SUPPORTIVE CARE

Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.

SUPPORTIVE CARE

Cancer Chemother Biol Response Modif; 10:390-6 1988. Unique Identifier : AIDSLINE ICDB/89657435
Markman M; Solid Tumor Service, Memorial Sloan-Kettering Cancer Center, New; York, NY 10021

Abstract: Supportive care for patients (pts) with cancer is discussed, including antiemetic therapy, management of infections, and application of hematopoietic colony-stimulating factors (CSFs). Developments in supportive care continue to be among the most important in clinical oncology, both in terms of optimizing the quality of life of pts with malignant disease and in allowing the application of therapies of increased efficacy. Much work in 1987 centered on improving antiemetic therapy, particularly various ways of using metoclopramide, with or without other agents. Other antiemetic agents studied included prochlorperazine, methylprednisolone, nabilone, iv ethanol, and 5-hydroxytryptamine (serotonin, 5-HT). Studies of infection management have employed acyclovir, ketoconazole, ceftazidime vs cephalothin + gentamicin + carbenicillin, and vancomycin. The use of vancomycin in the febrile neutropenic pt requires additional studies. Currently, it is suggested that vancomycin be added as part of the initial empiric regimen only if the pt is critically ill with signs of overwhelming sepsis, has a known cardiovascular abnormality (eg, artificial heart valve), or if there has been an outbreak of resistant gram-positive organisms in the institution. If none of these conditions is present, vancomycin therapy should be instituted for those with positive cultures or who fail to respond to the initial broad-spectrum coverage. Significant clinical activity has been reported for CSFs in aiding hematopoiesis in myelodysplastic syndrome, AIDS, and chronic neutropenia of childhood. Hematopoietic CSFs may protect the bone marrow from the suppressive effects of cytotoxic chemotherapy (principally granulocytopenia), potentially allowing for either an escalation of dosage or a decrease in morbidity associated with marrow suppression. (33 Refs)

Keywords: Antibiotics/THERAPEUTIC USE Antiemetics/THERAPEUTIC USE Antifungal Agents/THERAPEUTIC USE Antineoplastic Agents/ADVERSE EFFECTS Clinical Trials Colony-Stimulating Factors/THERAPEUTIC USE Human Neoplasms/*THERAPY Opportunistic Infections/DRUG THERAPY Palliative Care/*METHODS Random Allocation Vomiting/DRUG THERAPY CLINICAL TRIAL JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL
891230
M89C0815

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, Gill Foundation, the National Library of Medicine, Quest Diagnostics, Roche and Trimeris, and donations from users like you. Always watch for outdated information. This article first appeared in 1989. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1989. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .