Description of the medicine: Hexaphosphamidum (Hexaphosphamidum)

HEXAPHOSPHAMIDE (Hexaphosphamidum).

N, N'-di- (Ethylenimide) -N "-cyclohexylamide of thiophosphoric acid.

White crystalline powder. Sensitive to light. Almost nerastvorim in water, it is difficult soluble in alcohol.

Has anti-leukemia activity. In large doses, suppresses hemopoiesis (especially granulocytopoiesis).

Applied with exacerbations of chronic myelogenous leukemia. The drug is subject to leukemia and subleukemic forms of the disease, especially cases with severe hepato- and splenomegaly. Hexaphosphamide is prescribed both as the first treatment agent and after treatment with other cytostatic drugs (myelosan, myelobromol, dopane, etc.) with their insufficient effectiveness.

Apply the drug inside. Usually the daily intake for adults is 20 mg (0.02 g). When the number of leukocytes in the blood does not exceed 100 x 10 9 / l start with 10 mg per day, in the absence of pronounced effect, the daily dose is increased to 20 mg.

Usually, the therapeutic effect of the drug occurs in 1 to 3 weeks. If there is no therapeutic effect after 3 to 4 weeks, the dose may be gradually increased, in some cases up to 40 - 80 mg. The course of treatment with hexaphosphamide and the course doses depend on the clinical effect and the hematological pattern.

With a decrease in the number of white blood cells in the blood to 20 x 10 9 - 30 x 10 9 / L, hexafosphamide should be discontinued, as the drug continues for 2 weeks and after it is discontinued.

With a rapid decrease in the number of leukocytes, the intervals between individual drug doses should be increased to 3 to 7 days, with mandatory preliminary analysis of peripheral blood before each drug intake.

Treatment with hexaphosphamide of patients receiving other cytotoxic drugs should be started no earlier than 1 month after their withdrawal. When remission is achieved or persistent improvement, the main course of therapy is considered complete and the patient is under observation. If a tendency to an increase in the number of leukocytes in the blood is detected more than 9 x 10 9 - 10 x 10 9 / l it is advisable to maintain maintenance treatment with hexaphosphamide at a dose of 20 mg once every 3-7 days, depending on the analysis of peripheral blood.

Hexaphosphamide exerts a pronounced inhibitory effect on leukopoiesis and, to a lesser extent, on thrombocytopoiesis. When an overdose of the drug or in the case of increased individual sensitivity, the development of leukopenia, thrombocytopenia and severe oppression of hematopoiesis are possible. After the drug is withdrawn, these phenomena usually stop after 2 to 4 weeks on their own. In the case of more resistant cytopenia, the use of gemostimulating therapy is recommended: corticosteroid hormones, B group vitamins, folic acid, 250 ml transfusion of freshly citrated blood 3-7 times per week. With a strong oppression of hematopoiesis in addition to the above, the administration of leukocyte mass or allogeneic bone marrow is indicated.