title: Association between patient characteristics and treatment history, and toxicity associated with methotrexate, vinblastine, adriamycin and cisplatin (M-VAC) for advanced urothelial cancer.
abstract: OBJECTIVE
  To determine whether patient characteristics and treatment history are associated with an increased risk of adverse side-effects resulting from combination chemotherapy.
  
  
  METHODS
  A study was made on 71 patients with advanced urothelial cancer who underwent combination chemotherapy consisting of methotrexate, vinblastine, adriamycin, and cisplatin (M-VAC). Both the laboratory data and the toxic symptoms were evaluated from cycle 1 to cycle 3.
  
  
  RESULTS
  A total of 168 cycles of treatment were performed. The mean value of the nadirs of the white blood cell counts showed a significantly lower level in cycle 1 than cycle 2 (P < 0.05). There were three deaths due to disseminated intravascular coagulation or sepsis resulting from severe myelosuppression. Factors related to the occurrence of myelosuppression were gender (female), poor performance status and previous treatment by radiotherapy.
  
  
  CONCLUSIONS
  Special consideration should be given to the patient's background prior to application of this regimen.
authors.affiliation: Department of Urology, Hiroshima University School of Medicine, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Igawa
authors.forename: H
authors.initials: H
authors.lastname: Kadena
authors.forename: M
authors.initials: M
authors.lastname: Ueda
authors.forename: T
authors.initials: T
authors.lastname: Usui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002945:Cisplatin / Q000009:adverse effects; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D006402:Hematologic Diseases / Q000139:chemically induced / Q000401:mortality; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008099:Liver / Q000503:physiopathology; D008297:Male; D008727:Methotrexate / Q000009:adverse effects; D008875:Middle Aged; D014571:Urologic Neoplasms / Q000188:drug therapy* / Q000503:physiopathology / Q000532:radiotherapy; D014747:Vinblastine / Q000009:adverse effects
chemical_list: D014747:Vinblastine; D004317:Doxorubicin; D002945:Cisplatin; D008727:Methotrexate