Hematologic effects of intravesicular thiotepa therapy for bladder carcinoma
D. Hollister Jr and M. Coleman
Twenty-nine patients with bladder carcinoma treated with intravesical
thiotepa administration were reviewed to assess hematologic toxicity. Ten
of 25 consecutive patients had at least one episode of acute
myelosuppression. Thrombocytopenia was the most common abnormality; anemia
was uncommon. Acute suppression occurred most often within the first three
months of therapy and was dose related. One of the 25 patients and four
additional patients had chronic myelosuppression; all were male. They were
older and had received more thiotepa over a longer period than those
patients without chronic myelosuppression. Thrombocytopenia was again the
most common abnormality. Anemia was nearly as frequent in this
subpopulation and may herald chronic blood dyscrasia. One patient had
refractory anemia with an excess of blast forms; another had smoldering
leukemia. Acute and chronic forms of myelosuppression were not related.
Thiotepa treatments should be limited to 90 mg/mo and protracted therapy
avoided in elderly men.
