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Background: Hematologic toxicity is a severe complication of chemotherapy. The objective of our study is to evaluate the impact of early lymphopenia on the risk of occurrence of febrile neutropenia and hematological toxicity after aggressive chemotherapy for Hodgkin lymphoma or high grade non-Hodgkin lymphoma
Methods: This prospective study involved 42 patients who received 193 cycles of chemotherapy in 2009. We assessed the impact of lymphopenia on day 1 and 8 on the risk of occurrence of febrile neutropenia. We also investigated the relation between the occurrence of hematologic toxicity after the first cycle and the subsequent cycles
Results: Febrile neutropenia was observed in 25% of cycles. Grade 3/4 hematologic toxicity occurred in 63% of cycles. Growth factors were used in 79% of cycles. Lymphopenia
Conclusion: Our results confirmed the impact of early lymphopenia on the occurrence of febrile neutropenia and hematologic toxicity after aggressive chemotherapy for Hodgkin lymphoma or high grade non Hodgkin lymphoma
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Background: Background: Non-small cell lung cancer [NSCLC] is the most common histologic form, leading causes of cancer death among masculine population. Half of CNPC was metastatic at diagnosis
Aim: To report the epidemiologic, anatomoclinic profile, therapeutic protocols and results of a retrospective study of non-small cell lung cancer [NSCLC] initially metastatic
Methods: our retrospective study include patients with NSCLC histologically confirmed with inaugural metastasis collected from January 1999 to december 2012. We had analysed epidemiologic, anatomopathologic data [TNM 2009], therapeutic protocols and results in term of overall survival, median survival and event free survival
Results: 100 case of NSCLC have been collected, mea nage was 57 years [22 to 81] and sex -ratio was 4,6. The majority of cases [74%] had a good performance statut [PS
Conclusion: Despite therapeutic progress in management of NSCLC, the prognosis of metastatic forms still reserved with a poor mean survival reported in litterature [12 years] valideted in our study. This push us to improve research mainly since advent of targeted therapy which still a promising way in the management of these tumors
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Background: Despite scientific advances, extended forms of pulmonary tuberculosis are still relevant. The aim of our study was to determine clinical features and outcome of extended pulmonary tuberculosis in immunocompetent patients
Methods: Retrospective comparative study including 100 patients HIV negative, presenting pulmonary tuberculosis divided into 2 groups of 50 patients [group1: extended tuberculosis and group2: localized tuberculosis]. Tuberculosis was considered extended when reaching above one lobe
Results:The average age was comparable in the 2 groups [p = 0.138]. In group1, we noted a higher incidence of diabetes [p = 0.037] and malnutrition [p = 0.045]. Clinically, patients in group1 had more general signs [p=0.033] and dyspnoea [p=0.037]. Biologically, anemia [p<0.001], leukocytosis [p=0.05], elevated CRP [p=0.031], thrombocytosis [p=0.023], hyponatremia [p = 0.001] and liver disturbances [p = 0.001] were significantly more frequent in group1. Concerning the evolution, time to smear negativity was significantly longer [p=0.012]. Similarly, radiological sequelae were more frequent [p = 0.02] and more extensive [p = 0.012]. Positive predictive value of radiological extent in disease evolution was 62% with a confidence interval between 47.2% and 75%
Conclusions: The extent of pulmonary tuberculosis is an important factor in clinical and biological presentation and disease evolution. Indeed, patients with extended tuberculosis develop more severe presentation and are more likely to develop parenchymal sequelae
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Background: Glioblastoma [GB] is the most common and lethal primary brain tumor in adults representing 25% of primary brain tumors in adults. The objective of our study was to report the epidemiologic, clinical and therapeutic features of GB in Tunisia.
Methods:Our retrospective study included 41 patients with histologically confirmed GB treated between 2006 and 2012 at the medical oncology departments of Abderrahmane Mami hospital in Ariana and the military hospital in Tunis
Results: Median age was 54 years [13 to 72 years] and sex-ratio was 2.3. Karnofsky performance status [KPS] was <70% in 31.7% of cases, while Recursive partitioning analysis radiation therapy oncology group [RTOG-RPA] classification was III in 11 [26.8%], IV in 19 [46.3%], V in 10 [24.3%] and VI in 1 [2.4%] cases. Complete resection [CR] was achieved in 29 patients [70.7%], partial resection [PR] or tumor debulking in 5 patients [12.2%] and biopsy alone [BA] in 7 patients [17.1%]. All patients received brain radiotherapy [RT] at a dose of 60 Gy combined with concurrent temozolomide [TMZ]. Nineteen patients [46.3%] received adjuvant TMZ, 8 of them completed 6 cycles. Median overall survival [OS] was 12 months [2 to 56 months]. Six, 12, 18 and 24-months OS rates were 84.6%, 57.6%, 35.4% and 20.7%, OS being correlated to age, KPS, RPA and quality of resection
Conclusion: Our retrospective study is the first African GB series. Despite it included predominantly poor prognosis patients with impaired neurocognitive function and adjuvant treatment discontinuation, our median OS was comparable to Stupp data
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Exocrine pancreatic carcinoma [EPC] occurs in the majority of cases with early locoregional spread and distant metastasis at diagnosis, leading to dismal prognosis and limited treatment options. Traditional cytotoxic chemotherapy provide only modest benefit to patients with EPC. Identification of different molecular pathways, overexpressed in pancreatic cancer cells, has provided the opportunity to develop targeted therapies with a crucial therapeutic role in this cancer setting. Our aim is to study the epidemiological, clinico-pathological characteristics, treatment modality and clinical outcome of pancreatic adenocarcinoma in Tunisian patients treated in the department of medical oncology Abderrahmane Mami Ariana. This retrospective study concerned patients with exocrine pancreatic carcinoma treated between 2009 and 2012. We analysed the following data: Anamnesis, age, sex, delay to diagnosis[DD], symptoms, clinical exam, performance status, stage, therapeutic protocol and results. We collected 158 patients [113 males/45 females, SR 2.5] with a median age of 64 years [20-93]. The median DD was 2 months [1-12]. Abdominal pain, jaundice and weight loss were the most frequent symptoms, 88.6%, 43% and 55.1% of cases respectively. Performance status was < 2 in 56.9% [90 pts]. Seric CA19-9 was increased in 86.6% of cases. Tumor was at stage III in 24.7% and stage IV in 58.2%. Surgery was done in 24.7% of cases [39pts], curative in 21 patients. Neoadjuvant chemotherapy[NACT] was administrated to 10.8% of patients, adjuvant to 13.9% [22 pts] and palliative chemotherapy[PCT] concerned 58.8% of patients. We used weekly Gemcitabine, Gemcitabine-CDDP, Gemcitabine-Oxaliplatine and LV5-FU2-CDDP in palliative setting respectively in 20%, 31.1%, 2.2 and 36.7% of cases. Median survival was 6 months [2-60] and the 1year overall survival at 38.8%. EPC remains a rare cancer in Tunisia. The prognosis is still grim worldwide and so does in our country. In this retrospective serie, we noted the predominance of locally advanced and metastatic cases with a long delay to diagnosis. Awareness campaigns have to be programmed to improve early diagnosis in EPC and improve outcomes
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Interventional endoscopic procedures involving the gastrointestinal [GI] tract in children are very common. Over the last several years the number of procedures in this area has steadily increased. To study indications and results of GI interventional endoscopies performed in a Pediatric GI unit. Retrospective study over a period of 10 years [1999- 2008]. Data were collected from endoscopic files. All procedures were performed endoscopically under general anesthesia. 185 interventional endoscopic procedures were done during this period in 96 patients [58 boys] median age: 4.9 +/- 4.7 years [1 month-13 years]. Indications were as follows: esophageal stenosis [n= 46; 47.9%], rectal polyp resection [n=21; 19.8%], esophageal varices ligation [n=19; 19.7%], foreign body extractions [n= 8; 8.3%] and percutaneous endoscopic gastrostomy [n= 2; 2.1%]. One hundred and thirteen esophageal dilations [61.1% of procedures] were performed in 46 patients: caustic stenosis [n=22; 22.9%], peptic stenosis [n=13; 13.5%] and anastomotic stenosis [n= 11; 11.4%]. The main indication of interventional GI endoscopy in this series was oesophageal stenosis followed by rectal polyp resection, esophageal varices ligation and foreign body extractions