A general chemotherapy myelotoxicity score to predict febrile neutropenia in hematological malignancies.

BACKGROUND: Chemotherapy-induced neutropenia is the most common adverse effect of chemotherapy and is often complicated by febrile neutropenia (FN). The objective of this study is to validate a classification of aggressiveness of a chemotherapy regimen and to evaluate its usefulness in a risk prediction model of FN in patients with hematological cancer at the beginning of a chemotherapy cycle. PATIENTS AND METHODS: Two hundred and sixty-six patients were prospectively enrolled and followed during 1053 cycles. Relevant patient informations were collected at the beginning of the first cycle and the number of days of FN were counted in the follow-up [dichotomized (no FN versus >or= 1 day of FN)]. RESULTS: Aggressive chemotherapy regimen is the major predictor of FN [odds ratio 5.2 (3.2-8.4)]. The other independent predictors are the underlying disease, an involvement of bone marrow, body surface

The use of low-energy laser (LEL) for the prevention of chemotherapy- and/or radiotherapy-induced oral mucositis in cancer patients: results from two prospective studies.

BACKGROUND: Low-energy laser (LEL) treatment has been suggested as an effective and safe method to prevent and/or treat oral mucositis induced by chemotherapy and/or radiotherapy; however, it has not gained wide acceptance so far. MATERIALS AND METHODS: We conducted two clinical trials testing the LEL technique: firstly, as a secondary prevention in patients with various solid tumors treated with chemotherapy who all developed severe mucositis after a previous identical chemotherapy and, secondly, as therapeutic intervention (compared to sham illumination in a randomized way) in patients with hematological tumors receiving intensive chemotherapy and having developed low-grade oral mucositis. RESULTS: We entered 26 eligible patients in the first study and 36 were randomized in the second study. The success rate was 81% (95%CI = 61-93%) when LEL was given as a preventive treatment. In the second study, in patients with existing lesions, the therapeutic success rate was 83% (95%CI = 59-96%), which was significantly different from the success rate reached in the sham-treated patients (11%; 95%CI = 1-35%); the time to development of grade 3 mucositis was also significantly shorter in the sham-treated patients (p < 0.001). CONCLUSION: Our results strongly support the already available literature, suggesting that LEL is an effective and safe approach to prevent or treat oral mucositis resulting from cancer chemotherapy.

[The Cancer Registry of the Jules Bordet Institute, a new tool for the institution and its researchers. Description of cases incident in 2000-2001]. / Le Registre du Cancer de l'Institut Bordet, un nouvel outil à la disposition de l'institution et de ses chercheurs. Présentation des cas d'incidence en 2000 et 2001.

A hospital Cancer Registry has recently been initiated at the Jules Bordet Institute. The collected information allows to report pathology items such as incidence date, site, morphology and stage. It permits to describe the therapeutic choices, which, broken down by organ and stage, can be compared to guidelines in a process assessment. The objectives of this registry are institutional (statistical and organisational finalities as well as quality control ones), extra-institutional (participation to the public network of cancer registration), and scientific (providing the researchers a common database that can be queried using multiple criteria to be completed by further detailed data). This paper reports on 3,587 incident cancer cases in 2000 and 2001 which were managed at the Jules Bordet Institute for the primary episode. Cancers in women represent 64.3% of all records, for only 35.7% of men, while in the Belgian National Cancer Registry, the proportion is reversed to 46.7% of women and 53.3% of men. The distribution of cancer by site is also quite different in our hospital registry where breast cancer in women, melanoma in both sexes, lung cancer and head and neck cancers in men are over-represented compared to the general population, while colorectal cancer is underrepresented in both sexes.

[Belgian registry of thyroid cancer. Preliminary epidemiological characteristics revealed by a retrospective study (1988-1995). Belgian Thyroid Cancer Study Group]. / Le registre belge du cancer thyroïdien. Premières caractéristiques épidémiologiques révélées par une étude rétrospective (1988-1995). Belgian Thyroid Cancer Study Group.

The aim of a cancer registry is to study the incidence of cancer in a well-determined population and to allow epidemiological research to the setting up of diagnosis and therapeutic strategies. The Belgian Thyroid Cancer Study Group (BTCSG) was founded in 1990. In the present study we report data collected from 1988 to 1995 in 397 patients with a differentiated (papillary and follicular) thyroid carcinoma living in the french-speaking area of Belgium. The sex ratio female/male is 3.5 and the median ages at the diagnosis, is similar (45 yrs, 12-82) in both sexes. Seven cases of thyroid cancer were registered in young patients less than 18 yrs old. Thyroid carcinoma were associated with multinodular goiter in more than 50% cases. Cancer was bilateral in 17%. Papillary histological type accounts for 84% in our series while its diagnosis was established in 45% at early clinical stages (TO-T1). These observations could probably be related with 1) broader indications and more aggressive options for the surgical removal of diffuse multinodular goiter, 2) more sophisticated pathologic examinations that might have led to the detection of a greater incidence of occult carcinomas, incidentally discovered. Lymph nodes metastases were present at the time of diagnosis in 20%, especially in young patients. The risk for local and/or lateral recurrence or distant metastases is significantly related to the size of the tumor, histologically verified lymph node metastases and the values of the EORTC prognostic index (> or = 50) that additionally takes into account the differentiation of the tumor. Considering our short median follow-up time of 25 months, it is currently too early to define if the controversial attitude about the extent of surgery (total thyroidectomy plus I131 or individualized surgery) can also negatively influence the risk for recurrence. In our series, eight patients died of thyroid cancer.

Survival of patients with radiation enteritis of the small and the large intestine.

We reviewed the clinical and survival data of 108 consecutive patients who presented with radiation enteritis between 1965 and 1981. One hundred and two (94%) had been irradiated for carcinoma of the cervix uteri. The median follow-up was of 11 years. The median time of occurrence of severe radiation-induced lesions (obstruction, perforation) after radiotherapy was of 18 months, against 10.5 months for mild symptoms (e.g., tenesmus) and 9 months for rectal bleeding (p < 0.001). Cox survival analysis taking into account the stage of the cancer and the age at diagnosis showed that rectal bleeding is a factor with a prognosis significantly poorer than the mild symptoms (p = 0.05), equivalent to that of the severe complications. We conclude that in the evaluation of patients who underwent radiotherapy for abdominal or pelvic tumours, rectal bleeding should be considered as a sign of serious radiation-induced complication.

Comparison of three fully implantable venous access systems. A randomized study.

Three different fully implantable venous access devices were randomly inserted in 72 patients. Comparison both from the point of view of their ease of insertion and their later use failed to show any significant difference between the three systems.

Preliminary report on the rigid disc lens.

Theoretically, a circular and lenticular implant is the most appropriate for implantation in the capsular bag. Various prototypes have led to a single-piece model in polymethylmethacrylate with a bioconvex 7-mm optic and a 9-mm total diameter. This so-called disc lens has been implanted in 61 eyes. The longest follow-up is 18 months. Thus far, the clinical results are excellent. It appears that this 9-mm disc lens permits centration without acting as a spring in the capsular bag. A large mydriasis and the use of viscoelastic material are mandatory for inserting the rigid disc lens. A circular implant appears to be an advance in IOL design adapted to the capsular bag configuration. A greater number of cases and longer follow-up are necessary to evaluate the rigid disc lens.

Buoyancy of human and intraocular lenses in air and in aqueous humor.

The weights of seven human lenses in air and in aqueous humor were determined and compared to those of ten intraocular lens implants (IOLs). All IOLs tested were found to be significantly lighter than the human lenses in both air and in the aqueous humor.

Adriamycin and derivatives interaction with the mitochondrial membrane: O2 consumption and free radicals formation.

Adriamycin induces the formation of semiquinone free radicals, O(2) and OH. species, in beef heart intact mitochondria, submitochondrial particles and complex I-III containing proteoliposomes. Free radicals were detected by the use of Electron Spin Resonance (ESR) spectroscopy with the spin trapping method. However, to observe transient oxygen species in intact mitochondria, a flow technique was mandatory. ESR results were compared with oxygen consumption measurements. Since free radicals could be involved in the mechanism of the adriamycin induced cardiotoxicity, it was essential to design new adriamycin derivatives which do not generate radicals. From the study of two adriamycin analogs (N-acetyl-adriamycin and 5-Iminodaunorubicin), it was shown that oxygen radicals formation require both the binding of the drug to the mitochondrial membrane and a quinone function associated with the drug structure. The data reported here might be useful in the synthesis of less cardiotoxic compounds.

Photoacoustic spectroscopy of bacteriorhodopsin photocycle.

Photoacoustic spectroscopy was applied to study the energetics and the kinetics of the slow intermediates of the bacteriorhodopsin photocycle. An analysis of the modulation frequency dependence of the photoacoustic signal allowed us to estimate the enthalpy changes and the kinetic parameters associated with those intermediates. The effects of pH, salt concentration, and protein aggregation were studied. Three photoacoustic transitions were found. The two low frequency transitions were attributed to O660 and M412, respectively. The third transition was interpreted as resulting from a protein conformational change undetected spectrophotometrically. The frequency spectra were simulated between 5 and 180 Hz at pH's 5.1, 7.0, and 8.9 assuming a branching in the bacteriorhodopsin photocycle at the M412 level. The enthalpy changes associated with M412 and O660 were computed and compared with the experimental values.

Architecture and dynamics of microvillar photoreceptor membranes of a cephalopod.

Microvillar membranes of cephalopod photoreceptors, Eledone aldrovandii were analysed with respect to their protein and lipid composition. Molecular dynamics of this membrane type were investigated by ESR measurements using frog rod outer segment membranes as a reference system. The photoreceptor membrane is composed of about 56 wt% protein and 44 wt% lipid. Rhodopsin (mol wt 51 000) represents at least 70% of the membrane protein. The molar ratio of phospholipid to cholesterol to rhodopsin is about 55:24:1. Phosphatidylcholine (28.9 mol%) and phosphatidylethanolamine (27.8 mol%) are the major phospholipids. The ESR measurements suggest that the cephalopod photoreceptor membrane is less fluid than from rod outer segment membranes although the major phospholipids show remarkable high levels of polyunsaturated fatty acids (e.g. 88 mol% in phosphatidylethanolamine). It is concluded that the lower fluidity of microvillar membranes results in part from high cholesterol content and that a restricted mobility of rhodopsin in this membrane does not result only from the fact that the membrane is rolled into a microvillar structure.

Fusion and lipid exchange in vesicles containing lipophilic spin labels.

Lipophilic non-electrolyte spin labels greatly accelerate the fusion of unilamellar vesicles of dipalmitoylphosphatidylcholine when the system is maintained below the lipid phase transition. Differential scanning calorimetry and centrifugation measurements show that the transformed vesicles are large and probably unilamellar. Differential scanning calorimetry and fluorescence depolarization measurements were also carried out on mixtures of labeled dipalmitoylphosphatidylcholine vesicles and of vesicles composed of pure dimyristoylphosphatidylcholine. A mixing of the membrane components is observed when the vesicles are incubated above the transition temperature of the two constituent lipids. However, the process does not involve a real fusion of the entire vesicles. An exchange of lipid and label monomers between the two lipid phases seems to occur. These observations are discussed in view of the molecular organization of the spin label within the dipalmitoylphosphatidylcholine matrix below and above the lipid transition temperature.

Effect of compression on rat-liver mitochondrial membranes. A biochemical and morphological study.

When rat-liver mitochondria are subjected to compression at 0 degrees C, they become permeable to sucrose and the latency of malate dehydrogenase disappears. Freeze fracture electron microscopy shows smooth areas devoid of particles in fracture faces of the membranes. The effects of pressure can be inhibited as the temperature increases. Such results are explained by supposing that compression increases the transition temperature of mitochondrial membrane lipids above 0 degrees C and causes their freezing.

Quantum efficiency of light-driven proton extrusion in Halobacterium halobium. pH dependence.

The quantum yield for light-induced proton extrusion in Halobacterium halobium cells pretreated with an ATPase inhibitor was measured between pH 5 and 9 using two separate spectrophotometric techniques. The transmittance of the cell suspension was measured with a spectrometer equipped with "end-on" photomultipliers, whereas the reflectance was measured using a light-integrating sphere. The potentialities of the two techniques are critically compared. These measurements are used to evaluate the intensities of light absorbed by the cells. Since the initial rates of proton release into the extracellular medium were simultaneously measured, the quantum yield values [QY(H+)] could be determined. The results obtained with the two techniques are in reasonable agreement. QY(H+) is 0.64 at pH 5.9 and decreases gradually to 0.28 at alkaline pH values.