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Pharmacotherapy May 2010Procarbazine hydrochloride is an oral alkylating agent primarily used as a component of chemotherapy regimens for Hodgkin's lymphoma, as well as in regimens for primary... (Review)
Review
Procarbazine hydrochloride is an oral alkylating agent primarily used as a component of chemotherapy regimens for Hodgkin's lymphoma, as well as in regimens for primary central nervous system lymphoma and high-grade gliomas. Although the prescribing information for procarbazine lists hepatic dysfunction as a potential adverse reaction, we found only one published report with a probable link between procarbazine and liver injury. We describe a 65-year-old man who developed liver injury due to procarbazine during salvage chemotherapy for non-Hodgkin's lymphoma. The patient had no preexisting liver disease, his lymphoma was without hepatic involvement, and no liver injury developed after initial chemotherapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). Due to relapse of his non-Hodgkin's lymphoma, salvage chemotherapy with C-MOPP-R (cyclophosphamide, vincristine, procarbazine, prednisone, and rituximab) was administered, and the patient developed fever and aminotransferase level elevation during the second cycle. After discontinuation of all drug therapy, exclusion of other potential etiologies, and resolution of hepatic injury, the patient was rechallenged with procarbazine and again experienced fever with aminotransferase level elevation. His aminotransferase levels promptly returned to normal after discontinuation of procarbazine, and he experienced no further evidence of liver disease. Use of validated scoring systems of drug-induced liver injury indicated a definitive association between the patient's hepatic injury and procarbazine. Based on our experience with this patient, periodic assessment of hepatic function, as suggested in the package insert, is recommended in patients receiving procarbazine.
Topics: Aged; Alanine Transaminase; Antineoplastic Agents, Alkylating; Chemical and Drug Induced Liver Injury; Drug Monitoring; Humans; Liver; Lymphoma, Non-Hodgkin; Male; Procarbazine; Salvage Therapy; Time Factors; Treatment Outcome
PubMed: 20412004
DOI: 10.1592/phco.30.5.540 -
Annals of Internal Medicine Dec 1974
Review
Topics: Animals; Bone Neoplasms; Carcinogens; Carcinoma; Drug Evaluation; Hodgkin Disease; Humans; Lung Neoplasms; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Multiple Myeloma; Myeloproliferative Disorders; Neoplasms; Polycythemia Vera; Procarbazine
PubMed: 4611297
DOI: 10.7326/0003-4819-81-6-795 -
Current Medicinal Chemistry 2008The methylhydrazine derivative Procarbazine (PCZ) as monotherapy or in combination with CCNU and vincristine (PCV) was evaluated in a vast number of clinical trials and... (Review)
Review
The methylhydrazine derivative Procarbazine (PCZ) as monotherapy or in combination with CCNU and vincristine (PCV) was evaluated in a vast number of clinical trials and is still used in patients with high-grade and low-grade gliomas. The compound is an antineoplastic agent with multiple sites of action. It inhibits incorporation of small DNA precursors, as well as RNA and protein synthesis. PCZ can also directly damage DNA through an alkylation reaction. The drug is not cross-resistant with other mustard-type alkylating agents. As PCZ was in almost all trials used in a combination with CCNU and Vincristin, the efficacy can only be evaluated in the view of the PCV regimen. The published data suggest a role of PCV as a salvage regimen, especially in oligodendroglial tumors; however, well designed studies with high evidence are rare in all entities. This article summarizes the existing data with the goal to define the role of PCZ/PCV in modern neurooncology.
Topics: Animals; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Brain Neoplasms; Clinical Trials as Topic; Drug Interactions; Glioma; Humans; Lomustine; Procarbazine; Vincristine
PubMed: 18537615
DOI: 10.2174/092986708784567707 -
Leukemia & Lymphoma Apr 2006Procarbazine hydrochloride is an oral alkylating agent with activity against lymphoma. It is most commonly used in the treatment of Hodgkin's disease. The use of...
Procarbazine hydrochloride is an oral alkylating agent with activity against lymphoma. It is most commonly used in the treatment of Hodgkin's disease. The use of procarbazine-containing chemotherapeutic regimens in non-Hodgkin's lymphoma fell out of favor with the advent of CHOP. We report two patients with relapsed and/or refractory follicular lymphoma that achieved a complete and durable remission with a prolonged course of daily procarbazine.
Topics: Adult; Alkylating Agents; Antineoplastic Agents; Enzyme Inhibitors; Female; Humans; Lymphoma, Non-Hodgkin; Male; Middle Aged; Monoamine Oxidase Inhibitors; Procarbazine; Remission Induction; Stem Cell Transplantation
PubMed: 16690522
DOI: 10.1080/10428190600591517 -
Thorax Mar 1984
Topics: Adult; Alveolitis, Extrinsic Allergic; Humans; Male; Procarbazine
PubMed: 6710430
DOI: 10.1136/thx.39.3.206 -
Cancer May 1992The authors report the clinical features of hypersensitivity reactions believed to result from procarbazine in eight patients treated with mechlorethamine, vincristine,... (Review)
Review
The authors report the clinical features of hypersensitivity reactions believed to result from procarbazine in eight patients treated with mechlorethamine, vincristine, and procarbazine (MOP) for high-grade glioma. There was one instance of hypersensitivity in 7 patients treated for recurrent disease and seven instances in 16 patients treated with an adjuvant protocol using MOP directly after surgery. Maculopapular rash was seen in seven of eight, fever was seen in four of eight, and reversible abnormal liver function test results were seen in three of four patients. Pulmonary toxic effects were seen in five of eight patients and consisted of isolated interstitial pneumonitis in one, fever and infiltrate after rechallenge with procarbazine after previous rash in two, and cough accompanying rash in two. The toxic effects were mild to moderate in six patients but severe to life threatening in the two who were rechallenged after development of rash. The observed incidence of rash during adjuvant therapy was higher than that previously found by the authors for recurrent disease, and it appears to be higher than has been reported in Hodgkin's disease, lymphoma, and other solid tumors. The findings by the authors suggest that a high index of suspicion be kept for hypersensitivity reactions to procarbazine when treating primary brain tumors and that, contrary to the experience in other settings, procarbazine be stopped if rash develops.
Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Astrocytoma; Brain Neoplasms; Drug Hypersensitivity; Female; Glioma; Humans; Male; Mechlorethamine; Middle Aged; Oligodendroglioma; Procarbazine; Vincristine
PubMed: 1568176
DOI: 10.1002/1097-0142(19920515)69:10<2532::aid-cncr2820691024>3.0.co;2-i -
Veterinary and Comparative Oncology Mar 2018The aim of this study was to describe the use of a lomustine (CCNU), vincristine, procarbazine and prednisolone (LOPP) protocol used for treatment of chemotherapy naive...
BACKGROUND
The aim of this study was to describe the use of a lomustine (CCNU), vincristine, procarbazine and prednisolone (LOPP) protocol used for treatment of chemotherapy naive T-cell lymphoma patients and to describe the response rate, toxicity and disease-free interval compared historically to CHOP chemotherapy.
MATERIALS AND METHODS
Retrospective case study of 31 dogs with naïve T-cell lymphoma treated with a lomustine (CCNU), vincristine, procarbazine and prednisolone (LOPP) protocol.
RESULTS
Thirty-one dogs with T cell lymphoma were treated. The overall response rate was 97%. Of the 30 dogs that had a response to LOPP chemotherapy, the median disease free interval was 176 days (range 0-1745 days). The median overall survival time for this study group was 323 days (range 51-1758 days). All deaths in this study were attributable to lymphoma.
CONCLUSION
LOPP chemotherapy for T cell lymphoma is well tolerated with a low toxicity profile and an excellent overall response rate. This protocol showed minimal toxicity and comparable disease free interval and survival times for canine high grade T cell lymphoma treated with CHOP.
Topics: Animals; Antineoplastic Combined Chemotherapy Protocols; Dog Diseases; Dogs; Female; Lomustine; Lymphoma, T-Cell; Male; Prednisone; Procarbazine; Retrospective Studies; Survival Analysis; Treatment Outcome; Vincristine
PubMed: 28508557
DOI: 10.1111/vco.12318 -
Psycho-oncology Jan 2014Procarbazine is an anticancer agent that also inhibits monoamine oxidase, an enzyme responsible for the metabolism of various catecholamines, including serotonin.
BACKGROUND
Procarbazine is an anticancer agent that also inhibits monoamine oxidase, an enzyme responsible for the metabolism of various catecholamines, including serotonin.
METHODS
A retrospective chart review of lymphoma patients who were treated with both procarbazine and an antidepressant, as well as procarbazine alone, was performed to determine if signs and symptoms of serotonin toxicity were present.
RESULTS
A total of 65 patients received procarbazine between 2004 and 2010 and were eligible to be included in the study. Twenty-six of these patients received an antidepressant in combination with procarbazine, with selective serotonin reuptake inhibitors being the most common type of antidepressant. No patients in the study were diagnosed with serotonin toxicity, nor did any meet Hunter's diagnostic criteria for serotonin toxicity. Diarrhea, tremor, and shivering were the symptoms from Sternbach's criteria that were further analyzed, with diarrhea occurring 8.54% of the time, tremor occurring 5.53% of the time, and shivering occurring 2.51% of the time in patients who received an antidepressant with their procarbazine. Despite these symptoms, the diagnosis of serotonin toxicity according to Sternbach's criteria was determined to be unlikely.
CONCLUSIONS
In this small sample of patients treated with procarbazine plus an antidepressant (most typically SSRIs), there were no reports of serotonin toxicity, nor did any patients demonstrate symptoms consistent with serotonin toxicity. The authors urge clinicians to ensure depression is adequately managed in cancer patients who are undergoing procarbazine therapy, starting with typical first-line antidepressant agents.
Topics: Antidepressive Agents; Antineoplastic Agents; Drug Interactions; Female; Humans; Lymphoma; Male; Middle Aged; Procarbazine; Retrospective Studies; Serotonin; Selective Serotonin Reuptake Inhibitors
PubMed: 24038727
DOI: 10.1002/pon.3378 -
Reevaluation of procarbazine for the treatment of recurrent malignant central nervous system tumors.Cancer Dec 1989Ninety-nine patients with primary recurrent malignant tumors of the central nervous system were treated with procarbazine as a single agent. Procarbazine was not given... (Review)
Review
Ninety-nine patients with primary recurrent malignant tumors of the central nervous system were treated with procarbazine as a single agent. Procarbazine was not given as a specified protocol, but for patients who were ineligible or refused other protocols. All patients had been treated previously with radiotherapy and 96 patients had also received previous chemotherapy. Twenty-five patients were treated at the first progression of their tumor, 47 were treated at the second progression, and 27 were treated at the third progression of their tumor. For the aggregate, the response plus stabilization rate was 27% for glioblastoma multiforme with median time to tumor progression of 30 weeks, and 28% for other anaplastic gliomas with a median time to tumor progression of 49 weeks. With respect to the percent of patients who responded or stabilized to treatment, these results are inferior to those reported previously for patients treated with procarbazine at recurrence. With respect to duration of response and stabilization, the data are comparable.
Topics: Adolescent; Adult; Aged; Brain Neoplasms; Child; Child, Preschool; Female; Glioblastoma; Glioma; Humans; Infant; Male; Middle Aged; Neoplasm Recurrence, Local; Procarbazine; Retrospective Studies; Spinal Cord Neoplasms
PubMed: 2555038
DOI: 10.1002/1097-0142(19891215)64:12<2420::aid-cncr2820641204>3.0.co;2-b -
Mutation Research 1978
Review
Topics: Animals; Carcinogens; Carcinoma, Ehrlich Tumor; Cell Line; Chromosomes, Human; Drosophila melanogaster; Escherichia coli; Female; Humans; Male; Mice; Mutagens; Oogenesis; Pregnancy; Procarbazine; Rats; Spermatogenesis; Teratogens
PubMed: 105288
DOI: 10.1016/0165-1110(78)90009-x