Temporary reversal by topotecan of marked insulin resistance in a patient with myelodysplastic syndrome: case report and possible mechanism for tumor necrosis factor alpha (TNF-alpha)-induced insulin resistance.

Tumor necrosis factor-alpha (TNF-alpha) is an important mediator of insulin resistance in obesity and diabetes through its ability to decrease the tyrosine kinase activity of the insulin receptor. We report here a remarkable degree of insulin resistance in a patient with adult respiratory distress syndrome and myelodysplasia.

Weight gain in patients receiving adjuvant chemotherapy for carcinoma of the breast.

Twenty-nine patients treated with adjuvant chemotherapy for carcinoma of the breast were evaluated for frequency and amount of weight gained during treatment. No difference with respect to age, menopausal status, estrogen receptor status, nodal status, biochemical parameters, or treatment regimen (CMF versus CMFVP) were seen. The gain in weight seen in some 50% of the patients treated seems to be a function of a decrease in activity level during treatment.