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Vol. 282, Issue 3, 1131-1138, 1997
Departments of
Medicine (Z.Y.W., M.S.R.) and
Surgery (B.M.S.),
University of Queensland, Princess Alexandra Hospital, Brisbane,
Queensland, Australia 4102
Melphalan is commonly used as a cytotoxic agent in isolated limb
perfusion for locally recurrent malignant melanoma. The time course of
melphalan concentrations in perfusate and tissues during a 60-min
melphalan perfusion and 30-min drug-free washout in the single-pass
perfused rat hindlimb was examined using a physiologically based
pharmacokinetic model. The rat hindlimbs were perfused with Krebs-Heinseleit buffer containing 4.7% bovine serum albumin (BSA) or
2.8% dextran 40 at a constant rate of 3.8 ml/min. The concentration of
melphalan in perfusate and tissues was determined by high-performance liquid chromatography. The tissue concentrations of melphalan were
significantly higher with the perfusate containing dextran than BSA
during the 60-min perfusion. During the washout period, the melphalan
concentration in the perfusates decreased rapidly in first few minutes,
followed by a slower monoexponential decline. The estimated half life
(t1/2) for melphalan removal from skin and fat
was 59 ± 2 min for both BSA and dextran perfusates. However, the
estimated t1/2 for melphalan removal from muscle
was 79 and 96 min for BSA and dextran washout perfusates, respectively.
The predicted concentration-time profiles obtained for melphalan with BSA and dextran perfusates appear to correspond closely to the observed
data. This study showed that the uptake of melphalan into perfused
tissues is impaired by the use of perfusates in which melphalan is
highly bound. Melphalan washout from muscle, but not skin and fat, was
facilitated by the use of perfusates in which melphalan is highly
protein bound.
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