title: Gut protection by cyclophosphamide "priming" in patients receiving high-dose melphalan--effect of drug scheduling.
abstract: A "priming" injection of cyclophosphamide (400 mg/m2 given i.v. on day -7) has been shown to reduce intestinal permeability and thus gut toxicity in patients receiving high-dose melphalan. To determine the optimal timing for this injection, patients receiving 200 mg/m2 melphalan with an autologous bone marrow transplant were randomly assigned to receive cyclophosphamide at 5, 7 or 9 days before the melphalan. The median percentage of [51Cr]-ethylenediaminetetraacetic acid excretion was similar (9.1% vs 7.1% vs 7.7%, respectively), with equivalent duration of WHO grade 2-4 mucositis and diarrhoea being recorded for each group. Thus, the timing of the cyclophosphamide prime is not critical, and the priming injection may be given between 5 and 9 days prior to high-dose melphalan.
authors.affiliation: CRC Section of Medicine, Institute of Cancer Research, Sutton, Surrey, U.K.
authors.forename: J
authors.initials: J
authors.lastname: Mansi
authors.forename: E
authors.initials: E
authors.lastname: Ellis
authors.forename: C
authors.initials: C
authors.lastname: Viner
authors.forename: J
authors.initials: J
authors.lastname: Mundy
authors.forename: T
authors.initials: T
authors.lastname: Smith
authors.forename: J
authors.initials: J
authors.lastname: Millar
authors.forename: S
authors.initials: S
authors.lastname: Milan
authors.forename: M
authors.initials: M
authors.lastname: Gore
authors.forename: D
authors.initials: D
authors.lastname: Cunningham
mesh_terms: D016026:Bone Marrow Transplantation; D002860:Chromium Radioisotopes; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004492:Edetic Acid / Q000493:pharmacokinetics; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000517:prevention & control*; D006801:Humans; D008558:Melphalan / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D009369:Neoplasms / Q000188:drug therapy* / Q000601:surgery
chemical_list: D002860:Chromium Radioisotopes; D003520:Cyclophosphamide; D004492:Edetic Acid; D008558:Melphalan