Pentoxifyllin attenuates the systemic inflammatory response induced during isolated limb perfusion with recombinant human tumor necrosis factor-alpha and melphalan

Isolated limb perfusion (ILP) with recombinant human tumor necrosis factor-alpha (rhTNF-alpha) and melphalan harbors the risk of septic shock-like syndrome. Pentoxifyllin (PTX) produced a beneficial effect on cytokine response and survival in animal experiments of septic shock, and we were intereste...

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Bibliographic Details
Published in:Annals of surgical oncology 2003-06, Vol.10 (5), p.562
Main Authors: Hohenberger, Peter, Latz, Eicke, Kettelhack, Christoph, Rezaei, Amir-Hossein, Schumann, Ralf, Schlag, Peter M
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antineoplastic Agents - administration & dosage
Antineoplastic Agents - adverse effects
Antineoplastic Agents - pharmacology
Antineoplastic Agents, Alkylating - administration & dosage
Antineoplastic Agents, Alkylating - adverse effects
Antineoplastic Agents, Alkylating - pharmacology
Chemotherapy, Cancer, Regional Perfusion
Enzyme Inhibitors - pharmacology
Extremities - blood supply
Female
Humans
Inflammation
Male
Melanoma - drug therapy
Melphalan - administration & dosage
Melphalan - adverse effects
Melphalan - pharmacology
Middle Aged
Pentoxifylline - pharmacology
Sarcoma - drug therapy
Shock, Septic - chemically induced
Shock, Septic - prevention & control
Skin Neoplasms - drug therapy
Soft Tissue Neoplasms - drug therapy
Syndrome
Tumor Necrosis Factor-alpha - administration & dosage
Tumor Necrosis Factor-alpha - adverse effects
Tumor Necrosis Factor-alpha - pharmacology
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Summary:Isolated limb perfusion (ILP) with recombinant human tumor necrosis factor-alpha (rhTNF-alpha) and melphalan harbors the risk of septic shock-like syndrome. Pentoxifyllin (PTX) produced a beneficial effect on cytokine response and survival in animal experiments of septic shock, and we were interested to explore its effect during TNF-ILP in humans. Eighteen consecutive patients underwent TNF-ILP and received PTX (30 mg/kg/day), whereas another 13 consecutive patients did not. PTX was given systemically after the limb extracorporeal circulation was started. Cardiac index, systemic vascular resistance (SVR), and pulmonary vascular resistance were recorded via a Swan-Ganz catheter. Blood levels of TNF-alpha, interleukin-6, procalcitonin, and lipopolysaccharide-binding protein were determined before, during, and after ILP. After reperfusion, systemic levels of TNF-alpha were significantly less increased in the PTX group (peak, 2.8 vs. 1.3 ng/mL; P
ISSN:1068-9265
DOI:10.1245/ASO.2003.10.005