title: Severe myelotoxicity of oral etoposide in heavily pretreated patients with non-Hodgkin's lymphoma or chronic lymphatic leukemia.
abstract: BACKGROUND
  Promising results have been reported for patients with non-Hodgkin's lymphoma (NHL) receiving chronic oral etoposide. Due to the small number of patients reported, information regarding side effects is limited, and therefore warrants further evaluation.
  
  
  METHODS
  Twenty eligible patients with NHL and chronic lymphatic leukemia (CLL), resistant to or relapsed after previous protocols of polychemotherapy were treated with oral etoposide at a dosage of 50 mg/m2/day for 21 days in a 28-day cycle. Response and toxicity were evaluated according to standard criteria.
  
  
  RESULTS
  Total response was noted in 13 patients, complete response in 2 patients, and partial response in 11 patients. Two patients had stable disease and five patients had progression of disease during treatment. Seventy-five percent of patients experienced neutropenia below 1500/microL. Half acquired infection and required hospitalization. Fifty-five percent required blood transfusions. All patients needed course shortening and dosage reduction.
  
  
  CONCLUSIONS
  Chronic daily administration of oral etoposide is effective in patients with NHL and CLL. In heavily pretreated patients, myelotoxicity is severe. Therefore, modification of the schedule plan is mandatory in this group of patients.
authors.affiliation: Division of Hematology, Beilinson Medical Center, Petach Tikva, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Shaklai
authors.forename: O
authors.initials: O
authors.lastname: Bairey
authors.forename: D
authors.initials: D
authors.lastname: Blickstein
authors.forename: M
authors.initials: M
authors.lastname: Prokocimer
authors.forename: H
authors.initials: H
authors.lastname: Hadar
authors.forename: M
authors.initials: M
authors.lastname: Lahav
authors.forename: J
authors.initials: J
authors.lastname: Sulkes
authors.forename: M
authors.initials: M
authors.lastname: Shaklai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001855:Bone Marrow Diseases / Q000139:chemically induced; D018450:Disease Progression; D004198:Disease Susceptibility / Q000139:chemically induced; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D007239:Infections / Q000209:etiology*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy*; D007958:Leukocyte Count; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced*; D011241:Prednisone / Q000627:therapeutic use; D012074:Remission Induction; D016879:Salvage Therapy
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide; D011241:Prednisone