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Objective:To investigate the cost-effectiveness of long-acting versus short-acting recombinant human granulocyte stimulating factor in the treatment of III° and IV° bone marrow suppression after chemotherapy. Methods:The data of patients who presented with III and IV° bone marrow suppression after chemotherapy and received treatment with recombinant human granulocyte stimulating factor from January 2018 to December 2019 were collected. These patients were divided into the short-acting recombinant human granulocyte stimulating factor group (rhG-CSF group) and the long-acting recombinant human granulocyte stimulating factor group (PEG-rhG-CSF group) group. Clinical efficacy, the incidence of adverse reactions, and cost-effectiveness were compared between the two groups.Results:There were 88 patients, aged (63.97 ± 11.64) years, in the rhG-CSF group. There were 80 patients, aged (63.26 ± 9.09) years in the PEG-rhG-CSF group. There was no significant difference in baseline data between the two groups ( P > 0.05). Total response rate was 72.72% (64/88) in the rhG-CSF group and 78.75% (63/80) in the PEG-rhG-CSF group ( χ2 = 0.82, P = 0.360). The incidence of related adverse reactions was 7.95% (7/88) and 7.5% (6/80) in the rhG-CSF and PEG-rhG-CSF groups respectively ( χ2 = 0.01, P = 0.910). The average cost was (124.88 ± 113.07) yuan and (3 159.04 ± 505.05) yuan in the rhG-CSF and PEG-rhG-CSF groups respectively ( t = 51.68, P < 0.01). The cost-effectiveness ratio was 1.55 and 40.11 in the rhG-CSF and PEG-rhG-CSF groups respectively. Taking the rhG-CSF group as a reference, the incremental cost-effectiveness ratio in the PEG-rhG-CSF group was 505.13. Conclusion:Long-acting and short-acting recombinant human granulocyte stimulating factors have similar curative effects and related adverse reactions in the treatment of III° and IV°bone marrow suppression after chemotherapy. The cost-effectiveness ratio of the rhG-CSF group is lower than that of the PEG-rhG-CSF group. Appropriate treatment schemes for increasing white blood cell levels should be selected based on the individual situation of the patient.
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The study aims to explore the effects and mechanisms of water extract of Potentilla anserina (PA) on myelosuppression mice induced by cyclophosphamide based on metabonomics. The myelosuppressive mouse model was established by injected with cyclophosphamide and treated with water extract of PA. Thymus and spleen indexes, peripheral hemogram and bone marrow nucleated cells of each group was detected. Bone marrow pathology analysis was performed by hematoxylin-eosin staining. The levels of interleukin 3 (IL-3), interleukin 6 (IL-6), erythropoietin (EPO), granulocyte colony stimulating factor (GM-CSF), malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) in serum were measured. The changes of biomarkers and related metabolic pathways were analyzed by UPLC-Q-TOF/MS-based metabonomics. Animal experiments were approved by the Animal Ethics Committee of Southwest Minzu University. The high doses of PA could significantly improve the decrease of white blood cell (WBC), red blood cell (RBC) counts and hemoglobin (HGB) levels of mice induced by cyclophosphamide (P < 0.05), and significantly increase the number of nucleated cells and the area of hematopoietic tissue in femoral bone marrow. The medium and high doses of PA could significantly improve the serum levels of SOD, CAT, MDA, IL-6 and GM-CSF (P < 0.05), and have no significant effect on the expression of IL-3 and EPO (P > 0.05). Serum metabolomics analysis showed that the aqueous extracts of PA could alleviate myrosuppression by regulating the aminoacyl-tRNA, valine, leucine and isoleucine biosynthesis mediated by 13 different metabolites such as valine, leucine, asparagine and hydroxyisohexic acid. PA improve the inhibition of hematopoietic function in myelosuppression mouse, and its mechanisms may be related to anti-oxidation and promoting the expression of hematopoietic-related cytokines and regulating the related metabolic pathways.
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Objective:To investigate the expression of miR-211-5p in peripheral blood of patients with myelosuppression after neoadjuvant chemotherapy for breast cancer and its effect on Notch signaling pathway by targeting cyclooxygenase 2 (COX2) gene Regulation mechanism.Methods:From Jan. 2018 to Jan. 2021, 185 breast cancer patients who received neoadjuvant chemotherapy in Linyi People’s Hospital for the first time were included as the research objects. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to measure the mRNA expression levels of miR-211-5p, COX2 gene and Notch signaling pathway related genes (Notch1, Jagged1 and Hes1) . The miR-211-5p mimic, inhibitor, mimic NC, and inhibitor NC were transfected into SD rat bone marrow mesenchymal stem cells, and the mRNA expression of miR-10a-3p and COX2 genes was detected by qRT-PCR for 48 hours. Western blot method was used to detect the protein expression levels of Notch signaling pathway related genes.Results:The relative expression of miR-211-5p in patients with severe myelosuppression was 2.41±0.32, which was significantly higher than that in patients with mild myelosuppression (1.53±0.18) ( t=6.385, P<0.001) ; The relative expression of COX2 gene mRNA in patients with severe myelosuppression was 3.64±0.74, which was significantly lower than that in patients with mild myelosuppression (5.37±1.02) ( t=7.469, P<0.001) . In patients with severe myelosuppression, there was a significant negative correlation between miR-211-5p and COX2 gene mRNA levels ( r=-0.694, P=0.006) . The results of the dual luciferase report experiment confirmed that COX2 was the target gene of miR-211-5p. The relative expression of Notch1, Jagged1, and Hes1 mRNA in peripheral blood of patients with severe myelosuppression were 2.35±0.41, 2.76±0.46 and 3.04±0.52, respectively, which were significantly lower than those in patients with mild myelosuppression (4.12±0.63, 4.53±0.58 and 5.12±0.67) ( t=5.367, 6.114 and 6.135, respectively, P<0.001) . After transfecting SD rat bone marrow mesenchymal stem cells with miR-211-5p mimics and inhibitors, the relative expression of miR-211-5p in the mimic group was 3.46±0.49, significantly higher than that in the mimic NC group (2.24±0.32) The relative expression of miR-211-5p in the inhibitor group was (1.28±0.19) and (2.33±0.37) inhibitor NC group ( P<0.001) , while the relative expression of miR-211-5p in the inhibitor group was significantly lower than that in the other three groups ( P<0.001) . The mRNA expression of COX2 gene in mimic group was 2.73±0.36, which was significantly lower than that in mimic NC group (4.05±0.59) , inhibitor group (6.15±0.86) and inhibitor NC group (4.18±0.65) ( P<0.001) , while mRNA expression of COX2 gene in the inhibitor group was significantly higher than that in the other three groups ( P<0.001) . The expression of Notch1, Jagged1, and Hes1 in the inhibitor group was significantly increased, while the expression of Notch1, Jagged1, and Hes1 in the mimic group was significantly decreased. Conclusion:The expression level of miR-211-5p in peripheral blood of severe myelosuppressed patients with breast cancer after neoadjuvant chemotherapy is significantly increased, and the Notch signaling pathway can be inhibited by targeted down-regulation of COX2 gene expression.
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OBJECTIVE@#To review systematically the effectiveness of acupuncture in treatment of chemotherapy-induced bone marrow suppression.@*METHODS@#From the date of database establishment to April 1, 2020, the articles on randomized controlled trials of chemotherapy-induced bone marrow suppression were retrieved by computer from the following databases, i.e. PubMed, Cochrane central register of controlled trials (CENTRAL), EMbase, cumulative index to nursing & allied health literature (CINAHL), JBI database of systematic reviews and implementation reports, CNKI, Wanfang, VIP and SinoMed. Using RevMan5.3, Meta-analysis was conducted. With GRADEpro GDT, the evidence quality was evaluated.@*RESULTS@#A total of 12 articles were included, 10 articles of which were analyzed by quantitative Meta-analysis. Compared with the control group, the improvements in the decrease of post-chemotherapy leukocyte (@*CONCLUSION@#Acupuncture alleviates the decrease of leukocyte, platelet, neutrophile granulocyte and erythrocyte counts and improves the survival quality of patients with chemotherapy-induced bone marrow suppression.
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Humans , Acupuncture Therapy , Antineoplastic Agents/adverse effects , Bone Marrow , Quality of Life , Systematic Reviews as TopicABSTRACT
OBJECTIVE@#To evaluate the effect of Guilu Erxian Glue (, GEG) on cyclophosphamide (CTX)-induced bone marrow hematopoietic stem cells (HSCs) senescence in mice and explore the underlying mechanism.@*METHODS@#The H@*RESULTS@#Compared with the model group, GEG increased cell viability as well as proliferation (P<0.05 or P<0.01) and reduced β -gal expression. Furthermore, GEG significantly decreased the expressions of p16@*CONCLUSION@#GEG can alleviate CTX-induced HSCs senescence in mice, and the p16
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OBJECTIVE： To compare the cost-effectiveness of long-effect and short-effect granulocyte stimulating factor in prevention and treatment of bone marrow suppression induced by chemotherapy for lung malignancies， and to provide reference for rational drug use in the clinic. METHODS： A retrospective analysis was conducted for 132 cases who used granulocyte stimulating factor to prevent and treat bone marrow suppression induced by chemotherapy for lung malignancies in the Affiliated Tumor Hospital of Zhengzhou University during Jan. 2017 to Jun. 2018. Among them， 60 cases were treated with Recombinant human granulocyte stimulating factor injection （short-effect， group A）， and 72 cases were treated with Polyethylene glycol recombinant human granulocyte stimulating factor injection （long-effect， group B）. Clinical efficacies， the occurrence of bone marrow suppression and ADR were compared between 2 groups. Cost was calculated， and cost-effectiveness analysis was conducted. Sensitivity analysis was conducted by down-regulating 20％ drug price. RESULTS： The total response rates of group A and B were 71.7％ and 75.0％， without statistical significance （P＞0.05）. There was no statistical significance in the incidence and duration of bone marrow suppression or the incidence of ADR （P＞0.05）. Average treatment costs of the two groups were （335.91±180.34） and （1 982.75±603.15） yuan； the cost of group A was significantly lower than that of group B （P＜0.05）. The cost-effectiveness ratio of them were 4.69 and 26.44， while group A as a reference， incremental cost-effectiveness ratio of group B was 494.55. The sensitivity analysis results were in agreement with the cost-effectiveness analysis. CONCLUSIONS： The effectiveness of Recombinant human granulocyte stimulating factor injection is similar to that of Polyethylene glycol recombinant human granulocyte stimulating factor injection for the prevention and treatment of bone marrow suppression induced by chemotherapy for lung malignancies. But the cost-effectiveness ratio of the former is lower than that of the latter.
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Objective: To analyze the effect and mechanism of low intensity ultrasound on bone marrow suppression induced by docetaxel in rat models. Methods: Forty female rats were randomly divided into ultrasound group and control group (each n=20). Daily intraperitoneal injection of docetaxel (25 mg/kg) was given all rats for consecutive 4 days. Rats in ultrasound group were daily irradiated with low intensity ultrasound for consecutive 7 days after the first injection of docetaxel, while rats in control group received false irradiation at the same time. Routine blood examination and immunoglobulin tests were performed before docetaxel injection on the 4th, 7th and 14th day of irradiation. On the 4th day of irradiation, 4 rats in each group were randomly selected and killed for detection of stem cell factor (SCF), intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1). Histological methods were used to detect the number of nucleated cells in the right femoral bone marrow tissue of rats before injection of docetaxel on the 4th, 7th and 14th day after the first time of irradiation. HE staining and pathological examinations of skin and muscle tissues of rats were performed on the 7th day after the first time of irradiation. Results: In ultrasound group, leukocyte, neutrophil and lymphocyte counts in peripheral blood on the 4th day after the first time of irradiatio, titer of immunoglobulin A (IgA) on the 7th and 14th day after the first time of irradiation, titers of immunoglobulin G (IgG) and immunoglobulin M (IgM) on the 4th and 14th day after the first time of irradiation increased obviously compared with those of control group (all P<0.05). The relative mRNA expression levels of SCF and ICAM-1 in bone marrow of rats in ultrasound group were significantly higher than those in control group, while the relative mRNA expression level of VCAM-1 in bone marrow of rats in ultrasound group was significantly lower than that in control group (all P<0.05). On the 4th and 7th day after the first time of irradiation, the numbers of bone marrow nucleated cells in ultrasound group were significantly higher than those in control group (both P<0.05). There was no obvious damage to the skin and muscle of the irradiated rats in both the two groups. Conclusion: Low intensity ultrasound is feasible in treatment of bone marrow suppression induced by docetaxel in rats, and its mechanism may be improvement of bone marrow hematopoietic microenvironment.
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Objective@#To investigate the correlation between bone marrow suppression and the dose volume analysis of pelvic bone and provide reference for defining the parameters of bone volume-dose restriction during pelvic radiotherapy.@*Methods@#A retrospective analysis of 102 cases of cervical cancer, 53 cases of rectal cancer and 34 cases of prostate cancer in People′s Hospital of Xinjiang Uygur Autonomous Region from January 2013 to April 2016 was performed. All patients received pelvic irradiation at a dose of 50.0-50.4Gy, and a boost of 10-24 Gy was given for different types of tumors or tumor beds. Concurrent chemotherapy was carried out in patients with cervical cancer and colorectal cancer, and endocrine therapy was given to prostate cancer patients during radiotherapy. The parameters including the target bone volume, V10, V20, V30, V40, V50, and the grade of bone marrow suppression according to RTOG grading scale within 3 months after radiotherapy or 6 months post-radiotherapy were evaluated. The correlation between the irradiation bone volume and the grade of bone marrow suppression was assessed by univariate analysis. The relationship between the grade of bone marrow suppression and age, chemotherapy and radiotherapy dose was further analyzed by multivariate analysis.@*Results@#In patients with cervical, rectal and prostate cancer, the overall incidence rate of early bone marrow suppression was 77.5%, 79.2% and 70.6%, and 65.7%, 62.3% and 35.3% for ≥grade 2 bone marrow suppression, respectively. Late-stage bone marrow suppression occurred in 11 patients, grade Ⅱ in 7 cases, and the incidence rate of ≥grade 2 bone marrow suppression was 3.7%. The target bone volume in the cervical, rectal and prostate cancer groups was (746.30±27.84) cm3, (736.15±28.72) cm3 and (740.70±35.08) cm3(P=0.023), respectively. Univariate and multivariate analyses revealed that V10, V20, V30, V40 and CV10, CV20, CV30, CV40 were not significantly correlated with the grading of bone marrow suppression (all P>0.05), whereas V50 and CV50 were significantly correlated with bone marrow suppression (both P<0.05). ROC curve analysis demonstrated that V50=72.33 cm3 and CV50=9.42% were the diagnostic cut-off values for ≥grade 2 bone marrow suppression.@*Conclusions@#The incidence of bone marrow suppression is relatively high in pelvic radiotherapy, which is correlated with the irradiation bone volume and dose in the target area. At a total dose of 50 Gy, the incidence of ≥grade 2 bone marrow suppression is not associated with ≤V40 or absolute volume. Besides, it is not correlated with dose boost or whether chemotherapy is delivered, whereas it is associated with V50 and absolute volume. V50=10.23% and CV50=72.33 cm3 are the cut-off values for the incidence of ≥grade 2 bone marrow suppression.
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Objective To study the hematopoietic stem cell injury(HSC)induced by busulfan. Methods C57BL/6 mice were treated with i.p. injection of 20 mg/kg or 40 mg/kg busulfan. All mice were euthanized at 15 days and 30 days after busulfan treatment for analysis of the peripheral blood cell counts, bone marrow cellularity and HPC (LKS-, lineage-sca1 -c-kit+), HSC(LSK, lineage-sca1 +c-kit+)and long-term HSC(CD34 - LSK, CD34 - lineage-sca1 +c-kit+)frequency. The colony-forming unit-granulocyte and macrophage(CFU-GM)ability of HPC was measured by colony-forming cell(CFC)assay,and the HSC self-renewal capacity was analyzed by single-cell colony-forming assay. Results The busulfan administration decreased the WBC,RBC and PLT compared with control mice. The HPC function (CFU-GM)was impaired(P < 0.05), and the HSC colony forming ability was decreased at 15 days after busulfan treatment(P < 0.05), whereas the body weight of the mice didn't change significantly after busulfan treatment. Conclusions Our findings suggest that busulfan can induce hematopoietic stem cell injury,and provide a support for the study of hematopoietic stem cell injury mechanism.
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Aim: The usefulness and safety of strontium chloride (89Sr), a radiopharmaceutical agent for painful bone metastasis, varies from patient to patient, but the reasons for why the usefulness and safety vary have not been elucidated. The purpose of this study is to explore the background factors of patients who experienced pain relief or bone-marrow suppression after 89Sr was administrated. Methods: In the cases of pain relief, we divided the results from a numeric rating scale (NRS) before and after 89Sr administration into effective and ineffective groups as outcomes. In the cases of bone-marrow suppression, we analyzed neutrophil cells, blood platelets, and hemoglobin levels, respectively, before and after 89Sr administration as outcomes. Then, we performed statistical analyses on both case groups. Results: The results showed that the background factors associated with pain relief were weight, the 89Sr dosage amount, NRS, eGFR, SCr, and Ca levels before 89Sr administration and the area of bone metastasis (number of sites reached). We found that background factors associated with bone-marrow suppression have a moderate significant correlation with hemoglobin, NRS, and SCr levels before 89Sr administration after investigating factors which influence neutropenia. In the case of thrombocytopenia, there was a moderate significant correlation with platelet counts before 89Sr administration. In the case of hypochromia, there was a moderate significant correlation with hemoglobin levels before 89Sr administration. Discussion: Our study could elucidate patient background factors associated with pain relief and bone-marrow suppression after 89Sr administration.
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Objective To explore the influence of the old Chinese national match the experience of haplostele liters of blood prescription of chemotherapy for colorectal cancer patients with immune function and bone marrow suppression .Methods 94 cases of metastatic nodes in patients with rectal cancer treated in our hospital from February 2011 to June 2015 were selected as the re‐search object ,and were randomly divided into observation group and control group according to different regimen in the treatment , with 47 cases in each group .Patients in control group was treated with conventional XELON chemotherapy ,and patients in the ob‐servation group recieved rise blood prescription treatment based on the chemotherapy in the control group .The immune function and bone marrow suppression situation in both groups were observed after two treatment cycles .Results The stable rate of the obser‐vation group was 42 .55% ,significantly higher than that of the control group (P0 .05);the CD4+ /,CD8+ CD8+ and CD4+ /cells were significantly higher than those in control group (P<0 .05);The incidence rate of KPS in the observation group and control group was 70 .21% ,70 .21% ,17 .02% ,14 .89% , 87 .23% ,25 .53% and 23 .40% respectively .The KPS score of the observation group and the control group were significantly higher than that in control group (P<0 .05) ,and the G‐CSF in the observation group was significantly higher than that in control group (P<0 .05) .Conclusion The treatment of advanced metastatic colorectal cancer patients in the course of chemotherapy to give rise to blood formula can effectively improve the patient′s immune function ,reduce the bone marrow suppression effect ,improve the quality of life ,and it is worthy of clinical application .
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Objective: To study the effects and mechanism of Xiaoyan Decoction on bone marrow suppression in mice from aspects of peripheral blood cell ratio, immune function, and cytokines. Methods: A mouse model of bone marrow suppression was established. Fifty mice were randomly divided into five groups (n = 10): control group, model group, Xiaoyan Decoction group, rhG-CSF group, and Xiaoyan Decoction combined with rhG-CS group. Lewis-tumor mice in Xiaoyan Decoction group were ig given Xiaoyan Decoction 18.2 g/(kg·d) twice daily, for 7 d. Lewis-tumor mice in rhG-CS group were treated by sc injection of rhG-CSF. The routine blood test, immunological functions of peripheral blood and cytokines (IL-3, IL-6, EPO, and GM-CSF) in serum were detected. Results: The bone marrow suppression model was successfully established. Compared with control group, the levels of WBC, RBC, Hb, and PLT in peripheral blood of model group were decreased, especially in WBC (P 0.05). The concentration of IL-3 and IL-6 was dramatically reduced in model group compared with control group (P < 0.05). And it showed an obviously increasing trend in IL-3, IL-6, EPO, and GM-CSF levels in Xiaoyan Decoction group and combined group, as well as an increase in IL-3, IL-6 levels in rhG-CS group (P < 0.05). Conclusion: It shows that Xiaoyan Decoction combined with rhG-CS can improve the level of WBC and immunological functions of peripheral blood in bone marrow suppression model mice. And the effect of combination of both drugs is more significant. This might be related to the effect of promoting the production of serum hematopoietic regulator such as IL-3, IL-6, EPO, and GM-CSF, and relieving chemotherapy-induced bone marrow suppression.
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Objective:To analyze the clinical and physical tactors associated with acute bone marrow suppression in concurrent chemo-radiotherapy for rectal cancer and to provide a reference standard for the best clinical treatment plan. Methods:Retrospective analy-sis was performed on 62 patients with rectal cancer who received concurrent radiotherapy and chemotherapy in our department. The pelvis was contoured for each patient in the radiotherapy treatment planning system and divided into three subsites: lumbosacral spine, ilium, and lower pelvis. Prognostic clinical and physical factors were analyzed by univariate and multivariate analyses. Evaluated prognostic clinical factors included sex, age, clinical stage, original hemoglobin levels, and chemotherapy, operation, and radiation modes;physical factors included V5, V10, V15, V20, V25, V30, V35, V40, V45, V50, Dmax, and Dmean of lumbosacral spine, ilium, low-er pelvis, and pelvis. Results:The percentage of patients who developed acute bone marrow suppression (≥2 grade) was 61.3%(38/62).Univariate analysis of related factors revealed statistically significant differences were sex, chemotherapy, lumbosacral spine V45, il-ium V20, and ilium V30. Multivariate logistic regression analysis indicated that chemotherapy and ilium V30 are the risk factors for acute bone marrow suppression. The receiver operating curve showed that the threshold of ilium V30 was 44%. Conclusion:Acute bone marrow suppression is influenced by more than one factor;local control rate of the tumor and acute bone marrow suppression are tradeoffs in rectal cancer treatment. An appropriate chemotherapy method should be selected, and ilium V30 must be maintained below 44%to prevent bone marrow suppression in rectal cancer patients.
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Objective:To provide reference for clinical pharmacist in the treatment of severe bone marrow suppression complicated with infection induced by chemotherapeutic drugs .Methods:The pharmaceutical care was performed by clinical pharmacist for a pa-tient with severe bone marrow suppression complicated with pulmonary infection caused by chemotherapy .The suggestions on the drug use in the evaluation of chemotherapy regimen and the treatment of bone marrow suppression and infection were provided .Results:The bone marrow inhibition was relieved , the pulmonary infection was improved , and no other severe adverse reactions were shown .Con-clusion:Clinical pharmacist can improve effectiveness and safety in the treatment of patients with severe bone marrow suppression by providing individualized drug treatment .
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Objective To identify the dose-volumetric parameters associated with acute bone marrow suppression in concurrent chemoradiotherapy for cervical cancer,and provide the reference standard for the radiotherapy planning.Methods In total,155 patients concurrently receiving chemoradiotherapy for cervical cancer were enrolled in this study.The pelvis was contoured for each patient in radiotherapy treatment planning system and divided into three subsites:lumbosacral spine,ilium,and lower pelvis.The pelvic dose volume parameters were analyzed using univariate analysis (Chi-Square and t test),and multivariate analysis (Logistic regression model).Dose volume parameters include V5,V10,V15,V20,V25,V30,V35,V40,V45,V50 and the average dose (D).Results The percentage of patients that developed acute bone marrow suppression (≥ grade 2) was 87.7％ (136/155).The univariate analysis revealed that pelvic V5,V10,V15,V,0,ilium V15,lower pelvis V15 of patients with acute bone marrow suppression (≥ grade 2) were significantly higher than those of ＜ grade 2 patients (t =-2.277,-2.142,-3.475,-2.018,-2.963,-2.741,P ＜0.05).Multiple regression analysis indicated that pelvic V15 was associated with acute bone marrow suppression (OR =1.728.P ＜ 0.05).The threshold of pelvic V15 was 88％ as determined by receiver operating curve (ROC).Conclusions The results show that Pelvic V15 is associated with acute bone marrow suppression in concurrent chemoradiotherapy for cervical cancer and is thus an independent risk factor.To better predict and control acute bone marrow suppression,pelvic V15 should be carefully controlled below 88％ in treatment planning to reduce the incidence of acute bone marrow suppression.
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Objective] To sum up professor He Ruoping’s clinical experience and academic views in the treatment of bone marrow suppression after chemotherapy in patients with malignant tumor. [Method] Through the way of clinical practice with teacher, arranging medical records and clinical observation, systematically arranging He Ruoping’s clinical experience and academic perspective in the aspects of etiology and pathogenesis, treatment ideas and drug characteristics. And further explain the characteristics of the treatment of He through case analysis.[Result] He Ruoping believes that the treatment of bone marrow suppression after chemotherapy related closely with spleen and kidney, and is also related with interweaving of toxicity, deficiency and blood stasis. The treatment should be based on kidney, spleen, centralizer, make Qi and blood sufficient. Besides, supplemented by the Quxie treatment, make Qi and blood flow.[Conclusion] Using Yishen Jianpi Fuzheng, supplemented by eliminating method in treating post chemotherapy bone marrow suppression, has significant clinical effect, has the value of popularization and application.
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Objective]Discussesing Professor Lu Su's experience for the treatment of gynecologic tumor bone marrow suppression after chemotherapy. [Methods] Through learning from the teacher, collecting and collating the relevant information and medical records ,summarizing the doctor's treatments for bone marrow suppression,introducing the special treatment from nourishing Yin and Yang, dialectical analysis;combination of Chinese and western, foster strengths and circumvent weaknesses;treatment based on overall, overall consideration;Regulate mood,treat both heart and kidney at the same time,and give examples to prove it. [Results] Professor Lu Su believes that the disease in the Yin and Yang as the main pathogenesis of the disease, the treatment nourishing of Yin and Yang, clinical examination of the combination of the dialectical analysis,nourishing Yin and Yang, dialectical analysis, for the treatment of gynecologic tumor bone marrow suppression after chemotherapy, with a certain clinical significance. [Conclusion ]Professor Lu Su's unique method of treatment of gynecologic tumor bone marrow suppression after chemotherapy, has remarkable curative effect.Her treatment and academic thoughts of bone marrow suppression of gynecological tumor after chemotherapy open a new path, unique method, and the effect is significant, the syndrome differentiation typing, prescription and addition and subtraction cut to clinical treatment after chemotherapy myelosuppression is of practical value, it is worth learning.
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Objective To evaluate the relationship between sternum protection and bone marrow suppression in postoperative radiotherapy for esophageal carcinoma. Methods Total of 98 postoperative patients with thoracic esophageal carcinoma were randomly divided into experimental group (52 cases) and control group (46 cases). All patients were given intensity-modulated radiotherapy (IMRT), with the dose of 50-50.4 Gy. The patients in experimental group were irradiated by 6 fields (4-fields in front, 2-fields behind) which were crossed to avoid direct exposure to the sternum. The patients in control group were irradiated by 5 fields (3-fields in front, 2-fields behind) with front-middle of the field passing through the sternum. Concurrently all patients received 2 cycles of cisplatin chemotherapy. Results Dmean, V20 and V30 of the sternum in the experimental group were (20.21 ±3.60) Gy, (40.78 ±7.19) % and (33.78 ±9.44) %, which were lower than those in the control group [(30.91±5.21) Gy, (81.01±4.81) %, (51.60±6.84) %], respectively (P 0.05). Both the incidence rates of bone marrow suppression at 14th day and 35th day after radiotherapy were significantly higher in the control group (52.2%, 73.9%) than those in the experimental group (28.8 %, 50.0 %) (P< 0.05), and the incidence rate of bone marrow suppression at 7th day after radiotherapy was similar between the two groups. Conclusion Protecting and sketching for sternum in postoperative radiotherapy for esophageal carcinoma can reduce the incidence of bone marrow suppression effectively, which would not increase the radiation dose in the lung, heart and spinal cord.
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Objective:To explore the pharmaceutical care for the elderly cancer patients complicated with bone marrow suppres-sion by clinical pharmacists. Methods:Clinical pharmacists performed the pharmaceutical care through the evaluation of chemothera-py, symptomatic treatment for bone marrow suppression and infection prevention after bone marrow suppression etc. Results:The bone marrow suppression was alleviated without bleeding related with the decrease of platelet and infection. Conclusion:The pharmaceutical care performed by clinical pharmacist can enhance the safety and effectiveness of medication.
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Thrombocytopenia is a common clinical problem with many etiological causes. Although transient bone marrow suppression and marrow infiltration by malignancies are important causes, certain non-malignant conditions such as nutritional causes and infections are equally important as the treatment is simple and cure is possible. Depending on the aetiology, the clinical presentation may vary. Knowing the exact aetiology is important for specific treatment and prognostication. A total of 303 cases of thrombocytopenia were studied out of which males were 44% and females were 56%. The patients’ age ranged from 5 months to 84 yrs. The commonest presenting symptom was fever with bleeding manifestations and jaundice. 14% of cases are of Grade 1, 20% of the cases of Grade 2, 5% of cases of Grade 3 and 31% of cases had counts less than 25000/cu.mm i.e. of Grade 4. 50% of cases in Grade 4 had a decreased number of megakaryocytes in the bone marrow. The most common cause of thrombocytopenia in our study was megaloblastic anaemia (48.6%), ITP (20%), post-viral (10.9%) followed by leukaemia, aplastic anaemia and others. Thrombocytopenia has a spectrum of causes which can be diagnosed by detailed history and peripheral smear examination supported by bone marrow examination. Megaloblastic anaemia was the commonest cause of thrombocytopenia followed by immune thrombocytopenia. Unlike in the western India megaloblastic anemia is highly prevalent and is the leading correctable cause of thrombocytopenia. Most of the patients with Grade 4 thrombocytopenia had a decreased number of megakaryocytes in the bone marrow suggesting a production defect.