Clinical assessment of EMA CO induced DNA damage in peripheral blood lymphocytes of high-risk gestational trophoblastic tumor patients

From 1989 to 1994, Etoposide, Methotrexate, Actinomycin-D, Cyclophosphamide , Vincristine, Folic acid (EMA/CO) regimen was administered to seven patien ts with high-risk gestational tumours according to the Bagshawe 1976 criter ia. Peripheral blood lymphocytes were obtained from two of these seven high -risk gestational trophoblastic patients receiving the EMA/CO regimen, and damage levels of DNA during chemotherapy were assessed using SCGE (single c ell gel electrophoresis) assay. Additionally, the efficacy, toxicity and clinical results of EMA/CO regimen were evaluated in patients with high-risk gestational trophoblastic tumour s. Fever (71.4%), leukopenia (57%), increase in transaminase concentrations (57%), trombocytopenia (57%), and anemia (57%) were among the most frequen t side-effects of the EMA/CO regimen. All these toxic effects were reversib le and there was no need to stop the therapy. EMA/CO is highly effective in patients with high-risk gestational trophoblastic disease and its toxicity is predictable and reversible. Because of chemotherapy, DNA damage that is shown in peripheral blood lymphocytes, increases at the 8th day of the EMA /CO regimen. When DNA damage is higher in patients, the course of chemother apy per each patient is shortened. When DNA damage is higher in the patient s, the multisystem effects due to toxicity are more significant. The SCGE a ssay has many possibilities in such research and has proved to be a relativ ely simple, quick and sensitive technique.