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High dose: cerebral and ... Breast cancer, non-small cell lung cancer, ovarian cancer, prostate cancer, squamous cell head and neck cancer and gastric cancer ...
R-miniCHOP is indicated in elderly patients (>80 years) with diffuse large B-cell lymphoma due to less toxicity from the reduced dose in comparison to R-CHOP. R-Maxi-CHOP is used in mantle cell lymphoma and is given in 21-day intervals, alternating with R-HDAC (rituximab + high-dose cytarabine).
The neuropsychiatric effects are partly mediated by sensitization of the body to the actions of adrenaline. Therapeutically, the bulk of corticosteroid dose is given in the morning to mimic the body's diurnal rhythm; if given at night, the feeling of being energized will interfere with sleep. An extensive review is provided by Flores and Gumina ...
It was developed at the National Cancer Institute in the 1960s by a team that included Vincent DeVita, Jr. Although no longer the most effective combination, MOPP is still used after relapse or where the patient has certain allergies or lung or heart problems which prevents the use of another regimen.
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Some of medication used to treat the symptoms are: ACTH has shown improvements in symptoms but can result in an incomplete recovery with residual deficits. Corticosteroids (such as prednisone or methylprednisolone) used at high dosages (500 mg - 2 g per day intravenously for a course of 3 to 5 days) can accelerate regression of symptoms ...
Then change to oral hydrocortisone or cortisone as a single morning dose, and gradually decrease by 2.5 mg each week. When the morning dose is less than replacement, the return of normal basal adrenal function may be documented by checking 0800 cortisol levels prior to the morning dose; stop drugs when 0800 cortisol is 10 μg/dl.
In a study based in the US, the average age of diagnosis was 66.5 years [3] whereas in a French study the median age at diagnosis was 59 years (with an age range of 12–87 years old). [4] In the French study, only 26% of patients were younger than 50 years which suggests that this disorder is associated with older age at diagnosis. [ 4 ]
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