Increase in the peripheral lymphocyte populations expressing CD54 (ICAM-1) after hyperthermic isolated limb perfusion in patients with malignant melanoma: an analysis of four cases

Nakayama, Juichiro; Guan, Xiao-Chun; Tominaga, Ryuji; Nagae, Shonosuke; Matsuda, Kazuhisa; Nakao, Tomoko; Rikihisa, Wataru; Yang, Hsien Hsun; Shibata, Satoko; Eguchi, Akira; Takeuchi, Satoshi; Hori, Yoshiaki; Yasui, Hirofumi; Takahashi, Seisuke

doi:10.1016/s0923-1811(97)00073-x

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“…We use high dose carboplatin (300 mg/m 2 ) and interferon‐β (12 million U) because our HILP system can keep systemic leakage low during perfusion. The previous study demonstrated that the concentration of the drug (carboplatin) was 30 times higher than that of systemic circulation (8), which meant a very low systemic leak occurred during HILP.…”

Section: Discussionmentioning

confidence: 97%

“…When the tissue temperature increased to 40°C, 300 mg/m 2 body surface area of carboplatin and 12 million U of interferon‐β were administered by 30 min drip injection from an arterial line. The choice of drugs and those dosages were determined from the results of previous studies (6–8). The combination of interferon and anticancer drugs was demonstrated to dramatically inhibit cellular proliferation in cultured melanoma cells (9).…”

Section: Methodsmentioning

confidence: 99%

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Systemic Effects of Hyperthermic Isolated Lower Limb Perfusion with Carboplatin and Interferon‐β

Tominaga¹,

Nakano²,

Shibata

et al. 2001

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The changes in systemic circulation during hyperthermic isolated lower limb perfusion with carboplatin and interferon-beta were investigated in 19 patients with malignant melanoma. The cardiac output (CO) increased significantly (p < 0.01) from 3.81 +/- 0.22 L/min before the procedure to 5.30 +/- 0.49 L/min 1 h after hyperthermic perfusion. The double product (mean arterial pressure x heart rate) also increased significantly (p < 0.01) from 5,145 +/- 372 mm Hg/min to 6,760 +/- 486 mm Hg/min. In some patients, it increased to more than twice the control value. These changes were accompanied by an increase in body temperature, presumably caused by the systemic leakage of both warmed blood and interferon-beta. Blood chemistry data demonstrated no significant changes in the liver or renal function. However, the serum CPK level increased markedly on the first postoperative day, and persisted for 1 week, thus suggesting that some muscle damage occurred during the procedure. There was no operative death or severe complications. From these data, we concluded that hyperthermic isolated limb perfusion with interferon-beta is a relatively safe therapeutic method for malignant melanoma of the extremities. However, care should be taken in patients with ischemic heart disease who may suffer a heart attack due to the rapid increase in cardiac work during the procedure.

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Section: Discussionmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%