Ravikumar T S, Grage T B
J Surg Oncol. 1983 Nov;24(3):242-5. doi: 10.1002/jso.2930240322.
A clinical picture compatible with the syndrome of inappropriate ADH (antidiuretic hormone) secretion was observed in two patients receiving vinblastine-bleomycin chemotherapy. The mechanism by which this response is brought about is unclear. Penetration of Vinka alkaloids into CSF of humans is poor in the absence of extensive meningeal involvement, and hence an indirect method of action by a reduction in the osmotic threshold for vasopressin release has been suggested. By administering vinblastine on days 1 and 4 (instead of days 1 and 2, as suggested in the high-response regimen consisting of vinblastine, bleomycin, and cis-platinum) we have found better bone marrow tolerance and have not noticed the inappropriate ADH syndrome.
在两名接受长春碱-博来霉素化疗的患者中观察到了与抗利尿激素分泌不当综合征相符的临床表现。导致这种反应的机制尚不清楚。在没有广泛脑膜受累的情况下，长春花生物碱在人体脑脊液中的渗透较差，因此有人提出通过降低抗利尿激素释放的渗透阈值来产生间接作用机制。通过在第1天和第4天给予长春碱（而不是在由长春碱、博来霉素和顺铂组成的高反应方案中建议的第1天和第2天给药），我们发现骨髓耐受性更好，并且没有注意到抗利尿激素分泌不当综合征。
