Cyclophosphamide lymphomas

Clinical trials showed therapeutic efficacy in a broad spectrum of tumors these include SCLC, testicular tumors, sarcomas, breast cancer, renal cell cancer, pancreatic tumors and lymphomas. Ifosfamide is less myelosuppressive than cyclophosphamide but is more toxic to the bladder. Therefore it is recommended that ifosfamide is coadministered with the thiol compound mesna to avoid hemorrhagic cystitis and to reduce the risk of developing bladder cancer. Other side effects include neurotoxicity and myelosuppression. 

Thiotepa is chemically less reactive than the nitrogen mustards. It has antineoplastic activity against ovarian and breast cancers as well as lymphomas. However, it has been largely supplanted by cyclophosphamide and other nitrogen mustards. 

There are certain histologic subtypes of diffuse, aggressive NHL that respond less well to treatment with conventional regimens such as CHOP. Burkitt s lymphoma, lymphoblastic lymphoma, mantel cell lymphoma, and primary CNS lymphoma are examples of disease that benefit from more intensive therapy. Regimens such as hyper-CVAD, which alternate cycles of hyperfractionated cyclophosphamide, doxorubicin, vincristine, and dexamethasone with high-dose cytarabine and methotrexate, often are substituted for CHOP. Intrathecal therapy with methotrexate is indicated with documented CNS infiltration of tumor or involvement of the sinuses. The recent appreciation of the etiology of Helicobacter pylori in the etiology of peptic ulcer disease and the association between colonization and mucosal-associated lymphoma (MALT) has spurred... 

LL, a 47-year-old man, was diagnosed with high-risk diffuse large cell B-cell non-Hodgkin s lymphoma (NHL) 12 months ago. LL had a complete response to his initial treatment of six cycles of RCHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). LL is participating in a clinical trial and is randomized to receive a myeloablative autologous HCT TBI days 8 to 5, etoposide day 4, rest day 3, cyclophosphamide day 2, rest day 1, with infusion of autologous PBPC on day 0. 

Some lymphomas, for example, are related to overexpression of Bcl-2. Antisense oligonucleotides are specially designed to target the overexpression of Bcl-2. Oblimersen (Genasense) is an antisense drug by Genta to block Bcl-2 production and enhance the efficacy of other standard chemotherapy drugs such as paclitaxel, fludarabine, irinotecan, and cyclophosphamide. 

MACOP-B Methotrexate, daunomycin, cyclophosphamide, vincristine, prednisone, bleomycin Lymphoma... 

In addition, combination therapy trials of rituximab with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) in refractory and newly diagnosed patients suggests that rituximab may also have a role in the eradication of residual disease. This combination appears to be a viable treatment option for relapsed low-grade non-Hodgkin lymphoma... 

Cyclophosphamide is nsed both intravenously and orally. It is nsed for chronic lymphatic lenkemia, Hodgkin s disease, Burkitt s lymphoma, multiple myeloma, and cancer of the breast, neck, ovaries, and so on. Synonyms of this drug are endoxan, cyclostin, Cytoxan, cyclophosphane, and others. 

The alkylating agents can be considered to be cell-cycle independent drugs. They are used for the management of leukemias, lymphomas, multiple myeloma and some carcinoma s and soft tissue tumors, generally as components of drug combination regimens. Cyclophosphamide is also used for its marked immunosuppressant properties. 

Although the effects of various schedules are not always predictable, drugs that are rapidly metabolized, excreted, or both, especially if they are phase specific and thus act on only one portion of the cell cycle (e.g., cytarabine), appear to be more effective when administered by continuous infusion or frequent dose fractionation than by high-dose intermittent therapy. On the other hand, intermittent high-dose treatment of Burkitt s lymphoma with cyclophosphamide is more effective than fractionated treatment, since cyclophosphamide acts on all phases of the cell cycle and almost all of the tumor cells in that disease are actively proliferating. 

Ifosfamide is active against a broad spectrum of tumors, including germ cell cancers of the testis, lymphomas, sarcomas, and carcinomas of the lung, breast, and ovary. It is thought to be more active than cyclophosphamide in germ cell cancers and sarcomas. 

Mechlorethamine Forms DNA cross-links, resulting in inhibition of DNA synthesis and function Hodgkin s and non-Hodgkin s lymphoma Nausea and vomiting Moderate depression of peripheral blood count excessive doses produce severe bone marrow depression with leukopenia, thrombocytopenia, and bleeding alopecia and hemorrhagic cystitis occasionally occur with cyclophosphamide cystitis can be prevented with adequate hydration busulfan is associated with skin pigmentation, pulmonary fibrosis, and adrenal... 

Cyclophosphamide Same as above Breast cancer, ovarian cancer, non-Flodgkin s lymphoma, CLL, soft tissue sarcoma, neuroblastoma, Wilms tumor, rhabdomyosarcoma Nausea and vomiting ... 

Cyclophosphamide Cytoxan, Neosar Acute and chronic lymphocytic leukemia acute and chronic myelocytic leukemia carcinoma of ovary, breast Hodgkin disease non-Hodgkin lymphomas multiple myeloma Blood disorders (anemia, leukopenia, thrombocytopenia] Gl distress (nausea, vomiting, loss of appetite] bladder irritation hair loss car-diotoxicity pulmonary toxicity... 

CHOP Cyclophosphamide (Cytoxan), doxorubicin, vincristine (Oncovin), prednisone Non-Hodgkin lymphoma... 

Cyclophosphamide (Cytoxan and Endoxan) is used in the treatment of Hodgkin s disease, lymphosarcoma, and other lymphomas. It is employed as a secondary drug in patients with acute leukemia and in combination with doxorubicin in women with breast cancer. A drug combination effective in the treatment of breast cancer is cyclophosphamide, methotrexate, fluorouracil, and prednisone (CMFP). Cyclophosphamide is also an immunosuppressive agent. The toxicity of cyclophosphamide causes alopecia, bone marrow depression, nausea and vomiting, and hemorrhagic cystitis. 

Diffuse histiocytic lymphoma Cyclophosphamide, vincristine, methotrexate, and cytarabine (COMA). 

Nodular lymphoma Cyclophosphamide, Oncovin (vincristine), and prednisone (CVP). 

Diffuse histiocytic lymphoma Cyclophosphamide, Adriamycin (doxorubicin), vincristine, and prednisone (CHOP) bleomycin, Adriamycin (doxorubicin), cyclophosphamide, Oncovin (vincristine), and prednisone (BACOP) or cyclophosphamide, Oncovin (vincristine), methotrexate, and cytarabine (COMA). 

Non-Hodgkin s lymphoma Combination chemotherapy cyclophosphamide, doxorubicin, vincristine, prednisone Bleomycin, lomustine, carmustine, etoposide, interferon, mitoxantrone, ifosfamide, rituximab... 

Combination chemotherapy is the treatment standard for patients with diffuse non-Hodgkin s lymphoma. The anthracycline-containing regimen CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) has been considered the best treatment in terms of initial therapy. Recently, randomized phase III clinical studies have shown that the combination of CHOP with the anti-CD20 monoclonal antibody rituximab results in improved response rates, disease-free survival, and overall survival compared with CHOP chemotherapy alone. 

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