ABSTRACT
Introduction: Aromatase inhibitor (AI)-induced musculoskeletal symptoms (AIMSS) can decrease health-related quality of life and lead to discontinuation of AI therapy for postmenopausal women with breast cancer (BC). Although central sensitization (CS) may contribute to AIMSS, the relevance of CS-related symptoms to AIMSS has not been fully clarified. This study aimed to investigate the relationship between AIMSS and CS-related symptoms in women with BC who received AI therapy. Methods: This cross-sectional study recruited women who underwent BC surgery before at least 1 year and were taking AI for at least 6 months. Participants were assessed for joint pain and CS-related symptoms using the central sensitization inventory (CSI). The severity of CS-related symptoms was classified into three groups, and the prevalence of AIMSS was calculated. Multiple logistic regression analysis was used to assess the relationship between AIMSS and factors of possible relevance to AIMSS, including CSI severity. Results: Of the 73 women who were included in this study, 31 (42.4%) were categorized into the AIMSS group and 42 (57.6%) into the non-AIMSS group. Participants with a history of chemotherapy and higher CSI score were significantly more likely to have AIMSS. Multiple logistic regression analysis showed that a history of chemotherapy (odds ratio = 4.21) and higher CSI severity (odds ratio = 13.43) had significantly associated with AIMSS. Conclusion: CS-related symptoms assessed using CSI may be strongly associated with AIMSS. Further longitudinal studies to investigate the causal relationship and effectiveness of CS-targeted interventions are needed to prevent and treat AIMSS effectively.
ABSTRACT
PURPOSE: Chemotherapy-induced peripheral neuropathy (CIPN) commonly involves hand dexterity impairment. However, the factors affecting hand dexterity impairment are unknown and there is currently no established treatment. The purpose of the current study was to clarify factors influencing hand dexterity impairment in taxane-induced peripheral neuropathy using subjective and objective assessments. METHODS: We assessed patient characteristics, treatment-related factors, subjective symptoms of CIPN (Patient Neurotoxicity Questionnaire [PNQ]), psychological symptoms, and upper limb dysfunction (Quick Disabilities of the Arm, Shoulder and Hand [Quick DASH]). Quantitative assessments were pinch strength, sensory threshold, hand dexterity impairment, and grip force control. Multiple regression analysis was performed using hand dexterity impairment as the dependent variable and age and PNQ, Quick DASH, and control of grip force as independent variables. RESULTS: Forty-three breast cancer patients were included in the analysis. Hand dexterity impairment in taxane-induced peripheral neuropathy patients was significantly correlated with age, grip force control, and PNQ sensory scores (p < 0.008). Multiple regression analysis demonstrated that PNQ sensory scores and grip force control were significantly associated with hand dexterity impairment (p < 0.01). CONCLUSION: Subjective symptoms (numbness and pain) and grip force control contributed to impaired hand dexterity in taxane-induced peripheral neuropathy.
Subject(s)
Antineoplastic Agents , Breast Neoplasms , Hand Strength , Hand , Peripheral Nervous System Diseases , Taxoids , Humans , Female , Middle Aged , Peripheral Nervous System Diseases/chemically induced , Peripheral Nervous System Diseases/physiopathology , Hand Strength/physiology , Taxoids/adverse effects , Aged , Adult , Hand/physiopathology , Breast Neoplasms/drug therapy , Surveys and Questionnaires , Antineoplastic Agents/adverse effects , Regression Analysis , Disability Evaluation , Bridged-Ring Compounds/adverse effectsABSTRACT
BACKGROUND: Persistent post-surgical pain (PPSP) is associated with upper limb dysfunction and decreased quality of life and causes long-term suffering for breast cancer survivors after surgery. However, the predictors of PPSP remain unclear. The purpose of this study was to examine predictors of PPSP intensity and interference at 1 year postoperatively, focusing on treatment-related factors, pre- and postoperative central sensitization (CS), CS-related symptoms (e.g., muscle stiffness, fatigue, sleep disturbances), and psychological factors. METHODS: Eighty-eight women with planned unilateral breast cancer surgery were included in this longitudinal study. CS, CS-related symptoms, and psychological factors were assessed preoperatively, 1 month postoperatively, and 1 year postoperatively. Analysis of covariance was used to compare the groups with and without PPSP, accounting for treatment-related factors. Multiple regression analysis was performed to identify predictors of PPSP intensity and interference at 1 year postoperatively. RESULTS: Even after adjusting for covariates, preoperative and 1-month postoperative Central Sensitization Inventory scores in the PPSP group were significantly higher than scores in the group without PPSP. Multiple regression analysis showed that axillary lymph node dissection (ALND) and 1-month postoperative CS-related symptoms were independent predictors of PPSP intensity and interference at 1 year postoperatively (p < 0.01). CONCLUSION: We found that ALND and 1-month postoperative CS-related symptoms were predictors of PPSP intensity and interference at 1 year postoperatively.
Subject(s)
Breast Neoplasms , Humans , Female , Breast Neoplasms/surgery , Central Nervous System Sensitization , Longitudinal Studies , Quality of Life , Pain, Postoperative/etiologyABSTRACT
We report that granulocyte transfusion (GTX) was effective for prolonged pneumonia at allogeneic bone marrow transplantation. A 58-year-old man with MDS-RAEB-2 was admitted to our hospital for allogeneic bone marrow transplantation. He was complicated with pneumonia, which was not improved with G-CSF and antibiotics. We therefore decided to perform a GTX transplantation. During the period of neutropenia, pneumonia did not deteriorate. A combination of allogeneic stem cell transplantation and GTX is expected not only to improve transplantation results but also to expand the adaptation for transplantation. However, detailed investigation of the effect of GTX in allogeneic stem cell transplantation should be performed, and more cases should be accumulated.
Subject(s)
Granulocytes/transplantation , Hematopoietic Stem Cell Transplantation , Myelodysplastic Syndromes/therapy , Pneumonia/therapy , Humans , Male , Middle Aged , Myelodysplastic Syndromes/complications , Pneumonia/complications , Transplantation, Homologous , Treatment OutcomeSubject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Lymphoma, B-Cell/therapy , Lymphoma, Large B-Cell, Diffuse/therapy , Neoplasms, Second Primary/therapy , Parotid Neoplasms/therapy , Thymoma/therapy , Cyclophosphamide/administration & dosage , Doxorubicin/administration & dosage , Humans , Lymphoma, B-Cell/blood , Lymphoma, B-Cell/pathology , Lymphoma, Large B-Cell, Diffuse/blood , Lymphoma, Large B-Cell, Diffuse/pathology , Male , Middle Aged , Neoplasms, Second Primary/blood , Neoplasms, Second Primary/pathology , Parotid Neoplasms/pathology , Prednisone/administration & dosage , Thymoma/blood , Thymoma/pathology , Vincristine/administration & dosageSubject(s)
Cerebral Hemorrhage/etiology , Dementia, Vascular/etiology , Pancreatitis/chemically induced , Peripheral Blood Stem Cell Transplantation/adverse effects , Tacrolimus/adverse effects , Acute Disease , Aged , Dementia, Vascular/chemically induced , Dementia, Vascular/pathology , Endothelial Cells/pathology , Humans , Male , Neurotoxicity Syndromes/etiology , Peripheral Blood Stem Cell Transplantation/methods , Transplantation, HomologousABSTRACT
A 47-year-old woman who underwent allogenic peripheral blood stem cell transplant developed withdrawal symptoms soon after Fentanyl 25 mcg/h patch was stopped, which has not been reported at this dose. Possible causes, such as the inhibition of CYP3A4 induced by cyclosporine causing elevations of serum fentanyl, are discussed.
Subject(s)
Fentanyl/adverse effects , Opioid-Related Disorders/etiology , Peripheral Blood Stem Cell Transplantation/adverse effects , Substance Withdrawal Syndrome/etiology , Administration, Cutaneous , Analgesics, Opioid/administration & dosage , Analgesics, Opioid/adverse effects , Analgesics, Opioid/metabolism , Back Pain/complications , Back Pain/drug therapy , Cyclosporine/adverse effects , Cytochrome P-450 CYP3A , Cytochrome P-450 Enzyme Inhibitors , Cytochrome P-450 Enzyme System/metabolism , Drug Interactions/physiology , Female , Fentanyl/administration & dosage , Fentanyl/metabolism , Humans , Immunosuppressive Agents/adverse effects , Intervertebral Disc Displacement/complications , Intervertebral Disc Displacement/drug therapy , Leukemia, Myeloid, Acute/complications , Leukemia, Myeloid, Acute/therapy , Middle Aged , Opioid-Related Disorders/physiopathology , Substance Withdrawal Syndrome/physiopathologyABSTRACT
We report 3 cases of reduced cardiac function with complications in non-Hodgkin's lymphoma patients who were treated with rituximab. Patients experienced reduced cardiac functions after the administration of rituximab; there was no evidence of any preceding infusion reactions. Reticulin fiber was observed diffusely in cardiac muscles. Transforming growth factor-beta levels were elevated after the administration of rituximab. We believe that continuous elevation of transforming growth factor-beta may promote the growth of reticulin fiber in cardiac muscles. Reduction in cardiac functions is a severe complication that must be considered when rituximab is administered.
Subject(s)
Antibodies, Monoclonal/adverse effects , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Lymphoma, Non-Hodgkin/drug therapy , Ventricular Dysfunction, Left/chemically induced , Aged , Aged, 80 and over , Antibodies, Monoclonal, Murine-Derived , Drug Hypersensitivity/etiology , Humans , Male , Middle Aged , Myocardium/metabolism , Myocardium/pathology , Reticulin/drug effects , Reticulin/metabolism , Rituximab , Transforming Growth Factor beta/blood , Transforming Growth Factor beta/drug effects , Ventricular Dysfunction, Left/metabolism , Ventricular Dysfunction, Left/pathologySubject(s)
Arsenicals/adverse effects , Arsenicals/therapeutic use , Leukemia-Lymphoma, Adult T-Cell/drug therapy , Leukemia-Lymphoma, Adult T-Cell/pathology , Leukemic Infiltration/chemically induced , Lung/pathology , Oxides/adverse effects , Oxides/therapeutic use , Aged , Arsenic Trioxide , Arsenicals/administration & dosage , Deltaretrovirus Antibodies/blood , Fatal Outcome , Humans , Lung/immunology , Male , Oxides/administration & dosageABSTRACT
Helicobacter pylori (HP) eradication therapy is a useful treatment for idiopathic thrombocytopenic purpura (ITP). Some investigators have also reported the effects of proton pump inhibitor (PPI) monotherapy on ITP. We performed a randomized study of HP eradication therapy and PPI monotherapy on ITP. Four of nine patients achieved complete remission (CR), two of nine achieved partial remission (PR) in HP eradication therapy, three of eight achieved CR, and two of eight achieved PR in PPI monotherapy. No significant differences were observed in the CR + PR of these patients between HP eradication therapy and PPI monotherapy. As for cost comparisons, HP eradication therapy is cheaper than PPI monotherapy, but it is less effective.
Subject(s)
Amoxicillin/administration & dosage , Anti-Bacterial Agents/administration & dosage , Anti-Ulcer Agents/administration & dosage , Clarithromycin/administration & dosage , Helicobacter Infections/drug therapy , Helicobacter pylori , Omeprazole/analogs & derivatives , Purpura, Thrombocytopenic, Idiopathic , 2-Pyridinylmethylsulfinylbenzimidazoles , Aged , Amoxicillin/economics , Anti-Bacterial Agents/economics , Anti-Ulcer Agents/economics , Clarithromycin/economics , Drug Therapy, Combination , Helicobacter Infections/complications , Helicobacter Infections/economics , Helicobacter Infections/enzymology , Humans , Lansoprazole , Male , Middle Aged , Omeprazole/administration & dosage , Omeprazole/economics , Proton Pump Inhibitors , Purpura, Thrombocytopenic, Idiopathic/complications , Purpura, Thrombocytopenic, Idiopathic/economics , Purpura, Thrombocytopenic, Idiopathic/enzymology , Remission Induction , Treatment OutcomeABSTRACT
Rituximab has become a useful drug for the treatment of non-Hodgkin's lymphoma (NHL) and such autoimmune diseases as idiopathic thrombocytopenic purpura and rheumatoid arthritis. When combined with cytotoxic agents, rituximab showed synergistic effects for the treatment of NHL. In such treatment, hepatitis B virus (HBV) reactivation is a crucial complication when patients are treated with immunosuppressive or chemotherapeutic agents. Despite its treatment efficacy, several studies have pointed out unusual viral infections after its administration that resulted in fatal hepatitis due to HBV reactivation. In the cases at the authors' institute, the authors analysed the kinetics of HBV antibodies, HBV-reactivation timing, and the prophylactic efficacy of lamivudine. The authors reviewed their cases and the previous literature to clarify the characteristics of HBV-reactivated patients who were administered rituximab.
Subject(s)
Antibodies, Monoclonal/adverse effects , Antineoplastic Agents/adverse effects , Hepatitis B virus/pathogenicity , Hepatitis B/pathology , Antibodies, Monoclonal/therapeutic use , Antibodies, Monoclonal, Murine-Derived , Antibodies, Viral , Antineoplastic Agents/therapeutic use , Antiviral Agents/therapeutic use , Autoimmune Diseases/drug therapy , Humans , Kinetics , Lamivudine/therapeutic use , Lymphoma, Non-Hodgkin/drug therapy , RituximabSubject(s)
Chromosomes, Human, X , Leukemia/genetics , Sex Chromosome Aberrations , Acute Disease , Aged , Humans , MaleABSTRACT
A 47-year-old man was diagnosed with non-Hodgkin's lymphoma (NHL) follicular B-cell type (stage IVB). Although partial remission was observed after the administration of several combination chemotherapeutic agents, no more improvement was observed. After we finished the FND (fludarabine, mitoxantrone, dexamethasone) regimen, the patient's status improved. After the administration of the FND regimen, thrombocytopenia developed, and the platelet count did not recover to previous levels. After rituximab was administered for the treatment of thrombocytopenia, the platelet count recovered. Then we combined fludarabine and rituximab for the treatment of NHL. Although fludarabine was administered, the platelet count did not decrease when combined with rituximab. In the discussion, we analyze the characteristics and the treatment outcome of the thrombocytopenia induced by fludarabine reviewed in the literature.
Subject(s)
Antibodies, Monoclonal/therapeutic use , Lymphoma, Follicular/drug therapy , Thrombocytopenia/drug therapy , Vidarabine/analogs & derivatives , Vidarabine/adverse effects , Antibodies, Monoclonal, Murine-Derived , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Humans , Lymphoma, Follicular/complications , Male , Middle Aged , Rituximab , Thrombocytopenia/chemically induced , Thrombocytopenia/immunology , Thrombocytopenia/prevention & control , Treatment Outcome , Vidarabine/therapeutic useABSTRACT
Aleukemic leukemia cutis is a rare condition characterized by the invasion of leukemic blasts into the skin before their appearance in the peripheral blood. Leukemia cutis usually occurs in patients with myeloid leukemia, especially the myelomonocytic and monocytic types of acute myeloblastic leukemia. We describe the case of a 62-year-old woman with aleukemic leukemia cutis who developed Philadelphia-positive acute leukemia 1 month after skin involvement. Leukemic cells expressed both myeloid and B-cell lineage surface markers, and monoclonal rearrangement of the immunoglobulin heavy chain was detected by Southern blot analysis. This report is the first of a case of aleukemic leukemia cutis preceding Philadelphia-positive biphenotypic leukemia.
Subject(s)
Leukemia/pathology , Philadelphia Chromosome , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , B-Lymphocytes/pathology , Blast Crisis , Cell Lineage , Female , Gene Rearrangement , Humans , Immunoglobulin Heavy Chains/genetics , Leukemia/drug therapy , Leukemia/genetics , Middle Aged , Myeloid Cells/pathology , Phenotype , SepsisABSTRACT
Interferon (IFN) is one of several drugs effective in treating multiple myeloma (MM), and propagermanium is an IFN inducer. We report on 10 MM patients who were treated with propagermanium at doses from 10 to 40 mg. Two patients achieved complete remission (CR), two patients achieved partial remission (PR), and the condition of four patients was stable (stable disease, SD). After discontinuation of propagermanium, the status of MM progressed in two patients who were in SD and in two patients who had achieved PR. The administration of propagermanium was restarted in one patient resulting in a decrease in her paraprotein.
Subject(s)
Interferon Inducers/therapeutic use , Multiple Myeloma/drug therapy , Organometallic Compounds/therapeutic use , Aged , Aged, 80 and over , Disease Progression , Female , Germanium , Humans , Male , Middle Aged , Myeloma Proteins/analysis , Propionates , Remission Induction , Treatment OutcomeSubject(s)
Antineoplastic Agents/blood , Gastrointestinal Stromal Tumors/drug therapy , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Leukemia, Myeloid, Acute/drug therapy , Piperazines/blood , Pyrimidines/blood , Adult , Aged , Antineoplastic Agents/administration & dosage , Benzamides , Body Height , Body Weight , Dose-Response Relationship, Drug , Humans , Imatinib Mesylate , Japan , Middle Aged , Piperazines/administration & dosage , Pyrimidines/administration & dosage , Treatment OutcomeABSTRACT
A patient with Non-Hodgkin's lymphoma is reported, in which reactivation of the hepatitis B virus was achieved from treatment with rituximab. The patient's HBs antigens were positive on admission, and she tested positive for HBs, HBe, and HBc antibodies, and negative for the HBe antigens. She was treated with a regimen of three courses of rituximab-containing anti-cancer drugs and one course of combined anti-cancer drugs. Throughout these chemotherapy courses, prednisolone was not given. After the fourth course of chemotherapy with the third rituximab she developed hepatic dysfunction, and the serum titers of HBs and HBc antibodies suddenly decreased. After administration of lamivudine, however, she gradually recovered from liver failure.