Association between patient characteristics and treatment history, and toxicity associated with methotrexate, vinblastine, adriamycin and cisplatin (M-VAC) for advanced urothelial cancer.

OBJECTIVE: To determine whether patient characteristics and treatment history are associated with an increased risk of adverse side-effects resulting from combination chemotherapy. PATIENTS AND METHODS: A study was made on 71 patients with advanced urothelial cancer who underwent combination chemotherapy consisting of methotrexate, vinblastine, adriamycin, and cisplatin (M-VAC). Both the laboratory data and the toxic symptoms were evaluated from cycle 1 to cycle 3.
RESULTS: A total of 168 cycles of treatment were performed. The mean value of the nadirs of the white blood cell counts showed a significantly lower level in cycle 1 than cycle 2 (P < 0.05). There were three deaths due to disseminated intravascular coagulation or sepsis resulting from severe myelosuppression. Factors related to the occurrence of myelosuppression were gender (female), poor performance status and previous treatment by radiotherapy.
CONCLUSION: Special consideration should be given to the patient's background prior to application of this regimen.