title: High-dose-intensity MVAC for Advanced Renal Medullary Carcinoma: Report of Three Cases and Literature Review.
abstract: OBJECTIVE
  Renal medullary carcinoma is a rare and highly aggressive cancer that is characteristically resistant to most forms of chemotherapy. This pediatric tumor, exclusively affecting individuals who carry at least one sickle hemoglobin allele, carries a uniformly fatal outcome, usually within a matter of weeks, and no effective therapies have been reported.
  
  
  METHODS
  We report on the use of a high-dose-intensity regimen of methotrexate, vinblastine, doxorubicin, and cisplatin in 3 patients.
  
  
  RESULTS
  All 3 patients were able to tolerate multiple cycles of therapy and achieved at least a partial response and longer survival than predicted from the historical precedent.
  
  
  CONCLUSIONS
  Our results have shown that this regimen provides a tolerable therapy with efficacy to promote survival for several months and suggest that highly intensive regimens of chemotherapy might bring additional benefit to the young patients with these rare tumors.
authors.affiliation: Department of Medicine, Division of Hematology and Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina 27599-7295, USA. Rathmell@med.unc.edu
authors.forename: W Kimryn
authors.initials: WK
authors.lastname: Rathmell
authors.forename: J Paul
authors.initials: JP
authors.lastname: Monk
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy*; D002945:Cisplatin / Q000627:therapeutic use; D015897:Comorbidity; D018450:Disease Progression; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy*; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012805:Sickle Cell Trait / Q000150:complications; D016896:Treatment Outcome; D014747:Vinblastine / Q000627:therapeutic use
chemical_list: D014747:Vinblastine; D004317:Doxorubicin; D002945:Cisplatin; D008727:Methotrexate