INDEX chemotherapy

In the treatment of human neoplastic diseases methotrexate has largely supplanted aminopterin in chemotherapy, due to the better therapeutic index of the former in experimental animals, although this superiority over (325) has not been conclusively demonstrated in man. 

P2-microglobulin concentration have been correlated with survival. The International Index is a predictive model for aggressive NHL to be treated with doxorubicin-containing chemotherapy regimens.11 This index is used as a tool for selecting therapy for patients who may warrant a more intense treatment regimen based on known poor prognostic factors. 

In terms of pharmacokinetics, many host factors, such as the route of administration, the metabolism, the catabolism and clearance will considerably determine the anti neoplastic success of a drug. One major difficulty with the clinical effectiveness of chemotherapy of neoplastic diseases is the requirement that it kill malignant tumor cells at doses that allow cells in the patient s vital organs to survive so that the recovery can occur. In other words, it is to obtain a reasonably safe therapeutic index favoring introduction into clinical practice. 

Diffuse large B-cell lymphomas are the most common lymphoma in patients of all ages but most commonly seen in the seventh decade. Extranodal disease is present at diagnosis in 30% to 40% of patients. The International Prognostic Index score correlates with prognosis. Diffuse aggressive lymphomas are sensitive to chemotherapy with cure achieved in some patients. 

Individualization of dosing of chemotherapeutic drugs with a low therapeutic index is essential to effective, safe chemotherapy. 

A rise in body mass index has been reported in young patients with teratomas treated with chemotherapy, still apparent 14 years after the end of treatment (317). 

Shaw IC. 1987. MESNA and oxazaphosphorine chemotherapy [Abstract], In Anticancer Drugs Therapeutic Index Improvement by Toxicity Reduction, April 6-7, 1987, London, Westminster Hospital, Imperial Cancer Research Fund, and Deutsches Krebsforschungszentrum, A4.2. 

Chemotherapy is available for certain specific organisms, e.g. amoebiasis, giardiasis, typhoid fever (see Index). 

Leen, E., Goldberg, J.A., Angerson, W.J., McArdle, C.S. Potential role of Doppler perfusion index in selection of patients with colorectal cancer for adjuvant chemotherapy. Lancet 2000 355 34-37... 

As a therapeutic agent, mechlorethamine has many toxic effects. Acutely, it causes nausea and vomiting, skin blistering, and ulceration. After a week or two, it causes leukopenia, lymphopenia, anemia, thrombocytopenia, diarrhea, oral ulcers, and hyperuricemia. It can cause sterility and after a few years, leukemia. The most susceptible tissues are those with renewable cell populations, bone marrow, lymphoid tissues, and gastrointestinal (GI) epithelium. The therapeutic dose of mechlorethamine and most of the cytotoxic chemotherapy drugs is very close to the toxic dose. The therapeutic index (ratio of beneficial effect to toxic effect) is small. 

High risk. Medications, procedures, processes, and disease states for which there is a greater chance for adverse outcomes (e.g., chemotherapy administration, intravenous potassium use, intrathecal injections, anticoagulation, medications with a narrow therapeutic index, and care of immunocompromised patients). 

Introduction - This chapter will be limited to antibiotics for which antibacterial activity has been demonstrated. Subjects related to biosynthesis are excluded. A variety of antibiotic topics were presented at the 18th Interscience Conference on Antimicrobial Agents and Chemotherapy, for which abstracts were published. The proceedings of the previous year s 10th International Congress of Chemotherapy cover a variety of clinical topics. Two books of general interest are concerned with the indexing, isolation, separation and purification of antibiotics. > ... 

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