Biggar R J, Nkrumah F K
Br J Cancer. 1979 Jul;40(1):152-5. doi: 10.1038/bjc.1979.151.
Forty-four (44) patients with Burkitt's lymphoma received identical combination chemotherapy on the basis of body surface area. Patients with renal dysfunction, more common in those with abdominal tumours, were at significantly greater risk of developing severe leucopenia (less than 1000 cells/dl) than those with normal renal function (P less than 0.0001). Similar results were seen in a series of 8 patients with normal marrows treated with only i.v. cyclophosphamide and intrathecal methotrexate. Giving a lower initial dose of cyclophosphamide seemed to reduce the risk of severe leucopenia in 5 additional patients with evidence of renal dysfunction. The mechanism is postulated as delayed excretion of the active metabolites of cyclophosphamide. Adjustment of the chemotherapeutic dose should be considered when treating patients with renal dysfunction.
44例伯基特淋巴瘤患者根据体表面积接受相同的联合化疗。肾功能不全在腹部肿瘤患者中更为常见，与肾功能正常的患者相比，其发生严重白细胞减少（低于1000个细胞/分升）的风险显著更高（P＜0.0001）。在一组仅接受静脉注射环磷酰胺和鞘内注射甲氨蝶呤治疗的8例骨髓正常的患者中也观察到了类似结果。对于另外5例有肾功能不全证据的患者，给予较低初始剂量的环磷酰胺似乎可降低严重白细胞减少的风险。其机制推测为环磷酰胺活性代谢产物的排泄延迟。在治疗肾功能不全的患者时应考虑调整化疗剂量。
