Hematological response to the new synthetic muramyl dipeptide derivative muroctasin after chemotherapy in patients with malignant lymphoma. A randomized crossover trial.
A randomized crossover trial was performed in 20 patients receiving chemotherapy for malignant lymphoma. N2-[(N-acetylmuramoyl)-L-alanyl-D-isoglutaminyl]-N6-stearoyl-L-lysine (MDP-Lys(L18), muroctasin) at a dose of 200 micrograms was subcutaneously administered after one of two cycles of the same protocol. The administration was started on day 4 after the start of chemotherapy and continued for 10 days. The mean length from the start of chemotherapy to nadir of white blood cell (WBC) was not significantly different between the control and muroctasin cycles. The mean WBC and neutrophil counts at nadir of the control cycle were significantly lower than those at the same point of muroctasin cycle, respectively. A positive effect of muroctasin cycle, defined as WBC count at nadir being increased by 1,000/mm3, WBC count being increased by 1,000/mm3 on two points examined after nadir, or faster reach to nadir and faster recovery to normal range of WBC than in the control cycle, was observed in 7 (35%) of 20 patients. On the other hand, only one (5%) patient showed a superiority of the control cycle over the muroctasin cycle. Toxic effects of muroctasin were observed in 34.8% of patients, but were tolerable for most patients. These results show that muroctasin has a clinical efficacy in the restoration of leukopenia after chemotherapy.
Hiraoka
A
A
Fifth Department of Internal Medicine, Center for Adult Diseases, Osaka, Japan.
Masaoka
T
T
Satoh
T
T
Ota
K
K
Oyama
A
A
Horiuchi
A
A
Hasegawa
H
H
Nagai
K
K
Kosaki
M
M
Kanemaru
A
A
D000119:Acetylmuramyl-Alanyl-Isoglutamine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D002986:Clinical Trials as Topic; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D007279:Injections, Subcutaneous; D007958:Leukocyte Count; D007962:Leukocytes / Q000187:drug effects*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects*; D011897:Random Allocation
D000119:Acetylmuramyl-Alanyl-Isoglutamine; C036866:romurtide