PHARMACOKINETICS OF HIGH-DOSE METHYLPREDNISOLONE AND USE IN HEMATOLOGICAL MALIGNANCIES

The pharmacokinetics of oral and intravenous high dose methylprednisol one (Solu-medrone, Upjohn) were compared in patients with hematologica l malignancies. The aim of the study was to determine the oral bioavai lability of high dose methylprednisolone and to establish whether this is a feasible and more convenient route of administration. The plasma pharmacokinetics were described by a one-compartment open model with peak plasma levels of 6.9 +/- 2.5 mug/ml. Total area under the plasma concentration versus time curve was similar by either route. Mean rela tive oral bioavailability was generally high (91 +/- 27 per cent). Ret rospective analysis of 34 patients with chronic lymphocytic leukemia ( CLL), non-Hodgkin's and Hodgkin's lymphoma treated with high dose meth ylprednisolone showed 11 responses including two complete remissions a mong nine patients with CLL. There was significant improvement in plat elet counts in thrombocytopenic patients and treatment was well tolera ted and toxicity was relatively low. High dose methylprednisolone may therefore be a useful palliative treatment for hematological malignanc ies, particularly where marrow suppression is a problem.