A Placebo Controlled Study of a Seven Day Course of Lithium Carbonate Following Myelotoxic Chemotherapy

Abstract

The administration of myelotoxic cancer chemotherapy is associated with neutropenias which may lead to development of severe infections (Bodey, 1977). Lithium carbonate has been reported to attenuate chemotherapy-induced neutropenia (Stein et al., 1977; Greco and Brereton, 1977; Catane et al., 1977; Lyman et al., 1978; Visca et al., 1979). These studies have shown that the use of lithium carbonate following cytotoxic chemotherapy results in a less severe decrease of neutrophils during chemotherapy cycles and higher nadirs of neutrophil counts during each cycle. This benefit has been obtained using lithium therapy throughout the chemotherapy cycle. Since prolonged lithium therapy may produce deleterious side-effects even when serum levels are carefully monitored (Baldessarini and Lipinski, 1975), a trial of a shortened course of lithium carbonate following chemotherapy was indicated. The lithium carbonate therapy was given with a combination of chemotherapeutic agents which produced a marked neutropenia. The initial studies were done using an alternate cycle cross-over format. Subsequently, a placebo controlled randomized study of a 7 day course of lithium carbonate 300 mg three times daily was done.