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<p><b>OBJECTIVE</b>To evaluate chemotherapy-related toxicity and the short-term efficacy of topotecan and cyclophosphamide as maintenance chemotherapy for stage IV neuroblastoma in complete remission.</p><p><b>METHODS</b>The clinical data of 16 children with stage IV neuroblastoma received 3 cycles of maintenance chemotherapy with topotecan (0.75 mg·m(-2)·day(-1), infused on days 0-4) and cyclophosphamide 250 mg·m(-2)·day(-1), infused on days 0-4). The two-year event-free survival after complete remission was recorded and the chemotherapy-related toxicities were evaluated according to the Common Terminology Criteria for Adverse Events of the National Cancer Institute.</p><p><b>RESULTS</b>The most common chemotherapy-related toxicity was bone marrow suppression and suppressions of neutrophils, hemoglobin and platelets, which occurred in all the patients mostly of grade III and IV. All the patients experienced episodes of infections, which were controlled effectively with antibiotics. Impairment of gastrointestinal and liver functions in these cases was mostly mild (grade I and II) and recovered after corresponding treatments. None of the patients exhibited damages in the nervous system or the renal or cardiac functions. After complete remission, the two-year event-free survival rate of these patients was 68.75% (11/16).</p><p><b>CONCLUSION</b>Topotecan plus cyclophosphamide for maintenance chemotherapy can be effective and relative safe for stage IV neuroblastoma in complete remission, thus giving a chance to those patients who choose not to have stem cell transplantation.</p>
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Child , Child, Preschool , Female , Humans , Infant , Male , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Cyclophosphamide , Maintenance Chemotherapy , Neoplasm Staging , Neuroblastoma , Drug Therapy , Pathology , Topotecan , Treatment OutcomeABSTRACT
Objective To screen the differential expression proteins in the children with neuroblastoma (NB) by proteomics tools.Methods Three specimens were collected from the patients diagnosed Ⅳstage NB by biopsy at Department of Pediatric Surgery of Chinese PLA General Hospital in Beijing from July to December,2011.Another three specimens were acquired from the same patients underwent tumor excision.Average age was 3.17 years.Proteins in neuroblastoma before and after chemotherapy were separated by two dimensional gel electrophoresis,analyzed by high performance liquid chromatography-eleetrospray tandem MS (Nano-UPLC-ESIMS/MS).Results After two dimensional gel electrophoresis,we obtained the maps about tissues before and after chemotherapy.There were 7 differential protein spots identified by using the Image Master two dimensional gel electrophoresis software,in which 2 were up-regulated,including Nm23 protein and neuropolypeptide h3,5were down-regulated after chemotherapy,including stathminl,heat shock protein 27,mitochondrial short-chain enoyl-coenzyme A,peroxiredoxin 1 and peroxiredoxin 3.Conclusion The differential expression proteins of children neuroblastoma before and after chemotherapy were successfully identified by two dimensional gel electrophoresis and Nano-UPLC-ESI-MS/MS.
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BACKGROUND: Methoxy polyethylene glycol (mPEG) is a kind of amphotedc compound with no immunogenicity that has been used to modify various proteins covalently and to prepare versatile blood types. If mPEG modification blocks the activation of T cells in grafts, graft versus host disease (GVHD) reaction probably becomes less serious and transplantation may become successful. OBJECTIVE: To construct haploidentical bone marrow transplantation mudne model and to observe the effects of mPEG modification to grafts on acute GVHD following haploidentical bone marrow transplantation, DESIGN, TIME AND SETTING: A randomized paired design experiment was performed at the Laboratory Animal Center and Pediatric Laboratory of the General Hospital of Chinese PLA between March and November 2003. MATERIALS: Twenty 8-10 week old male BALB/cH-2d mice served as donors and sixty 8-10 week old female CBe F1H-2d/b mice served as recipients, mPEG was provided by Sigma, USA. METHODS: Mixture of donor bone marrow and spleen cells was routinely prepared. After irradiated with 60Co γ ray at a total dose of 8.0 Gy, recipient mice were randomly divided into 3 groups, with 20 rats per group: irradiation control, non-modification, and mPEG modification. Within 12 hours after irradiation, the irradiation control group was injected with 0.5 mL RPMI-1640 culture medium via caudal vein, the non-modification group was administered with 0.5 mL non-modified mixture of bone marrow and spleen cells via caudal vein, and mice from the group were given 0.5 mL mPEG-modified mixture of bone marrow and spleen cells via caudal vein. MAIN OUTCOME MEASURES: After transplantation, hematopoietic recovery, survival rate, acute GVHD and chromosomal karyotype were studied and compared with controls. RESULTS: All mice from the irradiation control groups died within 2 weeks. The 30-day survival rate was significantly higher in the mPEG modification group than in the non-modffication group (75% vs. 40%, x2 = 5.01, P= 0.025). Histopathological examinations of skin, liver and intestine showed typical signs of acute GVHD. The mPEG modification group exhibited less severe pathological presentation and lower Thomas grading than the non-modification group. Cheimedsm examination revealed complete donor-type implantation in living recipient mice at 75 days after transplantation. CONCLUSION: mPEG modification to grafts can greatly alleviate acute GVHD and enhance the survival rate of mice after haploidentical bone marrow transplantation.
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OBJECTIVE To analyze the treating efficacy of meropenem on blood tumor combined with the infection in children. METHODS A retrospective study protocol was adopted,totally 80 acute leukemia and other subjects complicated with infection were observed.The dosage of meropenem was 10-20 mg/kg,q8-12 h for all the patients and the treatment course in most patients was less than 10-14 days. RESULTS The effectiveness rate was 78.8%.The effectiveness rate was 80% for hematological system diseases complicated with septicemia and was 77.0% for hematological system diseases complicated with agranulocytosis.The occurrence rate of side effect of meropenem in this group was 0. CONCLUSIONS Meropenem is significantly effective and safe in the treatment of hematological system diseases complicated with infections.
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0.05),and the antifebric time of group A was shorter than that of group B.No significant difference was found in the incidence rate of side reaction between two groups. CONCLUSIONS Ceftazidime and vancomycin combination is more effective than ceftazidime alone.
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20?10 9/L) were 12 (8-20), 17(10-28) and 21 days (7-78), respectively. The average follow-up period was 7 3 years(ranged from 1 month to 14 years). The overall survival (OS) and death rates after transplantation were 70%(18/26) and 30%(8/26) respectively. Transplant-related mortality was 7 7%(2/26). Conclusion The combination of chemotherapy and G-CSF is an effective and low toxicity protocol for the mobilization of peripheral blood stem cells. APBSCT can be safely performed in children with malignant tumors.
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To investigate the safety, efficacy and feasibility of the administration of a number of DCs from HLA identical donor in the treatment of leukemia. Peripheral blood mononuclear cells (PBMNCs) of HLA identical healthy donors were collected. PBMNCs were cultivated initially with IL 4,hGM CSF,TNF ?, and stimulated by lysate of leukemic cells.Dendritic cells were induced and given to the patients. The response of the patients to the infusion of DCs was observed. Clinical observation showed that the progress of leukemia was limited partly. There was no toxicity directly referable to this treatment. It is feasible and safe to generate and administer DCs pulsed with tumor lysate, suggesting that it could be a potential treatment for advanced acute myeloid leukemia.
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Objective To explore the neuroprotective effect of honokiol against Parkinson's disease(PD)in mouse model,and investigate the possible mechanism involved.Methods 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)was injected into abdominal cavity of mouse to establish the PD model.Sixty C57BL/6 male mice were randomly allocated into five groups:control group,MPTP model group,amantadine group(positive control,40mg/kg),honokiol group A(10mg/kg)and honokiol group B(30mg/kg).Spontaneous movement test was used to measure the activity frequency of each mouse in 5 minutes.The technique of high performance liquid chromatography-electrochemistry was utilized to detect the changes of dopamine(DA)contents in mouse striatum.Results a)Since the involuntary movement appeared,such as trunk trembling,piloerection,tail extending and movement reduction,the PD model was regarded as having been reproduced successfully.b)The spontaneous movement frequency in 5 minutes of the mice in MPTP model group(102?7)was lower than that in the control group(583?11,P
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Objective To analyze the clinicopathological features and enhance the knowledge of Askin tumor in children. Methods The clinicopathological features of 4 cases of children with Askin tumor were described. Results Clinically, the tumor was often seen in elder child patients with painful thoracopulmonary masses.Histopathologically, the nest-like or lobular structures composed of small round-to-oval cells were surrounded by sparse fibrovascular stroma. Among tumor cells there were no or few resticular fibers,however in the surrounding of tumor masses the fibers were found. PAS staining in the tumor in a part of cases was positive. The positive rates of CD99 and Syn detected by immunohistochemistry were high. Neurosecretory granules can be observed by electron microscopy. Two patients received both chemotherapy and radiotherapy three patients died of metastatic tumor of lung and brain and chemotherapy complication in 24,25 and 5 months, respectively. Conclusions Askin tumor is a highly malignant neurosecretory tumor in thoracopulmonary region, which often be misdiagnosed as neuroblastoma, lymphoma, embryonal rhabdomyo sarcoma, tuberculosis and lung abscess, and requires a synthetical treatment plan consisting of pre-and postoperative chemotherapy, radiotherapy and surgical resection. The treatment methods of Askin tumor needs to be further studied.
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To observe the state of balance between Th1/Th2 in children with asthma by assaying lymphocyte produced cytokines and the expression of CD30 membrane antigen on PBMC. The levels of IFN ?, IL 4 in PBMC and serum total IgE were determined by ELISA, the counting of the CD30 expressing cells was performed by flow cytometry. The results showed: (1)The level of IL 4 was increased significantly in patients with asthma attack compared with normal children ( P