Erfassung regionaler und systemischer Toxizität der isolierten, hyperthermen Extremitätenperfusion mit Tumor-Nekrose-Faktor alpha und Melphalan
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Erfassung regionaler und systemischer Toxizität der isolierten, hyperthermen Extremitätenperfusion mit Tumor-Nekrose-Faktor alpha und Melphalan. / Hohenberger, P; Haier, J; Kettelhack, C; Schulze, G; Schlag, P M.
in: CHIRURG, Jahrgang 68, Nr. 9, 09.1997, S. 914-20.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Erfassung regionaler und systemischer Toxizität der isolierten, hyperthermen Extremitätenperfusion mit Tumor-Nekrose-Faktor alpha und Melphalan
AU - Hohenberger, P
AU - Haier, J
AU - Kettelhack, C
AU - Schulze, G
AU - Schlag, P M
PY - 1997/9
Y1 - 1997/9
N2 - Following isolated limb perfusion (ILP) with TNF alpha and melphalan the damage to muscle tissue and its systemic consequences in terms of myoglobinemia and myoglobinuria as well as the activation of the cytokine cascade were investigated. We measured the compartmental pressure of the limb during and after perfusion and determined the serum changes of myoglobin, creatine kinase (CK), interleukin (IL)-6, IL-1, s-IL-2-receptor, TNF-receptor, and ICAM-1 levels. The compartmental pressure rose significantly during ILP and decreased after reperfusion. Following its course, the decision whether to perform a fasciotomy or not can be more reliably made. Serum myoglobin levels exceeded 200 times normal values and the increase occurred significantly earlier than that of CK, thus enabling judgement of the risk of renal failure (crush kidney syndrome). The elevation of serum IL-1 and IL-6 values correlated with the frequency of cardiopulmonary problems (hyperdynamic shock) and facilitated counter-maneuvers. Our data, although obtained from ILP with TNF alpha, could be used to monitor toxicity also when other drug regimens are administered.
AB - Following isolated limb perfusion (ILP) with TNF alpha and melphalan the damage to muscle tissue and its systemic consequences in terms of myoglobinemia and myoglobinuria as well as the activation of the cytokine cascade were investigated. We measured the compartmental pressure of the limb during and after perfusion and determined the serum changes of myoglobin, creatine kinase (CK), interleukin (IL)-6, IL-1, s-IL-2-receptor, TNF-receptor, and ICAM-1 levels. The compartmental pressure rose significantly during ILP and decreased after reperfusion. Following its course, the decision whether to perform a fasciotomy or not can be more reliably made. Serum myoglobin levels exceeded 200 times normal values and the increase occurred significantly earlier than that of CK, thus enabling judgement of the risk of renal failure (crush kidney syndrome). The elevation of serum IL-1 and IL-6 values correlated with the frequency of cardiopulmonary problems (hyperdynamic shock) and facilitated counter-maneuvers. Our data, although obtained from ILP with TNF alpha, could be used to monitor toxicity also when other drug regimens are administered.
KW - Adolescent
KW - Adult
KW - Aged
KW - Antineoplastic Agents, Alkylating
KW - Chemotherapy, Cancer, Regional Perfusion
KW - Combined Modality Therapy
KW - Compartment Syndromes
KW - Cytokines
KW - Extremities
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Hyperthermia, Induced
KW - Male
KW - Melanoma
KW - Melphalan
KW - Middle Aged
KW - Myoglobin
KW - Myoglobinuria
KW - Neoplasm Recurrence, Local
KW - Recombinant Proteins
KW - Rhabdomyolysis
KW - Sarcoma
KW - Skin Neoplasms
KW - Soft Tissue Neoplasms
KW - Tumor Necrosis Factor-alpha
M3 - SCORING: Zeitschriftenaufsatz
C2 - 9410682
VL - 68
SP - 914
EP - 920
JO - CHIRURG
JF - CHIRURG
SN - 0009-4722
IS - 9
ER -
