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Effective Managements of Patients With This Complication

Paul H. Sugarbaker, MD; Arthur T. Skarin, MD; Richard E. Wilson, MD

AMA Arch Surg. 1973;107(4):523-527.

Abstract
Treatment of five patients with severe thrombocytopenia due to extensive bone marrow involvement by metastatic breast carcinoma produced a successful hematologic response in each. Sequential therapy with high doses of prednisone (50 to 100 mg/day), followed by ovarian ablation prior to or at the time of adrenalectomy combined with fluorouracil, is the recommended regimen. An objective response to corticosteroids occurred within one month; after adrenalectomy, a second favorable hematologic response was noted. Three patients who had adrenalectomy combined with fluorouracil therapy had excellent and sustained remissions (greater than ten months). One patient who did not receive fluorouracil had a shorter remission (5 Vi months). All patients tolerated their high-dose corticosteroids, surgery, and chemotherapy well.

Author Affiliations
Boston

From the departments of surgery (Drs. Sugarbaker and Wilson) and medicine (Dr. Skarin), Harvard Medical School at the Peter Bent Brigham Hospital; and Children's Cancer Research Foundation, Boston (Dr. Skarin).

Footnotes
Accepted for publication March 27, 1973.

Reprint requests to 721 Huntington Ave, Boston 02115 (Dr. Wilson).

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