Kazushi Inoue

High Incidence of Chemotherapy-Induced Acral Erythema in Female Patients with non-Hodgkin's Lymphoma Treated with the Vacop-B Regimen

Seven patients, all females out of 29 with non-Hodgkins lymphoma (NHL) (16 males and 13 females) treated with the VACOP-B regimen utilizing granulocyte-colony-stimulating factor (G-CSF) support developed chemotherapy-induced acral erythema (CAE). In contrast, none of 32 patients with NHL who were treated with CHOP, MACOP-B, or biweekly CHOP regimens without G-CSF developed CAE. Total dose intensities of VACOP-B regimen were higher than those of the three other regimens. However, no significant difference in dose intensities of each drug in the patients treated with the VACOP-B regimen was found between male and female patients and between female patients with or without CAE. The cause of the high incidence of CAE (7/13) in the female patients treated with VACOP-B regimen remains unknown. However, female sex hormones may increase susceptibility to CAE. Since the occurrence of CAE interrupts intensive chemotherapy and reduces the cure rate, high risk patients for CAE should be carefully monitored for early symptoms and signs of CAE and should be treated early and appropriately.

Oncogenic potential and normal function of the proto-oncogenes encoding protein-tyrosine kinases.

A number of protein-tyrosine kinases, including the cellular counterpart of the src gene product of Rous sarcoma virus, have been identified in mammalian cells and are suggested to be important in growth and/or differentiation of cells. Approximately half of the protein-tyrosine kinases are integral membrane proteins and are, in many cases, receptors for polypeptide growth factors (13). They are the receptors for epidermal growth factor (EGF), insulin, insulin-like growth factor-1, platelet-derived growth factors, and colony-stimulating factor-1. Cellular oncogenes such as met, erbB-2/neu, trk, and ret are also included in this group.