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Article in Chinese | WPRIM | ID: wpr-929075


OBJECTIVE@#To prepare an injectable hydrogel/staple fiber composite loaded with combretastain A-4 disodium phosphate (CA4P) and doxorubicin (DOX) and evaluate its antitumor efficacy via intratumoral injection.@*METHODS@#DOX-loaded PELA staple fibers (FDOX) were prepared using electro-spinning and cryo-cutting, and the drug distribution on the surface of the fibers was observed using a fluorescence microscope, and the encapsulation efficiency and loading capacity of FDOX were determined with a fluorospectro photometer. The fibers were then dispersed in CA4P-loaded PLGA-PEG-PLGA tri-block polymer solution at room temperature to obtain the hydrogel/staple fiber composite (GCA4P/FDOX). The thermo-sensitivity of this composite was determined by a test tube inverting method. An ultraviolet spectrophotometer and a fluorospectrophotometer were used to detect the release profile of CA4P and DOX, respectively. We observed in vivo gel formation of the composite after subcutaneous injection in mice. The in vitro cytotoxicity of GCA4P/FDOX composite in MCF-7 and 4T1 cells was assessed using cell Counting Kit-8 (CCK-8) reagent. In a mouse model bearing breast tumor 4T1 cell xenograft, we evaluated the antitumor efficacy of the composite by monitoring tumor growth within 30 days after intratumoral injection of the composite. HE staining, immunohistochemistry for Ki67 and immunofluorescence (TUNEL) assay were used for pathological examination of the tumor tissues 21 days after the treatments.@*RESULTS@#The average length of FDOX was 4.0±1.3 μm, and its drug loading capacity was (2.69±0.35)% with an encapsulation efficiency of (89.70±0.12)%. DOX was well distributed on the surface of the fibers. When the temperature increased to 37 ℃, the composite rapidly solidified to form a gel in vitro. Drug release behavior test showed that CA4P was completely released from the composite in 5 days and 87% of DOX was released in 30 days. After subcutaneous injection, the composite solidified rapidly without degradation at 24 h after injection. After incubation with GCA4P/FDOX for 72 h, only 30.6% of MCF-7 cells and 28.9% of 4T1 cells were viable. In the tumor-bearing mice, the tumor volume was 771.9±76.9 mm3 in GCA4P/FDOX treatment group at 30 days. Pathological examination revealed obvious necrosis of the tumor tissues and tumor cell apoptosis induced by intratumoral injection of G4A4P/FDOX.@*CONCLUSION@#As an efficient dual drug delivery system, this hydrogel/staple fiber composite provides a new strategy for local combined chemotherapy of solid tumors.

Animals , Breast Neoplasms/drug therapy , Cell Line, Tumor , Delayed-Action Preparations/therapeutic use , Doxorubicin/therapeutic use , Female , Heterografts , Humans , Hydrogels/therapeutic use , Mice , Mice, Inbred BALB C , Phosphates
Rev. invest. clín ; 73(4): 231-237, Jul.-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1347569


Background: Central nervous system international prognosis index (CNS-IPI) is validated in European and the USA cancer databases. However, no validation has been done in Mexican population. Objective: The objective of the study was to assess the impact of the CNS-IPI on central nervous system (CNS) relapse and survival in Mexican patients with diffuse large B-cell lymphoma (DLBCL). Methods: In this retrospective analysis, clinical, biochemical, and histological variables and the CNS-IPI were analyzed. Results: Six hundred and forty-two patients with DBLCL were included in the study. The mean ± SD age was 56.8 ± 14.9 years. Most had an ECOG of 0-1: 75% (n = 484) had absence of B-symptoms and advanced disease (clinical stage: III-IV, n = 433, 67.4%). According to the CNS-IPI, almost one-half were in the low-risk category. According to the CNS-IPI, CNS relapse rate was 1.36% (95% CI: 83.2-92.8), 3.1% (95% CI: 132.4-162.8), and 7.4% (95% CI 61-91) for patients in the low-, intermediate-, and high-risk categories, respectively. The median overall survival in the high-risk group (CNS-IPI) was 22 months, and it has not been achieved after 80 months of follow-up for the other groups. Conclusions: CNS-IPI was associated with survival; therefore, we propose its use as a prognostic tool for prospective validation.

Humans , Adult , Middle Aged , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Lymphoma, Large B-Cell, Diffuse/drug therapy , Central Nervous System Neoplasms/drug therapy , Prognosis , Vincristine/therapeutic use , Prednisone/therapeutic use , Doxorubicin/therapeutic use , Central Nervous System , Retrospective Studies , Cyclophosphamide/therapeutic use , Rituximab/therapeutic use , Mexico/epidemiology , Neoplasm Recurrence, Local
Rev. venez. oncol ; 33(1): 40-45, mar. 2021. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1147477


El linfoma de Burkitt es una neoplasia altamente agresiva y es un tipo raro de linfoma no Hodgkin localizado. Aunque los niños son los más frecuentemente afectados, en adultos ocurren principalmente durante el embarazo o el puerperio. La mama rara vez constituye la localización primaria del linfoma no Hodgkin. Se presenta un caso de linfoma de Burkitt primario de mama durante el embarazo. Paciente de 37 años con embarazo de 24 semanas quien presentó aumento de volumen difuso de mama derecha. La mama estaba aumentada de tamaño, dolorosa y homogénea con tumoración elástica y firme. La ecografía demostró inflamación difusa con tumoración heterogénea e hipoecoica con contornos ligeramente irregulares, marcadores tumorales estaban normales las pruebas serológicas fueron negativas. La biopsia de la lesión mostró tejido mamario reemplazado por células linfoideas de tamaño mediano con citoplasma basófilo y múltiples vacuolas. Estudios inmunohistoquímicos fueron positivos para el antígeno leucocitario común, CD10, CD20, CD43, Bcl-6. El análisis cromosómico reveló que más del 90 % de las células neoplásicas exhibieron translocación t llevando al diagnóstico final de linfoma de Burkitt de mama. Luego de evaluar las posibilidades terapéuticas y del consentimiento de la paciente se inició tratamiento citostático sistémico. Los linfomas primarios de mama son extremadamente raros. El linfoma de Burkitt primario de la mama es mucho menos común que los otros linfomas. Los métodos de clasificación, detección y tratamiento de esta afección siguen siendo objeto de debates e investigaciones(AU)

The Burkitt's lymphoma is a highly aggressive neoplasm and is a rare type of localized non-Hodgkin lymphoma. Although children are the most frequently affected, in adults they occur mainly during the pregnancy or the puerperium. The breast rarely constitutes the primary location for non-Hodgkin lymphoma. The study of a case of primary Burkitt lymphoma of the breast during pregnancy is presented. This is a 37 year old patient with a 24 week pregnancy who presented a diffuse increase in the volume of the right breast. The breast was enlarged, painful and homogeneous with a firm, elastic mass. The ultrasonography showed diffuse inflammation with a heterogeneous and hypoechoic tumor with slightly irregular contours. The tumor marker values were normal and the serological tests were negative. The biopsy of the lesion showed breast tissue replaced by medium-sized lymphoid cells with basophilic cytoplasm and multiple vacuoles. Immunohistochemically studies were positive for the common leukocyte antigen, CD10, CD20, CD43, Bcl-6. The chromosomal analysis revealed that more than 90 % of neoplastic cells exhibited t translocation leading to the final diagnosis of Burkitt lymphoma of the breast. After evaluating the therapeutic possibilities and the patient's consent, systemic cytostatic treatment was started. Primary breast lymphomas are extremely rare. The primary Burkitt lymphoma of the breast is much less common than other lymphomas. The methods of classification, detection, and the treatment of this condition continue to be the subject of debate and research(AU)

Humans , Female , Adult , Lymphoma, Non-Hodgkin , Breast Neoplasms , Burkitt Lymphoma/physiopathology , Precursor Cells, B-Lymphoid , Vincristine/therapeutic use , Prednisone/therapeutic use , Doxorubicin/therapeutic use , Tomography, X-Ray Computed , Cyclophosphamide/therapeutic use , Rituximab/therapeutic use
Journal of Experimental Hematology ; (6): 1136-1140, 2021.
Article in Chinese | WPRIM | ID: wpr-888529


OBJECTIVE@#To evaluate the efficacy and safety of CHOP regimen based on doxorubicin hydrochloride liposome in the initial treatment of elderly patients with diffuse large B-cell lymphoma (DLBCL).@*METHODS@#Thirty-one patients with DLBCL treated from January 1, 2012 to December 31, 2019 were analyzed retrospectively, their median age was 83 (71-95) years old, and all of them were in Ⅲ-Ⅳ stage, including 17 cases who had international prognostic index (IPI) ≥ 3. The patients were treated with R-CHOP and CHOP regimens based on doxorubicin hydrochloride liposome. The efficacy and safety were evaluated during and after treatment.@*RESULTS@#A total of 219 chemotherapy cycles and 7 median cycles were performed in 31 patients. The overall response (OR) rate and complete remission (CR) rate was 80.7% (25/31) and 61.3% (19/31), respectively, as well as 2 cases (6.5%) stable, 4 cases (12.9%) progressive. The main toxicities were as follows: the incidence of grade Ⅲ -Ⅳ neutropenia was 29% (9/31); two patients (6.5%) developed degree Ⅰ-Ⅱ cardiac events, which were characterized by new degree Ⅰ atrioventricular block; there were no cardiac events requiring emergency treatment and discontinuation of chemotherapy. The 1-year, 2-year and 3-year overall survival rate was 83.9%, 77.4% and 61.3%, respectively. The 1-year, 2-year and 3-year progression-free survival rate was 77.4%, 64.5% and 61.3%, respectively.@*CONCLUSION@#The chemotherapy regimen based on doxorubicin hydrochloride liposome has better efficacy and higher cardiac safety for elderly patients with DLBCL.

Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , Humans , Liposomes/therapeutic use , Lymphoma, Large B-Cell, Diffuse/drug therapy , Prednisolone , Prednisone/therapeutic use , Retrospective Studies , Rituximab/therapeutic use , Vincristine/therapeutic use
Journal of Experimental Hematology ; (6): 1919-1922, 2020.
Article in Chinese | WPRIM | ID: wpr-879993


OBJECTIVE@#To summarize and analyze the clinical characteristics, treatment and prognosis of acute lung injury in patients with diffuse large B-cell lymphoma (DLBCL) after chemotherapy with rituximab chemotherapy, so as to improve the understanding of the disease and guide the clinical treatment.@*METHODS@#Twenty-Six patients with DLBCL were treated with rituximab chemotherapy and developed to acute lung injury in Third Hospital of Peking University from January 2013 to September 2018 were selected. The clinical features, imaging findings, chemotherapy course, therapeutic effect and prognosis were analyzed.@*RESULTS@#The main clinical symptoms of patients were fever, cough and chest tightness, among which 12 patients showed hypoxia and 3 patients showed respiratory failure type I. The mainly manifested chest CT was diffusive glass grinding in both lungs, and some patients were complicated with a small amount of pleural effusion. The onset chemotherapy time was mainly distributed in 2 to 4 courses, the time between the onset of symptoms and the infusion of rituximab was 8 to 49 days. 25 patients shows no obvious limitation in daily life after effective treatment, and 1 patient died of ineffective treatment.@*CONCLUSION@#There are no typical clinical symptoms in the early stage of acute lung injury after rituximab chemotherapy in DLBCL. Early detection and early hormone therapy are very important to achieve good therapeutic effect.

Acute Lung Injury , Antineoplastic Combined Chemotherapy Protocols , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , Humans , Lymphoma, Large B-Cell, Diffuse/drug therapy , Prognosis , Rituximab/therapeutic use , Treatment Outcome , Vincristine/therapeutic use
Journal of Experimental Hematology ; (6): 1912-1918, 2020.
Article in Chinese | WPRIM | ID: wpr-879992


OBJECTIVE@#To analyze the efficacy of rituximab combined with CHOP/EPOCH regimen for treatment of diffuse large B-cell lymphoma(DLBCL) patients, and to explore the high risk factors of refractory and relapsed patients.@*METHODS@#The clinical data of 72 patients with de novo DLBCL from December 2012 to December 2018 in the Department of Hematology, Zhongda Hospital Affiliated to Southeast University were retrospectively analyzed. The remission rate of DLBCL patients treated by rituximab combined with CHOP/EPOCH was analyzed, and survival analysis was conducted to explore the risk factors influencing refractory recurrence.@*RESULTS@#45 cases among 72 patients achieved complete remission (CR), 11 cases achieved partial remission (PR), the total remission rate was 77.78%. 25 cases (34.2%) refractory and relapsed. Single factor analysis showed that the B symptoms, low Hb, high NLR, low MLR, high β@*CONCLUSION@#The remission rate of DLBCL patients treated by rituximab combined with CHOP/EPOCH regimen is high, but about one third of the patients still show refractory and relapsed. B Symptoms, anemia, high β

Antineoplastic Combined Chemotherapy Protocols , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , Etoposide , Humans , Lymphoma, Large B-Cell, Diffuse/drug therapy , Neoplasm Recurrence, Local , Prednisone/therapeutic use , Prognosis , Retrospective Studies , Rituximab/therapeutic use , Treatment Outcome , Vincristine
Chinese Medical Journal ; (24): 253-260, 2020.
Article in English | WPRIM | ID: wpr-877995


Although the first-line rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone regimen (R-CHOP) substantially improved outcomes for patients with diffuse large B-cell lymphoma (DLBCL), 40% of the patients suffered from relapsed/refractory disease and had poor survival outcomes. The detailed mechanism underlying R-CHOP resistance has not been well defined. For this review, we conducted a thorough search for literature and clinical trials involving DLBCL resistance. We discussed DLBCL biology, epigenetics, and aberrant signaling of the B-cell receptor (BCR), phosphatidylinositol 3-kinase (PI3K)/Akt, nuclear factor kappa light chain enhancer of activated B-cells (NF-κB), and the Janus kinase (JAK)/signal transducer and activator of transcription 3 (STAT3) pathways as defining mechanisms of DLBCL heterogeneity and R-CHOP resistance. The cell of origin, double- or triple-hit lymphoma and double-protein-expression, clonal evolution, tumor microenvironment, and multi-drug resistance help to contextualize DLBCL resistance in an (epi)genetically and biologically comparative manner. With better understanding of the biological and molecular landscape of DLBCL, a more detailed classification system and tailored treatments will ideally become available to further improve the prognosis of DLBCL patients.

Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , Humans , Lymphoma, Large B-Cell, Diffuse/genetics , Phosphatidylinositol 3-Kinases , Prednisone/therapeutic use , Prognosis , Rituximab/therapeutic use , Tumor Microenvironment , Vincristine/therapeutic use
Chinese Medical Journal ; (24): 334-343, 2020.
Article in English | WPRIM | ID: wpr-877961


BACKGROUND@#High agglomeration of myeloid-derived suppressor cells (MDSCs) in neuroblastoma (NB) impeded therapeutic effects. This study aimed to investigate the role and mechanism of targeted inhibition of MDSCs by low-dose doxorubicin (DOX) to enhance immune efficacy in NB.@*METHODS@#Bagg albino (BALB/c) mice were used as tumor-bearing mouse models by injecting Neuro-2a cells, and MDSCs were eliminated by DOX or dopamine (DA) administration. Tumor-bearing mice were randomly divided into 2.5 mg/kg DOX, 5.0 mg/kg DOX, 50.0 mg/kg DA, and control groups (n = 20). The optimal drug and its concentration for MDSC inhibition were selected according to tumor inhibition. NB antigen-specific cytotoxic T cells (CTLs) were prepared. Tumor-bearing mice were randomly divided into DOX, CTL, anti-ganglioside (GD2), DOX+CTL, DOX+anti-GD2, and control groups. Following low-dose DOX administration, immunotherapy was applied. The levels of human leukocyte antigen (HLA)-I, CD8, interleukin (IL)-2 and interferon (IFN)-γ in peripheral blood, CTLs, T-helper 1 (Thl)/Th2 cytokines, perforin, granzyme and tumor growth were compared among the groups. The Wilcoxon two-sample test and repeated-measures analysis of variance were used to analyze results.@*RESULTS@#The slowest tumor growth (F = 6.095, P = 0.018) and strongest MDSC inhibition (F = 14.632, P = 0.001) were observed in 2.5 mg/kg DOX group. Proliferation of T cells was increased (F = 448.721, P < 0.001) and then decreased (F = 2.047, P = 0.186). After low-dose DOX administration, HLA-I (F = 222.489), CD8 (F = 271.686), Thl/Th2 cytokines, CD4+ and CD8+ lymphocytes, granzyme (F = 2376.475) and perforin (F = 488.531) in tumor, IL-2 (F = 62.951) and IFN-γ (F = 240.709) in peripheral blood of each immunotherapy group were all higher compared with the control group (all of P values < 0.05). The most significant increases in the aforementioned indexes and the most notable tumor growth inhibition were observed in DOX+anti-GD2 and DOX+CTL groups.@*CONCLUSIONS@#Low-dose DOX can be used as a potent immunomodulatory agent that selectively impairs MDSC-induced immunosuppression, thereby fostering immune efficacy in NB.

Animals , Doxorubicin/therapeutic use , Mice , Mice, Inbred C57BL , Myeloid-Derived Suppressor Cells , Neuroblastoma/drug therapy , Tumor Microenvironment
Chinese Medical Journal ; (24): 2796-2802, 2020.
Article in English | WPRIM | ID: wpr-877934


BACKGROUND@#Numerous studies have focused on lymphoma among patients infected with human immunodeficiency virus (HIV). However, little is known about the treatment options and survival rate of lymphoma in the Chinese people living with HIV (PLHIV). Our study aimed to investigate the prognosis and compare outcome of dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (DA-EPOCH-R) with standard cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab(R-CHOP) as front line therapy for PLHIV with diffuse large B-cell lymphoma (DLBCL) receiving modern combined antiretroviral therapy (cART).@*METHODS@#A retrospective analysis evaluating PLHIV with DLBCL was performed in Shanghai Public Health Clinical Center from July 2012 to September 2019. The demographic and clinical data were collected, and overall survival (OS) and progression-free survival (PFS) analyses of patients receiving R-CHOP or DA-EPOCH-R therapy were performed by Kaplan-Meier analysis. Additionally, a Cox multiple regression model was constructed to identify related factors for OS.@*RESULTS@#A total of 54 eligible patients were included in the final analysis with a median follow-up of 14 months (interquartile range [IQR]: 8-29 months). The proportion of high international prognostic index (IPI) patients was much larger in the DA-EPOCH-R group (n = 29) than that in the R-CHOP group (n = 25). The CD4 cell counts and HIV RNA levels were not significantly different between the two groups. The 2-year OS for all patients was 73%. However, OS was not significantly different between the two groups, with a 2-year OS rate of 78% for the DA-EPOCH-R group and 66% for the R-CHOP group. Only an IPI greater than 3 was associated with a decrease in OS, with a hazard ratio of 5.0. The occurrence of grade 3 and 4 adverse events of chemotherapy was not significantly different between the two groups.@*CONCLUSIONS@#Outcomes of R-CHOP therapy do not differ from those of DA-EPOCH-R therapy. No HIV-related factors were found to be associated with the OS of PLHIV in the modern cART era.

Antineoplastic Combined Chemotherapy Protocols/therapeutic use , China , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , HIV , HIV Infections/drug therapy , Humans , Lymphoma, Large B-Cell, Diffuse/drug therapy , Prednisone/therapeutic use , Retrospective Studies , Rituximab/therapeutic use , Vincristine/therapeutic use
Cuad. Hosp. Clín ; 60(2): 39-45, dic. 2019. ilus.
Article in Spanish | LILACS | ID: biblio-1046722


OBJETIVO: determinar la supervivencia de pacientes con cáncer de mama en el Hospital Seguro Social Universitario, de la Gestión 2000 a 2016 MÉTODO: estudio de supervivencia. RESULTADOS: la supervivencia de pacientes con cáncer de mama, tuvieron un promedio global de 8,6 años, (104 meses I.C. 96,728 ­ 111,272) de supervivencia en los casos Hormono positivo (+) que recibieron como tratamiento exemestano. El grupo de mujeres que recibió como tratamiento Adriamicina (Doxorrubicina) y Ciclofosfamida su tiempo de supervivencia en promedio fue de 8,2 años (99,5 meses) con intervalo de confianza de 83,2-115.78. En pacientes con cáncer de mama Herb New (-) tratados con Trastuzumab, después de recibir Adriamicina y Ciclofosfamida fue de 8,6 años (103,28 meses) con un IC 86,54 -120,024. CONCLUSIONES: la supervivencia de pacientes con cáncer de mama, tratados en el Hospital Seguro Social Universitario, de la Gestión 2000 a 2016, fue de 8,6 años, resultado equivalente a los reportados en la literatura.

OBJECTIVE: to determine the survival of patients with breast cancer in the University Social Security Hospital, from term 2000 to 2016 METHOD: mixed cohort study RESULTS: survival of patients with breast cancer, had an average survival time of 104 months (8,6 years), in Hormonal cases (+) who received treatment with Exemestane, after Adriamycin and Cyclophosphamide survival time was 99,5 months (IC 83,2 - 115,78). In contrast, in patients with breast cancer Herb New (-) treated with Trastuzumab, after receiving Adriamycin and Cyclophosphamide was 103,28 months (IC 86,54 -120,024). The median survival time was 104,13 months. The only factor that predicts the survival of patients with breast cancer, in this study was the histological type (p = 0,026), with a relative risk of 17,6. CONCLUSIONS: the survival of patients with breast cancer, treated at the University Social Security Hospital, from the term 2000 to 2016, was 8.6 years, a result equivalent to those reported in the literature.

Humans , Adult , Middle Aged , Aged , Aged, 80 and over , Breast Neoplasms/drug therapy , Doxorubicin/therapeutic use , Oncology Service, Hospital , Statistics
Rev. méd. Chile ; 147(4): 437-443, abr. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1014244


Background: Hodgkin lymphoma has a high rate of curability, even in advanced stages. Aim: To assess the results of Hodgkin lymphoma treatment using the ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy regimen. Material and Methods: Analysis of a database held by the Chilean Ministry of Health, including all patients treated at accredited cancer treatment centers. Results: Data for 915 patients, median age 35 years (range 15-86 years) and followed for a median of 97 months (range 1-347 months) were analyzed. Forty-one percent had localized disease. Overall survival at five years for localized and advanced stages was 92% and 74%, respectively. The figures for progression free survival were 87% and 64%, respectively. Patients with relapse who received autologous stem cell transplantation (ASCT) had a five year overall survival of 92%, compared to 64% among those who did not undergo this procedure (p < 0.01). The Guarantees in Health Program set up by the Ministry of Health, was associated with earlier stage disease at diagnosis. Conclusions: The ABVD regimen achieves high rates of cure in localized stages of the disease but the results in advanced stages are not optimal. ASCT significantly improves survival in patients with relapse. The Guarantees in Health Program is associated with earlier diagnosis of the disease.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Hodgkin Disease/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Time Factors , Vinblastine/therapeutic use , Bleomycin/therapeutic use , Hodgkin Disease/mortality , Hodgkin Disease/pathology , Doxorubicin/therapeutic use , Chile , Treatment Outcome , Hematopoietic Stem Cell Transplantation/methods , Disease-Free Survival , Dacarbazine/therapeutic use , Kaplan-Meier Estimate
Rev. méd. Chile ; 147(2): 247-250, Feb. 2019.
Article in Spanish | LILACS | ID: biblio-1004339


Patients transplanted from solid organs have an increased risk of cancer, especially lymphomas. Lymphomas correspond to 4 to 5% of malignant neoplasms in the general population and in solid organ transplant patients it reaches an incidence of 21%. The incidence of non-Hodgkin lymphomas is 10 times higher than in the non-transplanted population. We report the case of a 68-year-old man with a kidney transplant who 6 years after transplantation, developed a non-Hodgkin diffuse large cells B lymphoma with lymph node and pulmonary involvement, with markers of very poor prognosis (triple MYC expressor, BCL2 and BCL6). and its evolution with chemotherapy with DA R EPOCH.

Humans , Male , Aged , Lymphoma, Non-Hodgkin , Lymphoma, Large B-Cell, Diffuse/genetics , Vincristine/therapeutic use , Lymphoma, Non-Hodgkin/etiology , Lymphoma, Non-Hodgkin/drug therapy , Prednisone/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Doxorubicin/therapeutic use , Biomarkers, Tumor/genetics , Genes, myc/genetics , Lymphoma, Large B-Cell, Diffuse/etiology , Lymphoma, Large B-Cell, Diffuse/drug therapy , Kidney Transplantation/adverse effects , Proto-Oncogene Proteins c-bcl-2/genetics , Cyclophosphamide/therapeutic use , Proto-Oncogene Proteins c-bcl-6/genetics , Etoposide/therapeutic use
Rev. bras. cancerol ; 65(3)19/09/2019.
Article in Portuguese | LILACS | ID: biblio-1047726


Introdução: A cardiotoxicidade é um dos efeitos mais significativos no tratamento oncológico. Entre as implicações mais consideráveis, destaca-se a insuficiência cardíaca com disfunção ventricular sistólica ou diastólica. Relato do caso: Paciente do sexo feminino, 39 anos, com linfoma não Hodgkin difuso de grandes células B, submetida à quimioterapia com rituximabe, ciclofosfamida, doxorrubicina, vincristina e prednisona (R-CHOP), que apresentou cansaço aos pequenos esforços e aumento da pressão arterial. O ecocardiograma demonstrou disfunção ventricular esquerda leve com hipocinesia difusa e redução da fração de ejeção do ventrículo esquerdo (FEVE), associadas à possível cardiomiotoxicidade da doxorrubicina. O caso foi identificado em uma pesquisa de prontuário e analisado segundo o algoritmo de Naranjo e, em seguida, foi determinada a gravidade das reações adversas cardiovasculares. Conclusão: Este estudo ressalta a importância da busca ativa de eventos cardiovasculares em prontuários de pacientes submetidos à quimioterapia cardiotóxica e do papel da farmacovigilância nesse contexto.

Introduction: Cardiotoxicity is one of the most significant effects of oncological treatment. Among the major relevant consequences, heart failure with systolic or diastolic ventricular dysfunction stands out. Case report: 39-year-old female patient with diffuse large B-cell non-Hodgkin's lymphoma who underwent rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP chemotherapy) and presented fatigue while exerting small efforts and increased blood pressure. The echocardiogram showed mild left ventricular dysfunction with diffuse hypokinesia and reduction of left ventricular ejection fraction (LVEF) associated with the possible cardiomyotoxicity of doxorubicin. The case was identified in a chart survey, and analyzed according to the Naranjo Algorithm, and then the severity of the adverse cardiovascular reactions was determined. Conclusion: This study highlights the importance of the active search for cardiovascular events in medical charts of patients undergoing cardiotoxic chemotherapy and the role of pharmacovigilance in this context.

Introducción: La cardiotoxicidad es uno de los efectos más significativos del tratamiento oncológico. Entre los efectos más considerables, destaca la insuficiencia cardíaca con disfunción ventricular sistólica o diastólica. Relato del caso: Paciente de 39 años con linfoma no Hodgkin difuso de células grandes B que se sometieron a quimioterapia con rituximab, ciclofosfamida, doxorubicina, vincristina y prednisona (R-CHOP). Pequeños esfuerzos y aumento de la presión arterial. El ecocardiograma mostró una disfunción ventricular izquierda leve con hipocinesia difusa y reducción de la fracción de eyección del ventrículo izquierdo (FEVI) asociada con la posible cardiomioxicidad de la doxorrubicina. El caso se identificó en una encuesta gráfica y se analizó de acuerdo con el algoritmo de Naranjo, y luego se determinó la gravedad de las reacciones cardiovasculares adversas. Conclusión: Este estudio destaca la importancia de la búsqueda activa de eventos cardiovasculares en los registros médicos de pacientes sometidos a quimioterapia cardiotóxica y el papel de la farmacovigilancia en este contexto.

Humans , Female , Adult , Cardiotoxicity/complications , Case Reports , Doxorubicin/therapeutic use , Medical Records , Pharmacovigilance
Arq. bras. cardiol ; 111(5): 721-728, Nov. 2018. tab, graf
Article in English | LILACS | ID: biblio-973792


Abstract Background: Chemotherapy with doxorubicin and cyclophosphamide, although efficient for treating breast cancer, is associated with cardiovascular complications. Recent studies seek to identify methods that can early detect cardiological and vascular changes as a strategy to decrease the incidence of cardiovascular comorbidities. Objective: To evaluate the role of arterial stiffness measurement in the monitoring of doxorubicin and cyclophosphamide-induced cardiotoxicity in breast cancer patients. Methods: Prospective longitudinal study in 24 breast cancer patients undergoing treatment with doxorubicin and cyclophosphamide. Patients underwent an indirect evaluation of arterial stiffness through non-invasive measurement of hemodynamic parameters such as pulse wave velocity with the Mobil-O-Graph® 24H PWA device at three different times of the chemotherapy treatment (pre-chemotherapy, after the first and the fourth cycle). The left ventricular ejection fraction was also evaluated by Doppler echocardiography (pre-chemotherapy and after the fourth chemotherapy cycle). Data were considered significant when p ≤ 0.05. Results: Patients had a mean age of 52.33 ± 8.85 years and body mass index of 31 ± 5.87 kg/m2. There was no significant difference between the hemodynamic parameters evaluated by the oscillometric method or in the left ventricular ejection fraction in the different evaluated periods. Conclusion: Evaluations of arterial stiffness by oscillometry and measurement of left ventricular ejection fraction by Doppler echocardiography showed equivalence in the values found, suggesting that the evaluation method of arterial stiffness studied could be used as a marker for cardiovascular adverse events associated with doxorrubicin-based chemotherapy drugs.

Resumo Fundamento: O tratamento quimioterápico com doxorrubicina e ciclofosfamida, apesar de eficiente no combate ao câncer de mama, está associado a complicações cardiovasculares. Trabalhos recentes identificam métodos que possam detectar alterações cardiológicas e vasculares precocemente, visando a uma estratégia para diminuição na incidência de comorbidades cardiovasculares. Objetivo: Avaliar o papel da medida da rigidez arterial no acompanhamento da ocorrência de eventos adversos cardiovasculares induzidos por doxorrubicina e ciclofosfamida em pacientes com câncer de mama. Métodos: Estudo longitudinal prospectivo realizado com 24 pacientes com câncer de mama em tratamento com doxorrubicina e ciclofosfamida. As pacientes foram submetidas à avaliação indireta da rigidez arterial, por mensuração não invasiva de parâmetros hemodinâmicos, como a velocidade de onda de pulso, pelo equipamento Mobil-O-Graph® 24H PWA em três diferentes momentos do tratamento quimioterápico (pré-quimioterapia, após o primeiro e após o quarto ciclos). Foi avaliada também a fração de ejeção do ventrículo esquerdo pelo ecoDopplercardiograma (pré-quimioterapia e após o quarto ciclo quimioterápico). Os valores de p ≤ 0,05 foram considerados significativos. Resultados: As pacientes apresentaram média de idade de 52,33 ± 8,85 anos e índice de massa corporal de 31 ± 5,87 kg/m2. Não houve diferença significativa entre os parâmetros hemodinâmicos avaliados pelo método oscilométrico ou na fração de ejeção do ventrículo esquerdo, nos diferentes períodos avaliados. Conclusão: As avaliações de rigidez arterial por oscilometria e medida da fração de ejeção do ventrículo esquerdo por ecoDopplercardiograma mostraram equivalência nos valores encontrados, sugerindo que o método de avaliação da rigidez arterial estudado possa ser utilizado como mais um marcador para eventos adversos cardiovasculares associados aos medicamentos quimioterápicos baseados em doxorrubicina.

Humans , Female , Adult , Middle Aged , Cardiovascular Diseases/chemically induced , Doxorubicin/adverse effects , Anthracyclines/adverse effects , Cyclophosphamide/adverse effects , Vascular Stiffness , Antineoplastic Agents/adverse effects , Breast Neoplasms/drug therapy , Cardiovascular Diseases/prevention & control , Echocardiography, Doppler , Doxorubicin/therapeutic use , Doxorubicin/pharmacology , Pilot Projects , Longitudinal Studies , Ventricular Function, Left/drug effects , Anthracyclines/therapeutic use , Anthracyclines/pharmacology , Cyclophosphamide/therapeutic use , Cyclophosphamide/pharmacology , Cardiotoxicity/physiopathology , Antineoplastic Agents/therapeutic use , Antineoplastic Agents/pharmacology
Arq. bras. med. vet. zootec. (Online) ; 69(6): 1508-1512, nov.-dez. 2017. graf
Article in English | LILACS, VETINDEX | ID: biblio-910434


Feline Injection Site-Associated Sarcoma (FISS) is a neoplasm that implies in reduction of quality of life and overall survival in feline patients. A retrospective study of 13 cases of FISS was conducted to evaluate the efficacy of surgical treatment associated to chemotherapy with doxorubicin or carboplatin. Local recurrence occurred in all patients. Patients treated with surgery and chemotherapy presented a longer overall survival and disease-free interval when compared to those that solely received surgical treatment, although no statistical significance was observed (p= 0.3360 and 0.7506, respectively). Surgery remains as the main option for FISS treatment. Further prospective studies with larger samples are warranted to investigate the benefit of chemotherapy for this neoplasm.(AU)

O Sarcoma de Aplicação Felino (SAF) é uma neoplasia associada a redução na qualidade de vida e sobrevida global. O objetivo deste estudo foi avaliar a eficácia da quimioterapia associada à cirurgia no manejo do SAF. Estudo retrospectivo de 13 pacientes com SAF submetidos à cirurgia isolada ou associada a quimioterapia com carboplatina ou doxorrubicina. Recorrência local ocorreu em todos os pacientes. Pacientes tratados com cirurgia e quimioterapia apresentaram maior sobrevida global e intervalo livre de doença quando comparados àqueles que receberam apenas tratamento cirúrgico, mas não foi observada diferença estatística (p=0,3360 e 0,7506, respectivamente). A cirurgia continua sendo a principal opção para o tratamento do SAF. Estudos prospectivos são necessários para investigação do real benefício da quimioterapia para esta neoplasia.(AU)

Animals , Cats , Carboplatin/therapeutic use , Chemotherapy, Adjuvant/veterinary , Doxorubicin/therapeutic use , Sarcoma/surgery , Sarcoma/therapy , Neoplasms, Connective and Soft Tissue/veterinary
Medicina (B.Aires) ; 77(3): 239-241, jun. 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-894466


Se describe el caso de una mujer de 70 años que consultó por dolor abdominal asociado a pérdida de peso y sudoración nocturna. En el examen físico se destacaban una masa abdominal comprendida entre el epigastrio y el flanco izquierdo, de unos 5 cm de diámetro, duro-elástica, móvil e indolora, y al menos tres adenopatías supraclaviculares bilaterales de 2 cm de diámetro, duras y adheridas a planos profundos. Se realizó una biopsia de la masa abdominal, con lo que se diagnosticó un sarcoma de células dendríticas interdigitantes. Se inició quimioterapia con el esquema CHOP (ciclofosfamida, doxorrubicina, vincristina y prednisona). Falleció luego de completado el primer ciclo del tratamiento, a los seis meses del diagnóstico.

A 70 year-old woman was admitted to our hospital with a 3-month history of abdominal pain, weight loss and night sweats. On physical examination, she presented with a 5 cm diameter abdominal mass extended from epigastrium to the left flank, and at least three bilateral supraclavicular adenopathies. A disseminated interdigitating dendritic cell sarcoma was diagnosed through a biopsy of the abdominal mass. After that, a CHOP regime (cyclophosphamide, doxorubicin, vincristine and prednisone) was iniciated. She died after completion of the first cycle of treatment, six months after diagnosis.

Humans , Female , Aged , Sarcoma/pathology , Dendritic Cell Sarcoma, Interdigitating/pathology , Lymph Nodes/pathology , Vincristine/therapeutic use , Biopsy , Dendritic Cells , Prednisone/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Doxorubicin/therapeutic use , Fatal Outcome , Cyclophosphamide/therapeutic use , Dendritic Cell Sarcoma, Interdigitating/drug therapy
Colomb. med ; 48(1): 35-38, Jan.-March 2017. graf
Article in English | LILACS | ID: biblio-890851


Abstract Background: Adult T-cell Leukemia/Lymphoma (ATLL) is classified as a peripheral CD4+ T-cell neoplasm caused by the human T-cell lymphotropic virus type 1 (HTLV-1). Typical symptoms are associated with leukemic infiltration; however, atypical and exaggerated manifestations of verrucous carcinoma have also been described. Case report: We present here the case of a patient with multiple skin lesions, ischemic necrosis in the hallux and lymphadenopathies. Biopsies were taken, which showed verrucous epidermal carcinoma and cutaneous lymphoma. Splenomegaly and adenopathy in mesentery, retro peritoneum and lymph node chains in the limbs were observed. Bone marrow examination showed findings compatible with T-cell leukemia/lymphoma; and it was ELISA positive for HTLV-1/2. Treatment and outcome: The patient had a good initial response to a CHOP scheme (cyclophosphamide, doxorubicin, vincristine and prednisone) with filgrastim. However, the patient had a relapse and died before the second cycle. Clinical relevance: Comorbidity could lead to the associated risk factors model. According to this model, secondary immunodeficiency caused by HTLV-1 may induce the development of verrucous carcinomas; alternatively, the disease could be due to a correlation between HTLV-1 and the human papillomavirus (HPV).

Resumen Antecedentes: La leucemia/linfoma de células T del adulto se clasifica como una neoplasia de células T CD4+ periféricas desencadenada por el virus linfotrópico de células T humanas tipo 1 (HTLV-1). Los síntomas típicos se asocian a la infiltración leucémica; sin embargo, también se ha descrito la manifestación atípica y exagerada de carcinomas verrugosos. Caso clínico: Se presenta el caso de una paciente con lesiones múltiples en piel, necrosis isquemica del hallux y linfadenopatías. se realizaron biopsias que reportaron carcinoma epidermoide verrugoso y linfoma cutáneo. Se detectó esplenomegalia y adenopatías en mesenterio, región retroperitoneal, y cadenas ganglionares de las extremidades. la medula ósea presentó hallazgos compatibles con leucemia/linfoma de células T y ELISA positivo para HTLV-1/2. Tratamiento y resultado: La paciente presentó buena respuesta inicial al esquema CHOP (ciclofosfamida, doxorrubicina, vincristina, prednisona) con filgrastim. Sin embargo, presentó recaída de la enfermedad antes del segundo ciclo y falleció Relevancia clinica: La comorbilidad podría conducir al modelo de factores de riesgo asociados. De acuerdo con este modelo, la inmunodeficiencia secundaria causada por HTLV-1 puede inducir el desarrollo de carcinomas verrugosos; Alternativamente, la enfermedad podría deberse a una correlación entre el HTLV-1 y el virus del papiloma humano (VPH).

Female , Humans , Middle Aged , Human T-lymphotropic virus 1/isolation & purification , Leukemia-Lymphoma, Adult T-Cell/diagnosis , Carcinoma, Verrucous/diagnosis , Vincristine/therapeutic use , Enzyme-Linked Immunosorbent Assay , Prednisone/therapeutic use , Leukemia-Lymphoma, Adult T-Cell/drug therapy , Leukemia-Lymphoma, Adult T-Cell/virology , CD4-Positive T-Lymphocytes , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Doxorubicin/therapeutic use , Risk Factors , Fatal Outcome , Carcinoma, Verrucous/etiology , Cyclophosphamide/therapeutic use
Int. braz. j. urol ; 42(5): 942-954, Sept.-Oct. 2016. tab, graf
Article in English | LILACS | ID: lil-796874


ABSTRACT The present study describes the histopathological and molecular effects of P-MAPA (Protein aggregate magnesium-ammonium phospholinoleate-palmitoleate anhydride) intravesical immunotherapy combined with systemic doxorubicin or cisplatin for treatment of non-muscle invasive bladder cancer (NMIBC) in an appropriate animal model. Our results showed an undifferentiated tumor, characterizing a tumor invading mucosa or submucosa of the bladder wall (pT1) and papillary carcinoma in situ (pTa) in the Cancer group. The histopathological changes were similar between the combined treatment with intravesical P-MAPA plus systemic Cisplatin and P-MAPA immunotherapy alone, showing decrease of urothelial neoplastic lesions progression and histopathological recovery in 80% of the animals. The animals treated systemically with cisplatin or doxorubicin singly, showed 100% of malignant lesions in the urinary bladder. Furthemore, the combined treatment with P-MAPA and Doxorubicin showed no decrease of urothelial neoplastic lesions progression and histopathological recovery. Furthermore, Akt, PI3K, NF-kB and VEGF protein levels were significantly lower in intravesical P-MAPA plus systemic cisplatin and in intravesical P-MAPA alone treatments than other groups. In contrast, PTEN protein levels were significantly higher in intravesical P-MAPA plus systemic cisplatin and in intravesical P-MAPA alone treatments. Thus, it could be concluded that combination of intravesical P-MAPA immunotherapy and systemic cisplatin in the NMIBC animal model was effective, well tolerated and showed no apparent signs of antagonism between the drugs. In addition, intravesical P-MAPA immunotherapy may be considered as a valuable option for treatment of BCG unresponsive patients that unmet the criteria for early cystectomy.

Animals , Female , Urinary Bladder Neoplasms/therapy , Carcinoma/therapy , Doxorubicin/therapeutic use , Cisplatin/therapeutic use , Immunotherapy/methods , Membrane Proteins/therapeutic use , Antineoplastic Agents/therapeutic use , Rats, Inbred F344 , Urinary Bladder Neoplasms/pathology , Administration, Intravesical , BCG Vaccine , Carcinoma/pathology , Blotting, Western , Reproducibility of Results , NF-kappa B/analysis , Treatment Outcome , Combined Modality Therapy , Disease Progression , Phosphatidylinositol 3-Kinases/analysis , Models, Animal , Vascular Endothelial Growth Factor A/analysis , PTEN Phosphohydrolase/analysis , Proto-Oncogene Proteins c-akt/analysis
An. bras. dermatol ; 91(2): 219-221, Mar.-Apr. 2016. graf
Article in English | LILACS | ID: lil-781354


Abstract Nasal type extranodal NK/T-cell lymphoma is a distinct entity according to the World Health Organization classification. Although 60% to 90% of patients with this disease present with a destructive mass in the midline facial tissues, it may also primarily or secondarily involve extranasal sites, like the skin. We report the case of a 77-year-old patient that came to our department with erythematous plaques of the right leg and eczematous lesions of the trunk. These lesions were biopsied and the patient was diagnosed with extranodal NK/T-cell lymphoma, nasal type. He was treated with multi-agent systemic chemotherapy but died 5 months after diagnosis. This case highlights the rarity and variability of cutaneous features of this disease and its aggressive course and poor prognosis.

Humans , Male , Aged , Skin Neoplasms/pathology , Nose Neoplasms/pathology , Lymphoma, Extranodal NK-T-Cell/pathology , Neoplasms, Multiple Primary/pathology , Skin/pathology , Skin Neoplasms/drug therapy , Vincristine/therapeutic use , Biopsy , Prednisone/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Doxorubicin/therapeutic use , Nose Neoplasms/drug therapy , Fatal Outcome , Cyclophosphamide/therapeutic use , Lymphoma, Extranodal NK-T-Cell/drug therapy , Neoplasms, Multiple Primary/drug therapy
Einstein (Säo Paulo) ; 14(1): 99-103, Jan.-Mar. 2016. tab, graf
Article in English | LILACS | ID: lil-778486


ABSTRACT The use of nanocarriers as drug delivery systems for therapeutic or imaging agents can improve the pharmacological properties of commonly used compounds in cancer diagnosis and treatment. Advances in the surface engineering of nanoparticles to accommodate targeting ligands turned nanocarriers attractive candidates for future work involving targeted drug delivery. Although not targeted, several nanocarriers have been approved for clinical use and they are currently used to treat and/or diagnosis various types of cancers. Furthermore, there are several formulations, which are now in various stages of clinical trials. This review examined some approved formulations and discussed the advantages of using nanocarriers in cancer therapy.

RESUMO A utilização de nanocarreadores como sistemas de entrega de drogas para agentes terapêuticos ou de imagem pode aumentar as propriedades farmacológicas dos compostos normalmente utilizados no tratamento e diagnóstico de câncer. Avanços em engenharia de superfície de nanopartículas para a acomodação de ligantes alvo têm feito dos nanocarreadores candidatos atrativos para um futuro trabalho envolvendo entrega de droga direcionada. Embora não direcionados, muitos nanocarreadores terapêuticos foram aprovados para uso clínico no tratamento e/ou diagnóstico de vários tipos de câncer. Além disso, há várias outras formulações que se encontram agora em estágio de testes clínicos. Este artigo de revisão examinou algumas formulações aprovadas e discutiu as vantagens da utilização de nanocarreadores na terapia de câncer.

Humans , Drug Carriers/therapeutic use , Nanoparticles/therapeutic use , Neoplasms/diagnosis , Neoplasms/drug therapy , Antineoplastic Agents/therapeutic use , Polyethylene Glycols/therapeutic use , Doxorubicin/analogs & derivatives , Doxorubicin/therapeutic use