High-dose hydroxyurea in autologous bone marrow transplantation

A promising "new" agent

William P. Vaughan, Philip Jay Bierman, Elizabeth Cecile Reed, Luther D. Glenn, Margaret Anne Kessinger, James Olen Armitage

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Hydroxyurea is an antineoplastic drug with a broad spectrum of clinical activity and minimal nonhematopoietic toxicity. It potentiates the cytotoxicity of alkylating agents and topoisomerase II active drugs in vitro and in vivo. It is not susceptible to alkylating agent-specific or multidrug-type resistance. We have therefore added high-dose oral hydroxyurea to widely used autologous bone marrow transplantation combination chemotherapy regimens for large cell lymphoma and metastatic breast cancer. Seventeen patients with primary-refractory or refractory-relapse large cell lymphoma received oral hydroxyurea (1.5 g/m2 every 6 hours for 12 doses) added to carmustine/cyclophosphamide/etoposide (BCV). Twelve patients with metastatic breast cancer received the same dose oral hydroxyurea added to cyclophosphamide and thiotepa. Mucositis severe enough to require parenteral narcotics was seen in over half of the patients, but none required intubation for airway maintenance. A thrombotic thrombocytopenic purpura-like hemorrhagic syndrome occurred in six patients and was fatal for three. With the BCV/hydroxyurea regimen, this syndrome was seen with the same frequency as with BCV alone. Death from rapidly progressive disease or toxicity occurred in seven of 29 patients (24%). For patients with 6 months' minimum follow-up, four of 12 (33%) of the metastatic breast cancer patients remain in complete response (median follow-up, 15 months), and four of 17 (24%) refractory large cell lymphoma patients remain in complete response (median follow-up, 10 months). High-dose hydroxyurea may increase the effectiveness of standard autologous bone marrow transplantation regimens without substantially increasing toxicity.

Original languageEnglish (US)
Pages (from-to)110-116
Number of pages7
JournalSeminars in Oncology
Volume19
Issue number3 SUPPL. 9
StatePublished - Jan 1 1992

Fingerprint

Hydroxyurea
Autologous Transplantation
Bone Marrow Transplantation
Lymphoma
Alkylating Agents
Breast Neoplasms
Cyclophosphamide
Thiotepa
Thrombotic Thrombocytopenic Purpura
Carmustine
Type II DNA Topoisomerase
Mucositis
Narcotics
Multiple Drug Resistance
Etoposide
Combination Drug Therapy
Intubation
Antineoplastic Agents
Maintenance
Recurrence

ASJC Scopus subject areas

  • Oncology

Cite this

High-dose hydroxyurea in autologous bone marrow transplantation : A promising "new" agent. / Vaughan, William P.; Bierman, Philip Jay; Reed, Elizabeth Cecile; Glenn, Luther D.; Kessinger, Margaret Anne; Armitage, James Olen.

In: Seminars in Oncology, Vol. 19, No. 3 SUPPL. 9, 01.01.1992, p. 110-116.

Research output: Contribution to journalArticle

Vaughan, William P. ; Bierman, Philip Jay ; Reed, Elizabeth Cecile ; Glenn, Luther D. ; Kessinger, Margaret Anne ; Armitage, James Olen. / High-dose hydroxyurea in autologous bone marrow transplantation : A promising "new" agent. In: Seminars in Oncology. 1992 ; Vol. 19, No. 3 SUPPL. 9. pp. 110-116.
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