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Potentiation of Carmustine-Cranial Irradiation-Induced Myelosuppression by Cimetidine

Potentiation of Carmustine-Cranial Irradiation-Induced Myelosuppression by Cimetidine Abstract In nine patients with glioblastomas, the histamine H2-receptor antagonist cimetidine was found to augment the myelosuppressive activities of carmustine and cranial irradiation. The nadir in neutrophil cell counts in this group averaged 650 ± 220/μL. In a comparable series of 31 patients who did not receive cimetidine, the lowest neutrophil cell count averaged 2,160 ± 240/μL.Further, marked suppression of these cells in the patients receiving cimetidine extended through day 42 of the treatment cycle. By contrast, the patients treated with carmustine and cranial irradiation alone did not experience significant neutropenia. This suggests that cimetidine may enhance the myelosuppressive effects of cytotoxic therapy. (Arch Intern Med 1982;142:243-245) References 1. Winship DH: Cimetidine in the treatment of duodenal ulcer. Gastroenterology 1978;74:402-406. 2. Burland WL, Sharpe PC, Colin-Jones DG, et al: Reversal of metiamideinduced agranulocytosis during treatment with cimetidine. Lancet 1975;2:1085.Crossref 3. Feldman EJ, Isenberg JI: Effects of metiamide on gastric acid hypersecretion, steatorrhea and bone-marrow function in a patient with systemic mastocytosis. N Engl J Med 1976;295:1178-1179.Crossref 4. Fleischer D, Samloff IM: Cimetidine therapy in a patient with metiamide-induced agranulocytosis. N Engl J Med 1977;296:342. 5. Finkelstein W, Isselbacher KJ: Cimetidine. N Engl J Med 1978;299:992-996.Crossref 6. James C, Prout BJ: Marrow suppression and intravenous cimetidine. Lancet 1978;1:987.Crossref 7. Klotz SA, Kay BF: Cimetidine and agranulocytosis. Ann Intern Med 1978;88:579-580. 8. Corbett CL, Holdsworth CD: Fever, abdominal pain, and leukopenia during treatment with cimetidine. Br Med J 1978;1:753-754.Crossref 9. Lopez LA, Rodriguez-Cuartero A, Perez-Galvez N, et al: Cimetidine and bone marrow toxicity. Lancet 1978;1:444.Crossref 10. Ufberg MH, Brooks CM, Bosanac PR, et al: Transient neutropenia in a patient receiving cimetidine. Gastroenterology 1977;73:635-638. 11. Craven ER, Whittington JM: Agranulocytosis four months after cimetidine therapy. Lancet 1977;2:294-295.Crossref 12. Selker RG, Moore P, LoDolce D: Bone marrow depression with cimetidine plus carmustine. N Engl J Med 1978;299-834. 13. Posnett DN, Stein RS, Graber SE, et al: Cimetidine-induced neutropenia. Arch Intern Med 1979;139:584-586.Crossref 14. Al-Kawas FH, Lenes BA, Sacher RA: Cimetidine and agranulocytosis. Ann Intern Med 1979;90:992-993. 15. Littlejohn GO, Urowitz MB: Cimetidine, lupus erythematosus, and granulocytopenia. Ann Intern Med 1979;91:317-318. 16. Chang HK, Morrison SL: Bone marrow suppression associated with cimetidine. Ann Intern Med 1979;91:580. 17. Carloss HW, Tavassoli M, McMillan R: Cimetidine-induced granulocytopenia. Ann Intern Med 1980;93:57-58. 18. Forrest JAH, Shearman DJC, Spence R. et al: Neutropenia associated with metiamide. Lancet 1975;1:392-393.Crossref 19. Idvall J: Cimetidine-associated thrombocytopenia. Lancet 1979; 2:159.Crossref 20. Rate R, Bonnell M, Chervenak C, et al: Cimetidine and hematologic effects. Ann Intern Med 1979;91:795. 21. Isaacs AJ: Cimetidine and thrombocytopenia. Br Med J 1980; 280:294.Crossref 22. Reddy J, Bailey R: Cimetidine and thrombocytopenia. NZ Med J 1980;91:232. 23. Price GB, Krogsrud RL: Differentiation of normal and neoplastic hematopoietic cells , in Clarkson B, Marks P, Till J (eds): Cold Spring Harbor Conference on Cell Proliferation. Cold Spring Harbor, NY, Cold Spring Harbor Laboratory, 1978, pp 371-381. 24. Byron JW: Cimetidine and bone marrow toxicity. Lancet 1977;2:555-556.Crossref 25. Byron JW: Mechanism for histamine H2 receptor induced cell cycle changes in the bone marrow stem cell. Agents Actions 1977;7:209-213.Crossref 26. Byron JW: Pharmacodynamic basis for the interaction of cimetidine with the bone marrow stem cell (CFU-s). Exp Hematol 1980;8:256-263. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Potentiation of Carmustine-Cranial Irradiation-Induced Myelosuppression by Cimetidine

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340150043011
Publisher site
See Article on Publisher Site

Abstract

Abstract In nine patients with glioblastomas, the histamine H2-receptor antagonist cimetidine was found to augment the myelosuppressive activities of carmustine and cranial irradiation. The nadir in neutrophil cell counts in this group averaged 650 ± 220/μL. In a comparable series of 31 patients who did not receive cimetidine, the lowest neutrophil cell count averaged 2,160 ± 240/μL.Further, marked suppression of these cells in the patients receiving cimetidine extended through day 42 of the treatment cycle. By contrast, the patients treated with carmustine and cranial irradiation alone did not experience significant neutropenia. This suggests that cimetidine may enhance the myelosuppressive effects of cytotoxic therapy. (Arch Intern Med 1982;142:243-245) References 1. Winship DH: Cimetidine in the treatment of duodenal ulcer. Gastroenterology 1978;74:402-406. 2. Burland WL, Sharpe PC, Colin-Jones DG, et al: Reversal of metiamideinduced agranulocytosis during treatment with cimetidine. Lancet 1975;2:1085.Crossref 3. Feldman EJ, Isenberg JI: Effects of metiamide on gastric acid hypersecretion, steatorrhea and bone-marrow function in a patient with systemic mastocytosis. N Engl J Med 1976;295:1178-1179.Crossref 4. Fleischer D, Samloff IM: Cimetidine therapy in a patient with metiamide-induced agranulocytosis. N Engl J Med 1977;296:342. 5. Finkelstein W, Isselbacher KJ: Cimetidine. N Engl J Med 1978;299:992-996.Crossref 6. James C, Prout BJ: Marrow suppression and intravenous cimetidine. Lancet 1978;1:987.Crossref 7. Klotz SA, Kay BF: Cimetidine and agranulocytosis. Ann Intern Med 1978;88:579-580. 8. Corbett CL, Holdsworth CD: Fever, abdominal pain, and leukopenia during treatment with cimetidine. Br Med J 1978;1:753-754.Crossref 9. Lopez LA, Rodriguez-Cuartero A, Perez-Galvez N, et al: Cimetidine and bone marrow toxicity. Lancet 1978;1:444.Crossref 10. Ufberg MH, Brooks CM, Bosanac PR, et al: Transient neutropenia in a patient receiving cimetidine. Gastroenterology 1977;73:635-638. 11. Craven ER, Whittington JM: Agranulocytosis four months after cimetidine therapy. Lancet 1977;2:294-295.Crossref 12. Selker RG, Moore P, LoDolce D: Bone marrow depression with cimetidine plus carmustine. N Engl J Med 1978;299-834. 13. Posnett DN, Stein RS, Graber SE, et al: Cimetidine-induced neutropenia. Arch Intern Med 1979;139:584-586.Crossref 14. Al-Kawas FH, Lenes BA, Sacher RA: Cimetidine and agranulocytosis. Ann Intern Med 1979;90:992-993. 15. Littlejohn GO, Urowitz MB: Cimetidine, lupus erythematosus, and granulocytopenia. Ann Intern Med 1979;91:317-318. 16. Chang HK, Morrison SL: Bone marrow suppression associated with cimetidine. Ann Intern Med 1979;91:580. 17. Carloss HW, Tavassoli M, McMillan R: Cimetidine-induced granulocytopenia. Ann Intern Med 1980;93:57-58. 18. Forrest JAH, Shearman DJC, Spence R. et al: Neutropenia associated with metiamide. Lancet 1975;1:392-393.Crossref 19. Idvall J: Cimetidine-associated thrombocytopenia. Lancet 1979; 2:159.Crossref 20. Rate R, Bonnell M, Chervenak C, et al: Cimetidine and hematologic effects. Ann Intern Med 1979;91:795. 21. Isaacs AJ: Cimetidine and thrombocytopenia. Br Med J 1980; 280:294.Crossref 22. Reddy J, Bailey R: Cimetidine and thrombocytopenia. NZ Med J 1980;91:232. 23. Price GB, Krogsrud RL: Differentiation of normal and neoplastic hematopoietic cells , in Clarkson B, Marks P, Till J (eds): Cold Spring Harbor Conference on Cell Proliferation. Cold Spring Harbor, NY, Cold Spring Harbor Laboratory, 1978, pp 371-381. 24. Byron JW: Cimetidine and bone marrow toxicity. Lancet 1977;2:555-556.Crossref 25. Byron JW: Mechanism for histamine H2 receptor induced cell cycle changes in the bone marrow stem cell. Agents Actions 1977;7:209-213.Crossref 26. Byron JW: Pharmacodynamic basis for the interaction of cimetidine with the bone marrow stem cell (CFU-s). Exp Hematol 1980;8:256-263.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Feb 1, 1982

References