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1.
Rev. bras. ginecol. obstet ; 43(4): 323-328, Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1280047

ABSTRACT

Abstract Complete hydatidiform mole (CHM) is a rare type of pregnancy, in which 15 to 20% of the cases may develop into gestational trophoblastic neoplasia (GTN). The diagnostic of GTN must be done as early as possible through weekly surveillance of serum hCG after uterine evacuation.We report the case of 23-year-old primigravida, with CHM but without surveillance of hCG after uterine evacuation. Two months later, the patient presented to the emergency with vaginal bleeding and was referred to the Centro de Doenças Trofoblásticas do Hospital São Paulo. She was diagnosed with high risk GTN stage/score III:7 as per The International Federation of Gynecology and Obstetrics/World Health Organization (FIGO/WHO). The sonographic examination revealed enlarged uterus with a heterogeneous mass constituted of multiple large vessels invading and causing disarrangement of the myometrium. The patient evolved with progressive worsening of vaginal bleeding after chemotherapy with etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristine (EMA-CO) regimen. She underwent blood transfusion and embolization of uterine arteries due to severe vaginal hemorrhage episodes, with complete control of bleeding. The hCG reached a negative value after the third cycle, and there was a complete regression of the anomalous vascularization of the uterus as well as full recovery of the uterine anatomy. The treatment in a reference center was essential for the appropriate management, especially regarding the uterine arteries embolization trough percutaneous femoral


Resumo Mola hidatiforme completa (MHC) é um tipo raro de gravidez, na qual 15 a 20% dos casos podem desenvolver neoplasia trofoblástica gestacional (NTG). O diagnóstico de NTG deve ser feito o mais cedo possível, pelo monitoramento semanal do hCG sérico após esvaziamento uterino. Relatamos o caso de uma paciente primigesta, de 23 anos de idade, com MHC, sem vigilância de hCG após esvaziamento uterino. Dois meses depois, a paciente compareceu na emergência com sangramento vaginal, sendo encaminhada ao Centro de Doenças Trofoblásticas do Hospital São Paulo, onde foi diagnosticada com NTG de alto risco, estádio e score de risco III:7 de acordo com a The International Federation of Gynecology and Obstetrics/Organização Mundial de Saúde (FIGO/OMS). O exame ultrassonográfico revelou útero aumentado com uma massa heterogênea constituída pormúltiplos vasos volumosos invadindo e desestruturando o miométrio. A paciente evoluiu com piora progressiva do sangramento vaginal após quimioterapia com o regime etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristine (EMA-CO). Ela foi submetida a transfusão de sangue e embolização das artérias uterinas devido aos episódios graves de hemorragia vaginal, com completo controle do sangramento. O hCG atingiu valor negativo após o terceiro ciclo, havendo regressão completa da vascularização uterina anômala, assim como recuperação da anatomia uterina. O tratamento em um centro de referência permitiu o manejo adequado, principalmente no que se refere à embolização das artérias uterinas através da punção percutânea da artéria femoral, que foi crucial para evitar a histerectomia, permitindo a cura da NTG e a manutenção da vida reprodutiva.


Subject(s)
Humans , Female , Pregnancy , Young Adult , Arteriovenous Malformations/complications , Uterine Hemorrhage/therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Gestational Trophoblastic Disease/complications , Gestational Trophoblastic Disease/drug therapy , Embolization, Therapeutic , Uterine Hemorrhage/etiology , Uterine Hemorrhage/diagnostic imaging , Vincristine/therapeutic use , Methotrexate/therapeutic use , Ultrasonography, Prenatal , Pregnancy, High-Risk , Cyclophosphamide/therapeutic use , Dactinomycin/therapeutic use , Gestational Trophoblastic Disease/diagnostic imaging , Etoposide/therapeutic use , Uterine Artery
2.
Chinese Journal of Lung Cancer ; (12): 808-814, 2021.
Article in Chinese | WPRIM | ID: wpr-922151

ABSTRACT

Small cell lung cancer (SCLC) is the most malignant lung cancer with the highest mortality. At present, the first-line standard treatment is still based on Etoposide and Platinum chemotherapy. However, for SCLC that progresses after first-line therapy, the treatment options are still very limited. Since the molecular mechanism of first-line drug resistance of SCLC is still unclear, and the precision medicine strategy after first-line drug resistance is still in the pre-clinical stage. The proportion of secondary biopsy and genetic testing is very low after the progress of first-line treatment of SCLC. In this study, we report a case of a middle-aged woman who was first diagnosed with SCLC. Adenocarcinoma with sensitive gene mutations and repeated changes of small cell carcinoma were detected by multiple biopsies during the course of the disease, suggesting that the patient may be a special subtype of SCLC - mixed SCLC (M-SCLC). In this case, the patient has been treated with radiotherapy and chemotherapy, immunotherapy and targeted therapy successively, and the survival time has reached 2 years and 8 months. Through the case report and literature review retrospectively, this study aimed to explore the part patients may start to present hybrid histopathologic types or tissue type change after treatment of SCLC. Biopsy pathologic histology and genetic testing is necessary after disease progression to look for potential therapeutic targets, so as to give precise treatment based on molecular markers detection results and provide the patient with the benefit of survival for as long as possible.
.


Subject(s)
Adenocarcinoma of Lung , Etoposide , Female , Humans , Lung Neoplasms/genetics , Middle Aged , Retrospective Studies , Small Cell Lung Carcinoma/genetics
3.
Article in Chinese | WPRIM | ID: wpr-880087

ABSTRACT

OBJECTIVE@#To investigate the effect of etoposide (ETO) on elimination of chronic myeloid leukemia (CML) stem cells by imatinib mesylate(IM) in vivo.@*METHODS@#SCL-tTA/BCR-ABL mice were used as CML animal model. Flow cytometry was used to assess the effect of ETO alone or in combination with IM on the number of leukemia stem cell (LSC) in bone marrow and spleen, and peripheral blood neutrophils in CML mice and normal control FVB mice.@*RESULTS@#The results showed that in CML mice, the number and proportion of LSC in bone marrow and the proportion of neutrophils in peripheral blood decreased significantly after ETO and IM combined treatment, and the degree of decrease was more significant than that of both alone. While in wild type FVB mice, the combination of ETO and IM showed no significant effect on the number and proportion of LSK cells in bone marrow and the proportion of neutrophils in spleen.@*CONCLUSION@#ETO can selectively enhance elimination of CML LSC by IM in vivo.


Subject(s)
Animals , Drug Resistance, Neoplasm , Etoposide , Fusion Proteins, bcr-abl , Imatinib Mesylate , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Mice , Stem Cells
4.
Article in Chinese | WPRIM | ID: wpr-880063

ABSTRACT

OBJECTIVE@#To present one patient initially diagnosed with dermatomyositis(DM) who was eventually revealed to be diffuse large B-cell lymphoma(DLBCL) complicated with hemophagocytic syndrome(HPS), and to improve the understanding of the disease.@*METHODS@#The clinical characteristics, diagnostic approach, treatment of the patient were retrospectively analyzed, and some related literatures were reviewed.@*RESULTS@#A 52-year-old female patient suffered from muscle weakness, elevated serum creatine kinase activity, electromyography changes and characteristic skin rashes and diagnosed as DM. The patient was treated with glucocorticoid therapy and the muscle strength, skin rashes, and creatine kinas index turns into remission. Subsequently, subcutaneous nodules appeared during treatment, and the patient was confirmed as DLBCL based on pathological biopsy; And the patient was considered HPS because of presenting with repeated fever, splenomegaly, cytopenias, hypofibrinogenemia, hypertriglyceridemia, hyperferritinemia, high levels of sCD25, low NK-cell activity and hemophagocytosis in bone marrow. But the patient refused chemotherapy, and only treated with "DXM+VP-16" to control hemophagocytic syndrome, and unfortunately died due to the disease progression.@*CONCLUSION@#Cutaneous involvement in diffuse large B-cell lymphoma and hemophagocytic syndrome patients with first presentation of dermatomyositis is relatively rare. Malignacy screening should be performed as soon as possible after newly diagnosed DM, so that the patient can get early diagnosis and effective treatment to improve survival rate.


Subject(s)
Dermatomyositis/complications , Etoposide , Female , Humans , Lymphohistiocytosis, Hemophagocytic/diagnosis , Lymphoma, Large B-Cell, Diffuse/complications , Middle Aged , Retrospective Studies
5.
Brasília; s.n; 4 ago. 2020.
Non-conventional in Portuguese | PIE, LILACS, BRISA, PIE | ID: biblio-1117744

ABSTRACT

O Informe Diário de Evidências é uma produção do Ministério da Saúde que tem como objetivo acompanhar diariamente as publicações científicas sobre tratamento farmacológico e vacinas para a COVID-19. Dessa forma, são realizadas buscas estruturadas em bases de dados biomédicas, referentes ao dia anterior desse informe. Não são incluídos estudos pré-clínicos (in vitro, in vivo, in silico). A frequência dos estudos é demonstrada de acordo com a sua classificação metodológica (revisões sistemáticas, ensaios clínicos randomizados, coortes, entre outros). Para cada estudo é apresentado um resumo com avaliação da qualidade metodológica. Essa avaliação tem por finalidade identificar o grau de certeza/confiança ou o risco de viés de cada estudo. Para tal, são utilizadas ferramentas já validadas e consagradas na literatura científica, na área de saúde baseada em evidências. Cabe ressaltar que o documento tem caráter informativo e não representa uma recomendação oficial do Ministério da Saúde sobre a temática. Foram encontrados 16 artigos e 13 protocolos.


Subject(s)
Humans , Coronavirus Infections/drug therapy , Betacoronavirus/drug effects , Pneumonia, Viral/drug therapy , Technology Assessment, Biomedical , Tetracyclines/therapeutic use , Vitamin D/therapeutic use , Chloroquine/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Azithromycin/therapeutic use , Antirheumatic Agents/therapeutic use , Ritonavir/therapeutic use , Etoposide/therapeutic use , Lopinavir/therapeutic use , Hydroxychloroquine/therapeutic use
6.
Rev. colomb. cancerol ; 24(2): 88-91, abr.-jun. 2020. graf
Article in Spanish | LILACS | ID: biblio-1144325

ABSTRACT

Resumen El carcinoma de célula pequeña (CPCP) o microcítico de pulmón es un subtipo de cáncer de pulmón que típicamente se ha asociado al tabaquismo y que se caracteriza por su agresividad y mal pronóstico a corto plazo. Como entidad, puede metastatizar en cualquier órgano, siendo las metástasis pancreáticas raras y la mayoría de las veces asintomáticas. Por ello, la presencia de una pancreatitis neoplásica, como en el caso presentado, es excepcional, y aún más cuando presenta refractariedad al tratamiento médico convencional y responde al tratamiento citotóxico sistémico. Por todo ello, se expone esta experiencia clínica y se debate la presencia de esta rara entidad y su manejo.


Abstract Small-cell lung carcinoma is a subtype of neoplasm that has been typically associated with smoking; it is characterized by its aggressiveness and poor prognosis in the short term. As an entity, it can metastasize in any organ, but pancreatic metastases are rare and most of the time asymptomatic. Therefore, the presence of neoplastic pancreatitis as in our case is exceptional; even more when it presents refractoriness to conventional medical treatment, responding instead to systemic cytotoxic treatment. Therefore, we expose our clinical experience and discuss the presence of this rare entity and its management.


Subject(s)
Humans , Male , Middle Aged , Pancreatic Neoplasms/secondary , Pancreatitis/etiology , Small Cell Lung Carcinoma/pathology , Lung Neoplasms/pathology , Pancreatic Neoplasms/drug therapy , Pancreatic Neoplasms/diagnostic imaging , Tobacco Use Disorder/complications , Acute Disease , Cisplatin/therapeutic use , Etoposide/therapeutic use , Small Cell Lung Carcinoma/drug therapy , Small Cell Lung Carcinoma/diagnostic imaging , Lung Neoplasms/drug therapy , Lung Neoplasms/diagnostic imaging , Antineoplastic Agents/therapeutic use
7.
Article in English | WPRIM | ID: wpr-876594

ABSTRACT

@#Background: Recent studies have shown poorer outcomes for patients with prognostic score above 12. Authors have proposed categorizing these patients as ultra high-risk to emphasize the need for a different treatment regimen. Objectives: This study was conducted to compare the clinical response of high-risk and ultra high-risk Gestational Trophoblastic Neoplasia (GTN) patients who were managed at the Philippine General Hospital, from January 1, 2010 to December 31, 2015, after receiving the EMACO regimen as first line treatment. Methods: All patients diagnosed with metastatic high-risk GTN who were managed at the Philippine General Hospital from January 1, 2010 to December 31, 2015 and given the EMACO regimen as first-line treatment were included in the study. Patients were divided into high-risk disease or patients with a WHO prognostic score of 7-11 and ultra high-risk disease or patients with WHO prognostic score of 12 and above. Using the Z-test on two proportion, treatment outcome between the two groups were compared. Results: A total of 57 patients diagnosed with metastatic high-risk GTN were included in the study. Of these, 35 or 61% were classified as high-risk while 22 or 39% were ultra high-risk. The primary remission rate of the high-risk group was 89% compared to 77% for the ultra high-risk group. The difference was not statistically significant (p=0.2542). Out of the 57 patients included in the study, 48 patients achieved remission after being treated with EMACO. An additional 4 patients achieved remission after being shifted to EPEMA due to resistance to the first line agent. All patients were alive after one year of follow-up, giving a one-year survival rate of 91.2%. Conclusion: The result of this study showed a relatively higher remission rate for high-risk (89%) than ultra highrisk GTN (77%) with EMACO as first line chemotherapy regimen, but statistical analysis revealed no significant difference. This finding suggests that EMACO may still be used as first line regimen for ultra high-risk GTN to attain remission.


Subject(s)
Gestational Trophoblastic Disease , Etoposide , Dactinomycin , Antineoplastic Combined Chemotherapy Protocols , Cyclophosphamide , Methotrexate , Vincristine
8.
Journal of Experimental Hematology ; (6): 1912-1918, 2020.
Article in Chinese | WPRIM | ID: wpr-879992

ABSTRACT

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


Subject(s)
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
9.
Article in Chinese | WPRIM | ID: wpr-828672

ABSTRACT

OBJECTIVE@#To study the clinical features of children with adenovirus pneumonia and hemophagocytic lymphohistiocytosis (HLH).@*METHODS@#A retrospective analysis was performed on the mediacal data of 7 children with adenovirus pneumonia and HLH from March to September, 2019.@*RESULTS@#The age of these children ranged from 11 months to 5 years, and among these children, 5 were aged <2 years and 5 were boys. None of these children had underlying diseases. All children were hospitalized due to persistent high fever and cough, and the peak temperature of fever was 39°C to 41°C. With disease progression, 7 children developed hepatomegaly and 6 developed splenomegaly. Routine blood test results showed reductions in two or three lineages of blood cells, with increases in serum ferritin (SF), C-reactive protein (CRP), procalcitonin (PCT), and lactate dehydrogenase (LDH). Phagocytosis of blood cells was observed in 6 children. Radiological examination of lungs showed pneumonia changes. All 7 children were diagnosed with human adenovirus type 7 infection based on pathogenic metagenome detection. No abnormality was found by HLH gene detection and the children were diagnosed with secondary HLH. All children received intravenous immunoglobulin. Among these children, 4 received dexamethasone and etoposide chemotherapy, 3 received dexamethasone alone, and 4 received plasma exchange. Of the 7 children, 2 died and 5 were recovered. Compared with those who survived, the children who died had significantly greater reductions in the three lineages of blood cells and significantly greater increases in serum levels of CRP, PCT, SF, and LDH.@*CONCLUSIONS@#The children with adenovirus pneumonia and HLH have main clinical features of persistent high fever, progressive reductions in two or three lineages of peripheral blood cells, and involvement of other organ systems, including hepatosplenomegaly. Significant increases in serum levels of CRP, PCT, SF, and LDH may suggest a poor prognosis.


Subject(s)
Adenoviridae , Child, Preschool , Etoposide , Female , Humans , Immunoglobulins, Intravenous , Infant , Lymphohistiocytosis, Hemophagocytic , Male , Retrospective Studies
10.
Rev. méd. Chile ; 147(2): 247-250, Feb. 2019.
Article in Spanish | LILACS | ID: biblio-1004339

ABSTRACT

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.


Subject(s)
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
11.
Int. braz. j. urol ; 45(1): 74-82, Jan.-Feb. 2019. tab, graf
Article in English | LILACS | ID: biblio-989965

ABSTRACT

ABSTRACT Purpose: The current first - line treatment for non - seminomatous germ cell tumor (NSGCT) consists of four cycles of cisplatin, etoposide, and bleomycin (BEP), which results in 5 - year overall survival < 60% in patients with poor - risk features. Autologous hematopoietic stem cell transplantation (auto - HSCT) as a method for overcoming high toxicity after high dose chemotherapy (HDC) has been explored in different solid tumors, but has remained standard practice only for NSGCT. Our objective was to describe outcomes of patients with poor - risk NSGCT who underwent first - line autologous HSCT in a tertiary center in Mexico. Patients and Methods: Twenty nine consecutive patients with NSGCT who received first - line, non - cryopreserved autologous HSCT at the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City, Mexico, from November 1998 to June 2016, were retrospectively analyzed. Results: The median age at transplantation was 23 (15 - 39) years. Most patients (n = 18, 62%) had testicular primary tumor, and 23 had metastases (79%). Complete response after auto - HSCT was observed in 45%. Non - relapse mortality was 0. Five - year relapse / progression free and overall survival were 67% and 69%, respectively. Conclusions: This small single limited - resource institution study demonstrated that patients with poor - risk NSGCT are curable by first - line HDC plus autologous HSCT and that this procedure is feasible and affordable to perform using non - cryopreserved hematopoietic stem cells.


Subject(s)
Testicular Neoplasms/therapy , Bleomycin/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Cisplatin/administration & dosage , Neoplasms, Germ Cell and Embryonal/therapy , Hematopoietic Stem Cell Transplantation/methods , Etoposide/administration & dosage , Retrospective Studies , Treatment Outcome , Combined Modality Therapy , Kaplan-Meier Estimate
12.
Clinical Endoscopy ; : 76-79, 2019.
Article in English | WPRIM | ID: wpr-739696

ABSTRACT

Primary gastric small cell carcinoma (GSCC) is one of the gastroenteropancreatic neuroendocrine tumors. It is a rare cancer with a very aggressive behavior and a poor prognosis because of the high rate of metastases. It is usually found in far advanced stage. We experienced a case of GSCC which had developed into a large subepithelial tumor (SET) from invisible state in a short period. A 65-year-old man consulted our hospital because of early gastric cancer. He underwent endoscopic submucosal dissection for the early gastric cancer at high body posterior wall. After 6 months, the follow-up endoscopy showed a large newly developed SET-like lesion with central ulceration at the gastric cardia. Endoscopic biopsy revealed GSCC. Total gastrectomy was performed. One out of the 26 perigastric lymph nodes had a metastasis. He received 6 cycles of adjuvant chemotherapy with etoposide and cisplatin. He is still in good health 12 months after operation.


Subject(s)
Aged , Biopsy , Carcinoma, Small Cell , Cardia , Chemotherapy, Adjuvant , Cisplatin , Endoscopy , Etoposide , Follow-Up Studies , Gastrectomy , Humans , Lymph Nodes , Neoplasm Metastasis , Neuroendocrine Tumors , Prognosis , Stomach , Stomach Neoplasms , Ulcer
13.
Article in English | WPRIM | ID: wpr-719712

ABSTRACT

PURPOSE: This randomized phase III study was designed to compare the efficacy and safety of irinotecan plus cisplatin (IP) over etoposide plus cisplatin (EP) in Korean patients with extensive-disease small-cell lung cancer (SCLC). MATERIALS AND METHODS: Patients were randomly assigned to receive IP, composed of irinotecan 65 mg/m2 intravenously on days 1 and 8+cisplatin 70 mg/m2 intravenously on day 1 every 3 weeks, or EP, composed of etoposide 100 mg/m2 intravenously on days 1, 2, 3+cisplatin 70 mg/m2 intravenously on day 1, every 3 weeks for a maximum of six cycles, until disease progression, or until unacceptable toxicity occurred. The primary endpoint was overall survival. RESULTS: A total of 362 patients were randomized to IP (n=173) and EP (n=189) arms. There were no significant differences between IP and EP arms for the median overall survival (10.9 months vs. 10.3 months, p=0.120) and the median progression-free survival (6.5 months vs. 5.8 months, p=0.115). However, there was a significant difference in response rate (62.4% vs. 48.2%, p=0.006). The pre-planned subgroup analyses showed that IP was associated with longer overall survival in male (11.3 months vs. 10.1 months, p=0.036), < 65 years old (12.7 months vs. 11.3 months, p=0.024), and Eastern Cooperative Oncology Group performance status 0/1 (12.4 months vs. 10.9 months, p=0.040) patient groups. The severity of treatment-related adverse events such as grade 3/4 anemia, nausea and diarrhea was more frequent in patients treated with IP. CONCLUSION: The IP chemotherapy did not significantly improve the survival compared with EP chemotherapy in Korean patients with extensive-disease SCLC.


Subject(s)
Anemia , Arm , Cisplatin , Diarrhea , Disease Progression , Disease-Free Survival , Drug Therapy , Etoposide , Humans , Lung Neoplasms , Male , Nausea , Small Cell Lung Carcinoma
14.
Article in English | WPRIM | ID: wpr-719709

ABSTRACT

PURPOSE: Determine the frequency and prognostic value of circulating Epstein-Barr virus (EBV) DNA copy number in angioimmunoblastic T-cell lymphoma (AITL) patients who were treated with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA-EPOCH) regimens. MATERIALS AND METHODS: Sixty newly-diagnosed AITL patients were retrospectively enrolled in the present study. All patients were treated with DA-EPOCH regimen. RESULTS: Twenty-two subjects (36.7%) had a EBV DNA-positive test at diagnosis. EBV DNA‒positive patients were associated with lower lymphocyte-monocyte ratio (p=0.024). Median follow-up was 40 months (range, 14 to 100 months). The overall response rate for all the 60 AITL patents were 71.7% (95% confidence interval [CI], 58.6 to 82.5) with 3-year progressive-free survival (PFS) rate of 30.9%±6.1% and overall survival (OS) rate of 60.1%±6.6%. Not only did PFS estimation differ between the EBV DNA‒positive and EBV DNA‒negative group (hazard ratio [HR], 2.24; 95% CI, 1.15 to 4.35; p=0.006), but also worse OS was observed in the pretreatment EBV DNA‒positive group than in the EBV DNA‒negative group (HR, 2.74; 95% CI, 1.22 to 6.19; p=0.006). EBV DNA test positivity was independent prognostic marker for both PFS (HR, 2.17; 95% CI, 1.17 to 4.00; p=0.014) and OS (HR, 3.24; 95% CI, 1.48 to 7.11; p=0.004) after adjusting International Prognostic Index and prognostic index for AITL score. Reduction in EBV copies was significantly associated with therapy-response. CONCLUSION: Circulating EBV DNA level was an important prognostic and monitoring marker for AITL patients who treated with DA-EPOCH regimens which cannot improve outcomes for AITL patients.


Subject(s)
Cyclophosphamide , Diagnosis , DNA , Doxorubicin , Etoposide , Follow-Up Studies , Herpesvirus 4, Human , Humans , Lymphoma, T-Cell , Prednisone , Prognosis , Retrospective Studies , T-Lymphocytes , Vincristine
15.
Article in Chinese | WPRIM | ID: wpr-772338

ABSTRACT

BACKGROUND@#Small cell lung cancer (SCLC) is characterized by poor differentiation, high malignancy and rapid growth fast, short double time, early and extensive metastatic malignancy. In clinical, chemotherapy is the main treatment method, while resistance to multiple chemotherapy drugs in six to nine months has been a major clinical challenge in SCLC treatment. Therefore, It has important clinical value to building SCLC aninimal model which is similar to patients with SCLC. Animal model of xenotransplantation (PDX) from the patients with small cell lung cancer can well retain the characteristics of primary tumor and is an ideal preclinical animal model. The study is aimed to establish SCLC PDX animal model and induce the chemoresistance model to help to study the mechanism of chemoresistance and individual treatment.@*METHODS@#Fresh surgical excision or puncture specimens from SCLC patients were transplanted into B-NSGTM mice subcutaneous tissues with severe immunodeficiency in one hour after operation the B-NSGTM mice subcutaneous in 1 hour, and inject chemotherapy drugs intraperitoneally after its tumor growed to 400 mm³ with EP which is cisplatin 8 mg/kg eight days and etoposide 5 mg/kg every two days until 8 cycles. Measure the tumor volum and mice weights regularly, then re-engrafted the largest tumor and continue chemotherapy.@*RESULTS@#Nine cases were conducted for B-NSG mice modeling. Three of nine cases could be engrafted to new B-NSG mice at least two generation. The SCLC PDX animal models have been established successfully. After adopting chemotherapy drugs, the chemoresistance PDX models have been established. High homogeneity was found between xenograft tumor and patient's tumor in histopathology, immunohistochemical phenotype (Syn, CD56, Ki67).@*CONCLUSIONS@#The SCLC PDX animal model and the chemoresistance PDX animal model have been successfully constructed, the success rate is 33%, which provides a platform for the clinical research, seeking for biological markers and choosing individual treatment methods of SCLC.


Subject(s)
Animals , Antineoplastic Combined Chemotherapy Protocols , Pharmacology , Cisplatin , Disease Models, Animal , Drug Resistance, Neoplasm , Etoposide , Female , Humans , Interleukin Receptor Common gamma Subunit , Genetics , Lung Neoplasms , Drug Therapy , Metabolism , Pathology , Mice, Inbred BALB C , Mice, Inbred NOD , Mice, Knockout , Mice, SCID , Small Cell Lung Carcinoma , Drug Therapy , Metabolism , Pathology , Transplantation, Heterologous , Methods , Xenograft Model Antitumor Assays
16.
Article in Chinese | WPRIM | ID: wpr-776659

ABSTRACT

OBJECTIVE@#To investigate the complications and clinical outcome of children with acute myeloid leukemia (AML) undergoing mitoxantrone-cytarabine-etoposide (MAE) induction therapy.@*METHODS@#A total of 170 children with AML were given MAE induction therapy, and the complications and remission rate were analyzed after treatment.@*RESULTS@#The male/female ratio was 1.33:1 and the mean age was 7.4 years (range 1-15 years). Leukocyte count at diagnosis was 29.52×10/L [range (0.77-351)×10/L]. Of all children, 2 had M0-AML, 24 had M2-AML, 2 had M4-AML, 48 had M5-AML, 3 had M6-AML, 7 had M7-AML, 69 had AML with t(8;21)(q22;q22), and 15 had AML with inv(16)(p13.1q22) or t(16;16)(p13.1;q22). The most common complication was infection (158/170, 92.9%). Among these 158 patients, 22 (13.9%) had agranulocytosis with pyrexia (with no definite focus of infection), and 136 (86.1%) had definite focus of infection (including bloodstream infection). Other complications included non-infectious diarrhea, bleeding, and drug-induced hepatitis. Treatment-related mortality was observed in 10 children, among whom 8 had severe infection, 1 had multiple organ failure, and 1 had respiratory failure. Remission rate was evaluated for 156 children and the results showed a complete remission rate of 85.3%, a partial remission rate of 4.5%, and a non-remission rate of 10.3%.@*CONCLUSIONS@#Induction therapy with the MAE regimen helps to achieve a good remission rate in children with AML after one course of treatment. Infection is the main complication and a major cause of treatment-related mortality.


Subject(s)
Adolescent , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Child , Child, Preschool , Cytarabine , Drug Administration Schedule , Etoposide , Female , Humans , Infant , Leukemia, Myeloid, Acute , Drug Therapy , Male , Mitoxantrone , Remission Induction
17.
Article in English | WPRIM | ID: wpr-763507

ABSTRACT

Ewing sarcoma is the second most frequently occurring malignant tumor of the bone and soft tissue in adolescents and young adults. Genetically, Ewing sarcoma is characterized by balanced chromosomal translocation in which a member of FET gene family is fused with an ETS transcription factor, with the most common fusion being EWSR1-FLI1 (85% of cases). Treatment of Ewing sarcoma is based on multidisciplinary approach (local surgery, radiotherapy and multiagent chemotherapy), which are associated with chronic late effects that may compromise quality of life of survivors. First line treatment includes combination of drugs incorporating doxorubicin, vincristine, cyclophosphamide, ifosfamide, etoposide, and dactinomycin. The beneficial role of high dose chemotherapy has been suggested in high-risk localized Ewing sarcoma patients, and the studies are being performed to investigate the role in metastatic disease. The 5-year overall survival for localized Ewing sarcoma has improved to reach 65% to 75%. But patients with metastatic disease have a 5-year survival rate of <30%, except for those with isolated pulmonary metastasis (approximately 50%). Patients with recurrent tumor have a dismal prognosis. Novel therapeutic strategies based on understanding of molecular mechanisms are needed to improve the outcome of Ewing sarcoma and to lessen the treatment-related late effects.


Subject(s)
Adolescent , Cyclophosphamide , Dactinomycin , Doxorubicin , Drug Therapy , Etoposide , Humans , Ifosfamide , Neoplasm Metastasis , Neuroectodermal Tumors, Primitive, Peripheral , Prognosis , Quality of Life , Radiotherapy , Sarcoma, Ewing , Survival Rate , Survivors , Transcription Factors , Translocation, Genetic , Vincristine , Young Adult
18.
Blood Research ; : 108-113, 2019.
Article in English | WPRIM | ID: wpr-763063

ABSTRACT

BACKGROUND: Bendamustine is an attractive option for the management of both de novo and relapsed lymphomas. It is being increasingly used in the conditioning regimen for autologous stem cell transplantation (SCT) and can be an alternative to the traditionally-used carmustine. In this study, we aimed to determine the safety and efficacy of bendamustine in the conditioning regimen for autologous SCT in refractory/relapsed lymphomas. METHODS: We designed a descriptive study to evaluate bendamustine in combination with etoposide, cytarabine, and melphalan (BeEAM) in the conditioning regimen for autologous SCT. RESULTS: Fourteen patients (median age, 28 yr) with Hodgkin's lymphoma (HL) (N=8), non-Hodgkin's lymphomas (NHL) (N=5), or peripheral T-cell lymphoma, not otherwise specified (PTCL NOS) (N=1) were included in the study. A median number of 5.95×10⁶ CD34+ cells/kg were transfused. Median times to absolute neutrophil count and platelet engraftment were 17 days and 24 days, respectively. The 100-day transplantation mortality rate was 28% (4 patients). Eight patients (57.14%) had GII-III acute kidney injury, four patients (28.5%) had GIII-IV hyperbilirubinemia, and twelve patients (85%) had GII-III diarrhea. After 3 months, 37% (5 patients) and 21.4% (3 patients) demonstrated complete response and partial response, respectively. The median follow-up was 5.5 months (15 days–19 mo). At the final follow-up, 7 patients (50%) were alive and in CR. CONCLUSION: Our study showed that bendamustine is a potentially toxic agent in the conditioning regimen for autologous SCT, resulting in significant liver, kidney, and gastrointestinal toxicity. Further studies are required to assess its safety and efficacy at reduced doses.


Subject(s)
Acute Kidney Injury , Bendamustine Hydrochloride , Blood Platelets , Carmustine , Cytarabine , Diarrhea , Etoposide , Follow-Up Studies , Hodgkin Disease , Humans , Hyperbilirubinemia , Kidney , Liver , Lymphoma , Lymphoma, Non-Hodgkin , Lymphoma, T-Cell, Peripheral , Melphalan , Mortality , Neutrophils , Stem Cell Transplantation , Stem Cells
19.
Article in English | WPRIM | ID: wpr-763048

ABSTRACT

Brain aging is an inevitable process characterized by structural and functional changes and is a major risk factor for neurodegenerative diseases. Most brain aging studies are focused on neurons and less on astrocytes which are the most abundant cells in the brain known to be in charge of various functions including the maintenance of brain physical formation, ion homeostasis, and secretion of various extracellular matrix proteins. Altered mitochondrial dynamics, defective mitophagy or mitochondrial damages are causative factors of mitochondrial dysfunction, which is linked to age-related disorders. Etoposide is an anti-cancer reagent which can induce DNA stress and cellular senescence of cancer cell lines. In this study, we investigated whether etoposide induces senescence and functional alterations in cultured rat astrocytes. Senescence-associated β-galactosidase (SA-β-gal) activity was used as a cellular senescence marker. The results indicated that etoposide-treated astrocytes showed cellular senescence phenotypes including increased SA-β-gal-positive cells number, increased nuclear size and increased senescence-associated secretory phenotypes (SASP) such as IL-6. We also observed a decreased expression of cell cycle markers, including Phospho-Histone H3/Histone H3 and CDK2, and dysregulation of cellular functions based on wound-healing, neuronal protection, and phagocytosis assays. Finally, mitochondrial dysfunction was noted through the determination of mitochondrial membrane potential using tetramethylrhodamine methyl ester (TMRM) and the measurement of mitochondrial oxygen consumption rate (OCR). These data suggest that etoposide can induce cellular senescence and mitochondrial dysfunction in astrocytes which may have implications in brain aging and neurodegenerative conditions.


Subject(s)
Aging , Animals , Astrocytes , Brain , Cellular Senescence , Cell Cycle , Cell Line , DNA , Etoposide , Extracellular Matrix Proteins , Homeostasis , Interleukin-6 , Membrane Potential, Mitochondrial , Mitochondria , Mitophagy , Mitochondrial Dynamics , Neurodegenerative Diseases , Neurons , Neuroprotection , Oxygen Consumption , Phagocytosis , Phenotype , Rats , Risk Factors , Wound Healing
20.
Article in Korean | WPRIM | ID: wpr-760172

ABSTRACT

A 57-year-old male with periampullary duodenal mass was diagnosed as grade 3 duodenal neuroendocrine carcinoma with multiple liver metastasis. After nine cycles of cisplatin and etoposide, abdominal computed tomography (CT) findings showed complete regression of primary duodenal mass with marked size reduction of liver metastasis. Positron emission tomography findings showed metabolic complete response in both duodenal and liver mass. Pylorus-preserving pancreaticoduodenectomy was done and pathologic finding showed 5 mm sized remnant neuroendocrine tumor. The patient has remained alive with no evidence of disease for 43 months after initial diagnosis. This case suggests the possibility of heterogeneous nature of grade 3 neuroendocrine carcinoma and selected population may have extreme sensitivity to cisplatin and etoposide chemotherapy leading to complete response.


Subject(s)
Carcinoma, Neuroendocrine , Cisplatin , Diagnosis , Drug Therapy , Etoposide , Humans , Liver , Male , Middle Aged , Neoplasm Metastasis , Neuroendocrine Tumors , Pancreaticoduodenectomy , Positron-Emission Tomography
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