ABSTRACT
The purpose of the research is to give the effectiveness and safety of ticagrelor in combination with acetylsalicylic acid as preoperative treatment of primary stenting in patients with ACS. We have investigated 42 patients with ACS, 3 of which were diagnosed with cardiogenic shock, age from 38 to 82 years (63 ± 6.5 years). The ACS diagnosis was verified using the results of the ECG, a troponin test and x-ray contrast coronary angiography. The purpose of preoperative antiplatelet treatment prior to primary PCI ticagrelor was administered in the dose of 180 mg and aspirin at a dose of 200 mg. Emergency coronary angiography and primary PCI was performed 15-90 minutes from the time of diagnosis. TIMI III flow in the infarct-related coronary arteries was achieved in all patients. None of the patients the phenomenon of "No-Reflow" has not developed. The appointment of the antiplatelet drug ticagrelor before primary PCI contributes to the achievement of full blood flow restoration in the infarct-related coronary artery, and also reduces the risk of intraoperative and postoperative complications.
Subject(s)
Acute Coronary Syndrome/drug therapy , Adenosine/analogs & derivatives , Coronary Restenosis/prevention & control , Fibrinolytic Agents/therapeutic use , Acute Coronary Syndrome/physiopathology , Acute Coronary Syndrome/therapy , Adenosine/adverse effects , Adenosine/therapeutic use , Adult , Aged , Aged, 80 and over , Female , Fibrinolytic Agents/adverse effects , Humans , Male , Middle Aged , Percutaneous Coronary Intervention , TicagrelorABSTRACT
In patients with relapsed or refractory (r/r) acute myeloid leukemia (AML), long-term disease control can only be achieved by allogeneic hematopoietic stem cell transplantation (HSCT). We studied the safety and efficacy of clofarabine-based salvage therapy. The study was designed as phase II, multicenter, intent-to-transplant (ITT) study. A total of 84 patients with r/r AML were enrolled. All patients received at least one cycle of CLARA (clofarabine 30 mg/m(2) and cytarabine 1 g/m(2), days 1-5). Chemo-responsive patients with a donor received HSCT in aplasia after first CLARA. Generally, HSCT was performed as soon as possible. The conditioning regimen consisted of clofarabine (4 × 30 mg/m(2)) and melphalan (140 mg/m(2)). The median patient age was 61 years (range 40-75). On day 15 after start of CLARA, 26% of patients were in a morphologically leukemia-free state and 79% exposed a reduction in bone marrow blasts. Overall, 67% of the patients received HSCT within the trial. The primary end point, defined as complete remission after HSCT, was achieved by 60% of the patients. According to the ITT, overall survival at 2 years was 43% (95% confidence interval (CI), 32-54%). The 2-year disease-free survival for transplanted patients was 52% (95% CI, 40-69%). Clofarabine-based salvage therapy combined with allogeneic HSCT in aplasia shows promising results in patients with r/r AML.
Subject(s)
Adenine Nucleotides/therapeutic use , Antimetabolites, Antineoplastic/therapeutic use , Arabinonucleosides/therapeutic use , Hematopoietic Stem Cell Transplantation , Leukemia, Myeloid, Acute/therapy , Salvage Therapy , Adult , Aged , Clofarabine , Female , Graft vs Host Disease/etiology , Hematopoietic Stem Cell Transplantation/adverse effects , Humans , Leukemia, Myeloid, Acute/mortality , Male , Middle Aged , Prospective Studies , Recurrence , Transplantation, HomologousABSTRACT
BACKGROUND: Tyrosine kinase inhibitors (TKI) improve the outcome of patients with advanced gastrointestinal stromal tumour (GIST), but treatment failure is frequent, and prognosis then bleak. Smaller trials in this setting suggested activity for sorafenib, a multikinase inhibitor of receptor tyrosine kinases and RAF serine/threonine kinases. PATIENTS AND METHODS: We retrospectively evaluated the efficacy of sorafenib, starting dose 400mg twice daily, in a large community-based cohort of 124 patients treated in 12 European and one United States (U.S.) cancer centre. All but one patient had a WHO performance score 0-2. All had failed both imatinib and sunitinib, 68 patients nilotinib and 26 had failed investigational therapy, too. RESULTS: Twelve (10%) patients responded to sorafenib and 70 (57%) patients achieved disease stabilisation. Sorafenib was moderately tolerated, and toxicity reported in 56% of the patients. Rash, hand-foot-syndrome and diarrhea occurred frequently. Sorafenib dosage was reduced in a third of patients, but this did not have an impact on progression-free survival (PFS) (p=0.15). Median PFS was 6.4 months (95% confidence interval [CI], 4.6-8.0 months) and median overall survival (OS) 13.5 months (95% CI, 10.0-21.0 months). Patients with a good performance status and those who responded to sorafenib had a significant better PFS. CONCLUSION: We conclude that sorafenib is active in GIST resistant to imatinib, sunitinib and nilotinib. These results warrant further investigation of sorafenib or similar molecules in GIST.
