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CNS dysfunction, especially impaired cerebellar function, is the dose-limiting toxicity associated with high-dose cytosine arabinoside, which precludes doses of greater than 48 g/m2. Four hundred eighteen patients between the ages of 2 and 74 years with leukemia or lymphoma received 36 to 48 g/m2 cytosine arabinoside either alone or with anthracycline antibiotics, 4'-(9-acridinylamino) methane sulfon-m-anisidine (m-AMSA), or total body irradiation. In only 35 of 418 patients (8%) did severe cerebellar toxicity develop; it was irreversible or fatal in four (1%) patients. The age of the patient was a critical factor in the incidence of severe cerebellar toxicity. Patients greater than 50 years old had a statistically significant greater incidence of cerebellar toxicity compared with younger patients (26/137, 19%, v 9/281, 3%; P less than .0005, chi 2). Neither the diagnosis, disease status, sex, nor the regimen altered the incidence of severe cerebellar toxicity (when corrected for age). A second course of high-dose cytosine arabinoside, administered to 62 patients, did not increase the incidence of severe cerebellar toxicity, which occurred in five (8%) of these patients. Two of the five patients had severe toxicity with the initial course. Of the 60 patients with no antecedent cerebellar dysfunction, three (5%) had severe toxicity with the second course: one of 41 patients were less than 50 years old; two of 19 patients were greater than or equal to 50 years. Since the occurrence of severe cerebellar dysfunction is greatly affected by age, reduced doses of high-dose cytosine arabinoside should be given to patients greater than 50 years old, and methods for reducing the cerebellar toxicity should be investigated in these patients.
R H Herzig, and
J D Hines, and
G P Herzig, and
S N Wolff, and
P A Cassileth, and
H M Lazarus, and
D J Adelstein, and
R A Brown, and
P F Coccia, and
S Strandjord
May 1985,
Journal of clinical oncology : official journal of the American Society of Clinical Oncology,
R H Herzig, and
J D Hines, and
G P Herzig, and
S N Wolff, and
P A Cassileth, and
H M Lazarus, and
D J Adelstein, and
R A Brown, and
P F Coccia, and
S Strandjord
September 1992,
Oncology nursing forum,
R H Herzig, and
J D Hines, and
G P Herzig, and
S N Wolff, and
P A Cassileth, and
H M Lazarus, and
D J Adelstein, and
R A Brown, and
P F Coccia, and
S Strandjord
February 1983,
Cancer,
R H Herzig, and
J D Hines, and
G P Herzig, and
S N Wolff, and
P A Cassileth, and
H M Lazarus, and
D J Adelstein, and
R A Brown, and
P F Coccia, and
S Strandjord
June 1985,
Seminars in oncology,
R H Herzig, and
J D Hines, and
G P Herzig, and
S N Wolff, and
P A Cassileth, and
H M Lazarus, and
D J Adelstein, and
R A Brown, and
P F Coccia, and
S Strandjord
February 1985,
Onkologie,
R H Herzig, and
J D Hines, and
G P Herzig, and
S N Wolff, and
P A Cassileth, and
H M Lazarus, and
D J Adelstein, and
R A Brown, and
P F Coccia, and
S Strandjord
June 1985,
Seminars in oncology,
R H Herzig, and
J D Hines, and
G P Herzig, and
S N Wolff, and
P A Cassileth, and
H M Lazarus, and
D J Adelstein, and
R A Brown, and
P F Coccia, and
S Strandjord
January 1983,
Medical and pediatric oncology,
R H Herzig, and
J D Hines, and
G P Herzig, and
S N Wolff, and
P A Cassileth, and
H M Lazarus, and
D J Adelstein, and
R A Brown, and
P F Coccia, and
S Strandjord
January 1986,
Acta medica Scandinavica,
R H Herzig, and
J D Hines, and
G P Herzig, and
S N Wolff, and
P A Cassileth, and
H M Lazarus, and
D J Adelstein, and
R A Brown, and
P F Coccia, and
S Strandjord
November 1983,
Annals of neurology,
R H Herzig, and
J D Hines, and
G P Herzig, and
S N Wolff, and
P A Cassileth, and
H M Lazarus, and
D J Adelstein, and
R A Brown, and
P F Coccia, and
S Strandjord
December 1981,
Cancer,
