A preliminary study of the inhibitive efficacy of iodized linoleic acid and its fluorodeoxyuridine ester in hepatocellular cancer / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore the potential of iodized linoleic acid (ILA) and its 5-fluoro-deoxyuridine ester (IFU) to inhibit hepatocellular carcinoma (HCC) cells in vitro and tumors in vivo.</p><p><b>METHODS</b>ILA and its constituent component IFU were chemically synthesized, purified, and confirmed by 1H-NMR. The HCC cell lines, QGY-7703 (5-fluorouracil (5-FU) treatment sensitive) and SMMC-7721 (5-FU resistant), were treated with ILA, IFU, 5-FU, or traditional lipiodol for 72 hours. Survival rates of the treated cells were assessed by the methyl thiazolyl tetrazolium method, and used to calculate the IC50 and IC90. In addition, thirty nude mice were subcutaneously inoculated with SMMC-7721 cells and randomly divided two weeks later into four treatment groups (n = 6 each) for intra-tumoral injection of ILA, IFU, 5-FU, lipiodol or DMSO (controls). The rate of tumor inhibition (RTI) was calculated for each group at week 4 after treatment.</p><p><b>RESULTS</b>For the cultured SMMC-7721 cells, the inhibitory concentrations for ILA, IFU, and 5-FU were: IC50: 134.38 mumol/L, 17.55 mumol/L, and 7.38 mumol/L; IC90: 192.88 mumol/L, 97.63 mumol/L, and more than 200 mumol/L. For the cultured QGY-7703 cells, the inhibitory concentrations for ILA, IFU, and 5-FU were: IC50: 109.55 mumol/L, 44.79 mumol/L, and 98.06 mumol/L; IC90: all, more than 200 mumol/L. In both cell types, the IC50 of lipiodol was more than 400 mumol/L. Compared with the RTI of the control mice (100%), the RTI of ILA-treated mice was 31.9% (t = 2.37, P less than 0.05), of IFU-treated mice was 56.9% (t = 4.91, P less than 0.01), and of 5-FU-treated mice was 31.0% (t = 2.59, P less than 0.05). The RTI of IFU was significantly stronger than that of either ILA or 5-FU (P less than 0.05). The lipiodol treatment showed no inhibition effect on tumors (P more than 0.05).</p><p><b>CONCLUSION</b>ILA and IFU can effectively inhibit the growth of HCC cells in vitro and tumors in vivo. Furthermore, IFU outperforms ILA in inhibiting HCC growth.</p>

Multicenter randomized control trial on safety of domestic idarubicin for acute leukemia / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the safety of domestically produced idarubicin in the treatment of acute leukemia by a multicenter randomized control trial.</p><p><b>METHODS</b>This trial was carried out in the hemotologica department of five hospitals throughout China, with hospitalized patients who suffered from acute myelogenous leukemia ( AML except M3 type) , acute lymphocytic leukemia ( ALL) , chronic myelogenous leukemia-blast (CML-blast) , totally 155 patients. Those with severely cardial, hepatic or renal disfunction or those who had ever treated with > or = 200 mg/m(2) idarubicin were excluded from the trial. All patients signed the letter of consent as required by the Ethics Committee of our government. In this study, 155 leukemia patients were randomly grouped into: 1. test group treated using domestic idarubicin, 2. control group using imported idarubicin. The acute myelogenous leukemia regimen included idarubicin 8 mg/m(2), dl -3 plus cytosine arabinoside 100 mg/m(2), dl - 7 for 1-2 cycles. The regimen for acute lymphocytic leukemia was idarubicin 8 mg/m2, dl - 3; vincristine 2 mg/mr, dl; cyclophosphamide 750 mg/m2, dl ; plus prednisone 60 mg/m(2),dl - 14 for 1-2 cycles.</p><p><b>RESULTS</b>Clinical response rate of the tested group treated with domestic idarubicin and control group treated with imported idarubicin was 78. 1% (50/64) vs. 76.9% (50/65) without any statistically significant difference between the two groups(P >0. 05). Grade Ill - IV hematological toxicity rate of the domestic idarubicin group and imported idarubicin group was 74. 0% vs. 73. 1% , respectively (P = 0. 73). Drug-related death was observed in 3 of 77 patients in the domestic idarubicin group (3.9%) due to cerebral hemorrage or septic infection. The incidence of non-hematological toxicities in domestic idarubicin group and imported idarubicin group was 84. 4% vs. 79. 5% for nausea or vomiting, 70. 1% vs. 71. 8% for infection, 42. 9% vs. 41. 0% for mucositis, 33. 8% vs. 33. 3% for alopecia, 28.6% vs. 28. 2% for serum glutamicoxalacetic transaminase abnormalitis, 16. 9% vs. 10. 3% for cardiac toxicity, all without statistically significant differences between these two groups (P > 0. 05). Discontinuation of treatment due to non-hematological toxicity was not neccessary.</p><p><b>CONCLUSION</b>Domestic idarubicin is comparable to imported counterpart in efficiency and safety for the treatment of acute leukemia. The most severe side effects of domestic idarubicin is hematological toxicity, which should be closely observed and treated in time, while its non-hematological toxicity is tolerable.</p>

Multi-institutional randomized controlled clinical trial on China made 4-demethoxydaunokrubicin (IDA) in the treatment of acute leukemia / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of IDA (Haizheng Parmacy, China) in the treatment of acute leukemia.</p><p><b>METHODS</b>A multi-institutional single-blind randomized controlled clinical trial was carried out. A total of 155 newly diagnosed patients with AML and ALL were enrolled. The patients were randomly divided into two groups, one was given IDA (n = 77) and the other given zevodas (Pharnacia & Upjohn, n = 78) for comparison.</p><p><b>RESULTS</b>All the patients enrolled in this trial were eligible for assessment of side effects, and 129 patients for evaluation of overall response rate. In patients treated with IDA vs zevodas, the overall response rate (OR) was 78.1% vs 76.9%, CR was 68.8% vs 67.7%; in AML patients, OR was 82.4% vs 71.8%, and CR was 76.5% vs 64.1%; in ALL patients, OR was 80.0% vs 81.8%, and CR was 68.0% vs 68.2%. There was no sitatistically significant difference in hematologic and non-hematologic toxicities between the two groups.</p><p><b>CONCLUSION</b>The efficacy of IDA in the treatment of acute leukemia is comparable to that of zevodas. Both have similar toxic side effects.</p>

Epidemiology and drug resistance of the pathogenic microbes in the complicated infection of hematological malignancies / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the epidemiological characteristics and drug resistance profile of the infection in patients with hematological malignancies.</p><p><b>METHODS</b>All the microbe strains isolated from the department of hematology in Ruijin hospital between 1998 and 2002 were collected for the assessment of antimicrobial susceptibility and the results were analysed by WHONET5 software.</p><p><b>RESULTS</b>Out of the 536 strains isolated in the department of hematology, 230 (42.9%) were Gram positive and 301 (56.2%) Gram negative organisms. The first 6 strains of Gram (-) microbes in frequent order were Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter cloacae, Escherichia coli, Acinetobacter Baumannii and Stenotrophomonas (xantho) maltophi. The extended spectrum beta-lactamase (ESBLs) producing rates of Escherichia coli and Klebsiella pneumoniae were 27.3% and 33.3%, respectively. Methylcillin resistant coagulase negative staphylococcus (MRCNS) was the most prevalent Gram (+) bacteria in the complicated infection patients with hematological malignancies, which accounted for 88.5%. Carbapenems were most sensitive for all of the gram negative bacteria, with a drug resistance rate of 11.4 (5.0% approximately 15.8%) of imipenem. For ESBLs strains, carbapenems and cefapime were the best choice, with the resistance rate of 46.4% approximately 94.4% and 50.0% approximately 75.9%, respectively. The drug resistance rate of Acinetobacter Baumannii was 25.0% approximately 41.3% for the third generation cephalosporin, 22.7% for the fourth generation cephalosporin and 12.7% for imipenem. Pseudomonas aeruginosa was resistant to carbapenems, with a resistance rate of 12.7% of imipenem; however, it was more sensitive to the third generation cephalosporin.</p><p><b>CONCLUSION</b>Antibiotics should be rationally administrated with more considerations to the characteristics of epidemiology and drug resistance profile of the microbes in the given department of hematology.</p>