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To the Editor.-Reply

To the Editor.-Reply Abstract —We appreciate the comments by Dr Feagin and Mr Dorr who both suggest alternative mechanisms for the severe neutropenia seen in patients treated with carmustine and cimetidine. Inhibition of the cytochrome system or alteration of hepatic blood flow by cimetidine may potentially delay the clearance of chemotherapeutic agents. This could increase their toxic or therapeutic effects.1 In our practice, we have seen one patient with a reversible neutropenia and another with severe aplastic anemia that followed ingestion of cimetidine. Since these patients were not receiving cytotoxic drugs, it seems likely that cimetidine can act to suppress marrow function. Further investigation should help to resolve the question of direct v indirect effect on the hematopoietic stem cell. References 1. Dorr RT, Alberts DS: Interaction of CMT-augmentation of cyclophosphamide in mice. Br J Cancer 1982;45:35-43.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

To the Editor.-Reply

Abstract

Abstract —We appreciate the comments by Dr Feagin and Mr Dorr who both suggest alternative mechanisms for the severe neutropenia seen in patients treated with carmustine and cimetidine. Inhibition of the cytochrome system or alteration of hepatic blood flow by cimetidine may potentially delay the clearance of chemotherapeutic agents. This could increase their toxic or therapeutic effects.1 In our practice, we have seen one patient with a reversible neutropenia and another with severe...
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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.1982.00340230221042
Publisher site
See Article on Publisher Site

Abstract

Abstract —We appreciate the comments by Dr Feagin and Mr Dorr who both suggest alternative mechanisms for the severe neutropenia seen in patients treated with carmustine and cimetidine. Inhibition of the cytochrome system or alteration of hepatic blood flow by cimetidine may potentially delay the clearance of chemotherapeutic agents. This could increase their toxic or therapeutic effects.1 In our practice, we have seen one patient with a reversible neutropenia and another with severe aplastic anemia that followed ingestion of cimetidine. Since these patients were not receiving cytotoxic drugs, it seems likely that cimetidine can act to suppress marrow function. Further investigation should help to resolve the question of direct v indirect effect on the hematopoietic stem cell. References 1. Dorr RT, Alberts DS: Interaction of CMT-augmentation of cyclophosphamide in mice. Br J Cancer 1982;45:35-43.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Oct 1, 1982

References