(2?-R)-4?-o-Tetrahydropyranyladriamycin, a new anthracycline derivative; its effectiveness in lymphoid malignancies

Abstract

Thirty-eight patients with adult acute lymphoblastic leukemia (ALL) or non-Hodgkin's lymphoma (NHL) were treated intravenously with (2"-R)-4'-o-Tetrahydropyranyladriamycin (THP) at a dose of 10 mg/m2 for 5 consecutive days. Seven complete and 15 partial responses were observed in 35 evaluable patients (overall response rate, 62.8%). Both antitumor activity and antitumor spectrum were similar to those for doxorubicin. Since the patients who had had chemotherapy previously, including other kinds of anthracycline, responded rather poorly to THP, cross-resistance between THP and other anthracyclines may be present. Leukopenia and thrombocytopenia were dose-limiting factors. Nausea and vomiting episodes were mild, and epilation was also minimal. Although the observation period was short and a cumulative dose was not large enough to evaluate cardiotoxicity, there were no abnormal EKG changes or clinical signs of cardiotoxicity in this study. THP is a potent antitumor agent in the treatment of lymphoid malignancies.

A phase II study of a THP‐COP regimen for the treatment of elderly patients aged 70 years or older with diffuse large B‐cell lymphoma

“…THP is a derivative of DOX and is reportedly less cardiotoxic than DOX [3][4][5]. Elderly patients often have cardiac dysfunction, and treatment with anthracyclines frequently has to be discontinued due to cardiotoxic side effects.…”

“…In particular, anthracyclines, which are regarded as effective for NHL, are difficult to administer because of their cardiotoxicity and myelosuppressive effects. Pirarubicin (tetrahydropyranyl adriamycin: THP), a derivative of doxorubicin (DOX), is a new anthracycline that has been reported to be less cardiotoxic than DOX [3][4][5]. Accordingly, a THP-COP regimen [6] composed of THP, cyclophosphamide (CPA), vincristine (VCR), and prednisolone (PSL) has been administered for the treatment of NHL in elderly patients [7][8][9].…”

Combination Chemotherapy with Pirarubicin (THP), Cyclophosphamide, Vincristine, and Prednisolone (VEP-THP Therapy) in the Treatment of Non-Hodgkin’s Lymphoma

“…A greater dose of each drug in VEP-THP (1) or administration schedule of THP might produce the difference. In the previous study [2], we have demonstrated a fairly good re sponse rate by administering 10 mg/'m2 of THP for 5 consecutive days. Experimental data [10] also support the advantage of an administration schedule of frac tionated low doses.…”

“…Alopecia induced by ADM is also a troublesome side effect especially for female patients although it is not life-threatening. In phase II study, pirarubicin (THP) has been proved to have almost equivalent antitumor activity and similar antitumor spectrum to ADM [2] with lesser car diotoxicity and much milder alopecia [2,3], Therefore, we intended to substitute ADM by THP in VEPA [4] or CHOP [5] regimen which are common first-line chemotherapy regimens in the treatment of NHL. This is a retrospective analysis of therapeutic results obtained by the combination chemotherapy with THP, cyclophosphamide (CPM), vincristine (VCR), and prednisolone (VEP-THP therapy).…”

Efficacy and Adverse Effects of Rituximab Combined with a TCOP Regimen in Patients with Untreated Diffuse Large B-cell Lymphoma and Follicular Lymphoma

“…Pirarubicin tetrahydropyranyl adriamycin : THP is an anthracycline derivative of doxorubicin DOX that is reportedly less cardiotoxic than DOX 1,2 . A regimen of THP, cyclophosphamide CPA , vincristine VCR , and prednisolone PSL THP-COP or TCOP has been used to treat Non-Hodgkin lymphoma NHL in elderly patients [3][4][5] ; the Japanese Clinical Study Group of THP Lymphomas in the Elderly JGTLE reported the ef cacy of the same regimen in a large-scale, multicenter trial 5 .…”