (LD 84.4%, ED 79.1%). The median survival rates for patients with limited disease have not yet been reached, and, at 11.5 months in the case of patients with extensive disease, are unexpectedly high. In comparison with combinations containing cisplatin, the present combination would appear to be superior, and its toxicity is also lower. For a definitive assessment of its usefulness, it must be compared with other standard treatment regimens in prospective, randomized studies.
Case Reports| August 14 2000 Cerebrocutaneous Xanthoma disseminatum and Disseminated Demyelinating Encephalomyelitis Subject Area: Neurology and Neuroscience G. Pfeiffer; G. Pfeiffer aDepartments of Neurology, Search for other works by this author on: This Site PubMed Google Scholar C. Hagel; C. Hagel bNeuropathology, Search for other works by this author on: This Site PubMed Google Scholar B. Eckert; B. Eckert cNeuroradiology, Search for other works by this author on: This Site PubMed Google Scholar R. Zschaber; R. Zschaber dHematology and Oncology and Search for other works by this author on: This Site PubMed Google Scholar G. Gross; G. Gross fDepartment of Dermatology, University Hospital Rostock, Germany Search for other works by this author on: This Site PubMed Google Scholar C.M. Bamberger C.M. Bamberger eMedicine, University Hospital Hamburg-Eppendorf, Hamburg, and Search for other works by this author on: This Site PubMed Google Scholar Eur Neurol (2000) 44 (2): 123–124. https://doi.org/10.1159/000008211 Article history Published Online: August 14 2000 Content Tools Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation G. Pfeiffer, C. Hagel, B. Eckert, R. Zschaber, G. Gross, C.M. Bamberger; Cerebrocutaneous Xanthoma disseminatum and Disseminated Demyelinating Encephalomyelitis. Eur Neurol 1 August 2000; 44 (2): 123–124. https://doi.org/10.1159/000008211 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsEuropean Neurology Search Advanced Search Article PDF first page preview Close Modal This content is only available via PDF. 2000Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. You do not currently have access to this content.
SummarySixty-seven patients (54 male and 13 female) with inoperable non-small cell lung cancer were treated with combined mitomycin C, vindesine, and ifosfamide. The performance status of all patients was over 70%. Forty-two patients had extensive disease, 19 limited disease. The most frequent histology was squamous cell carcinoma found in 46 patients. Only 9 patients had large cell carcinoma, and 6 patients adenocarcinoma. Four complete (6.5%) and 27 partial remissions (44.2%) were achieved. 10/61 (16.4%) patients showed a minor response. In 16/61 patients (26.2%), there was no change; 4/61 (6.5%) showed progressive disease. The median survival time for all patients is 9 (+) months. Patients who responded to the chemotherapy survived 14 (+) months. Ten out of 31 responding patients are still alive. The median survival time of the non-responding patients was 8 months. The toxicity of the regimen was relatively mild. In particular, the subjective gastro-intestinal symptoms occurred in only 50% of our patients. The hematological toxicity was acceptable, and the renal toxicity did not pose any problems. According to the remission rates, this regimen is comparable to combinations with cis-platinum and appears to have much less toxicity.
About 5 - 10 % of all Non-Hodgkin-Lymphomas (NHL) present within the major salivary glands. Two etio-pathologically different groups, the (extranodal)-parenchymal NHL and NHL of intra- or periglandular lymphnodes (nodal lymphomas) have to be distinguished. It was the aim of this study to evaluate the clinical presentation, therapy and biological behaviour of these etiopathologically different lymphoma-groups.In a retrospective study, therapy and course of disease of 26 patients with a NHL of the major salivary glands were examined (diagnosis and treatment between 1988 and 1996).Staging results in the group of parenchymal lymphoma always showed the disease limited to the effected gland, whereas nodal NHL presented with a stadium II to IV (Ann-Arbor) at time of diagnosis. Local recurrencies were five times higher in nodal NHL compared to parenchymal NHL. In only one case (7.7 %) of the patients with parenchymal NHL, dissemination was observed. In the group of nodal NHL, a dissemination was observed in 6 patients (46.2 %). 7 of 13 patients (53.8 %) with a nodal NHL died due to lymphoma dissemination, compared to one patient (7.7 %) with a parenchymal NHL.Based on the presented data, the histopathological diagnosis, under special recognition of the particular lymphoma-pathogenesis, constitutes an important prognostic factor in patients with NHL of the major salivary glands.
