Chemotherapy with the modified Bagshawe protocol for poor prognosis metastatic trophoblastic disease

The Southeastern Regional trophoblastic Disease Center has treated 126 patients with metastatic gestational trophoblastic disease from 1966 through 1979. Sixty-three cases were categorized as having a poor prognosis on the basis of criteria published previously. Since 1976, 18 patients have been treated with a modification of Bagshawe's multiagent chemotherapy protocol. Ten of 18 patients (56%) have achieved sustained remission. Seventy-eight percent of these patients encountered serious myelosuppression (white blood count 1000 cells or fewer) and 39% suffered severe thrombocytopenia (platelet count 50,000 or fewer). There were no deaths related to drug toxicity. The courses of therapy and complications of modified Bagshawe chemotherapy are reviewed.