W Kimryn Rathmell1, J Paul Monk. 1. 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
Abstract
OBJECTIVES: 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.
OBJECTIVES: 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.
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