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OBJECTIVE:To explore the role of clinical pharmacists in the process of drug treatment for leukemia children with neutrophil deficiency complicated with fever (NDCF). METHODS:Clinical pharmacists participated in the treatment for a leuke-mia child with NDCF. Considering about continuous decrease of platelet accompanied by epistaxis,combined with age,clinical symptom,lab indexes and related guidelines,clinical pharmacists thought it was possibly associated with bone marrow induced by chemotherapy drugs and drug-induced hemorrhage induced by cefoperazone sodium and sulbactam sodium. It was suggested to stop using cefoperazone sodium and sulbactam sodium;use Meropenem for injection 1.0 g,ivgtt,q8 h instead for anti-infection;addi-tionally use Recombinant human thrombopoietin injection 15000 U,sc,qd for elevating platelet. During treatment,taking into ac-count the low levels of neutrophils(0.17×109 L-1)and platelets(11×109 L-1)in this child,it was recommended to continue anti-in-fection and elevating platelet treatment,and continue to use Lienal polypeptide injection to auxiliarily enhance hematopoietic func-tion. When the child's condition was stable and neutrophils returned to normal,it was successively recommended to stop elevating platelet and anti-infection treatment;at the same time,conduct pharmaceutical care as body temperature examination,related indi-cator examination (such as routine blood test) and ADR monitoring,etc. RESULTS:Physicians adopted the clinical pharmacist's suggestions. The body temperature of the child was decreased,the hemogram recovered gradually,no infection occurred,and the next round of chemotherapy was successfully carried out. CONCLUSIONS:The clinical pharmacists participate in drug treatment for leukemia children with NDCF,pay attention to the prevention,diagnosis and treatment of drug-induced disease,and make com-prehensive analysis by using their own professional advantage,taking the possible effects of drugs on blood system,pharmacody-namics and pharmacokinetic characteristics as the breakthrough point,combing with the specific situation of children's age and ill-ness;assist physicians to formulate and optimize drug therapy plan so as to guarantee safe and effective drug use.
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Aim To investigate the effect of 2-deoxy-D-glucose(2-DG)on the sensitivity of leukemia multi-drug resistant K562/ADMcells to adriamycin by inhib-iting glycolytic pathway as well as its molecular mecha-nisms.Methods The leukemia drug-resistant K562/ADM cells and parental K562 cells were used as the target cell models.The cell proliferating activity was assessed with an MTT colorimetric assay,and the gly-colysis including glucose consumption,lactate export, and hexokinase activity was determined by glucose, lactic acid and hexokinase (HK)testing kits.The ex-pression and phosphorylation of mammalian target of rapamycin(mTOR)and glucose transporter-4 (GLUT-4)expression were analyzed by western blot.Results K562/ADM drug-resistant cells possessed higher HK activity,GLUT-4 expression level and aerobic glycolic ability than K562 sensitive cells. 2-DG treatment markedly inhibited HK activity,glucose consumption, and lactate export both in K562 cells and K562/ADM cells,and suppressed the proliferation of the two cells in a time-and concentration-dependent manner.Low concentration of 2-DG or adriamycin could increase the expression and phosphorylation of mTOR.However, the co-administration of 2-DG and adriamycin markedly counteracted adriamycin-mediated enhancement of mTOR expression and phosphorylation and down-regu-lated GLUT-4 expression in K562/ADM cells,and 2-DG dramatically improved the sensitivity of K562/ADM cells to cytotoxicity.Conclusion 2-DG inhibits the proliferation of drug-resistant K562/ADM cells and en-hances the sensitivity to adriamycin by blocking aerobic glycolysis pathway through inhibiting hexokinase activi-ty,counteracting adriamycin-stimulated increased ex-pression and phosphorylation of mTOR and downregu-lating GLUT-4 expression.
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Objectives To investigate the inlfuence of polymorphisms of SLC19A1 80G>A, MDR1 exon26C>T and MDR1 exon21G>T/A on curative effect and adverse reaction of high-dose methotrexate in patients with acute lymphoblastic leukemia. Methods MALDI-TOF-MS technique was used to detect the polymorphisms of SLC19A1 80G>A, MDR1 exon 26C>T and MDR1 exon21G>T/A in 108 patients with acute lymphoblastic leukemia (ALL). The relationship of genetic polymorphism, survival rate and toxicity was analyzed. Results The 36-month event-free survival was not related to any polymorphisms of MDR1 and SLC19A1. Patients with mutant types of MDR1 exon26C>T and MDR1 exon21G>T/A showed a much higher MTX plasma levels at 24 hours and higher incidence of hepatic injury (PT, MDR1 exon21G>T/A has a large inlfuence on hepatic toxicity and plasma concentra-tions of MTX.
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Objective:To study the expression of vascular endothelial growth factor(VEGF)and B-cell lymphoma/leuke mia-2(bcl-2) in nephroblastoma and to evaluate the relationship between VEGF and bcl-2.Methods:With mouse anti-human VEGF and bcl-2 monoclonal antibody,immunohistochemistry was used to examine 6)the expression of VEGF protein and bcl-2 protein in 17 cases of nephroblastoma and 7 cases of normal tissue as contrast.VEGF mRNA and bcl-2 mRNA expression was examined by in situ hybridization.Results:The positive expressions of bcl-2 protein in nephroblastoma(82.4%)were significantly higher than those in normal tissues(28.5%).The positive expressions of VEGF protein in nephroblastoma(58.8%)were significantly higher than those in normal tissues(14.3%).The rate of bcl-2,VEGF mRNA in nephroblastoma was 88.2%,82.4%,respectively.The expression of bcl-2,VEGF mRNA was increased significantly in nephroblastoma compare with control.VEGF expression and bcl-2 in nephroblastoma were positively related(rs=0.633,P