Abstract
Plasma exchange combined with intrahepatic arterial administration of Adriamycin (ADR) was evaluated in gastrointestinal cancer patients with liver metastasis in an attempt to reduce the systemic distribution of the drug.
The changes with time of peripheral blood levels of ADR after intrahepatic arterial administration at a dose of 30mg was examined up to 120 min after administration. ADR showed a distribution phase to decrease rapidly until 30 min after administration as a turning point and gradually disappear thereafter. The peripheral blood level of ADR 120 min after administration was 0.021μg/ ml/ min. In the pharmacokinetic evaluation of ADR by the trapezoidal rule, the area under the curve (AUC) was 6.252μg /ml / min up to 30 min after administration and 4.226μg/ ml/ min from 30 min to 120 min. The overall AUC was 10.476μg/ ml/ min. The ratio of AUC in the latter period of time after administration to the overall AUC, was estimated at 40.3%. Plasma exchange was combined after the turning point, 30 min after administration, and the peripheral blood level of ADR was found to have been reduced to an undetectable level. AUC was 5.672μg/ ml/ min, 1.476μg/ml/ min and 7.148μg/ ml/ min for fhe former period, latter period and overall, respectively, with the ratio of the latter period AUC to overall AUC being 20.6 %, which indicates that ADR could be eliminated from peripheral blood by the combined plasma exchange.
