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1.
Bull Cancer ; 105(2): 162-170, 2018 Feb.
Article in French | MEDLINE | ID: mdl-29066086

ABSTRACT

Patients with chronic hepatitis B infection are at risk of viral reactivation when treated by immuno- or chemotherapy, with potentially serious or even fatal consequences. This article proposes an overview on screening strategies and antiviral treatment recommendations for oncology patients. We have learned in hematology that reactivations are commun with rituximab and prophylactic treatment is recommanded for any patient who has been in contact with the virus. The risk appears to be lower with cytotoxics but has been far less studied. The recommandations are not formally consensual and upcoming studies will help to establish clearer practice guidelines.


Subject(s)
Antiviral Agents/therapeutic use , Hepatitis B virus/drug effects , Hepatitis B, Chronic/diagnosis , Hepatitis B, Chronic/drug therapy , Neoplasms/drug therapy , Rituximab/therapeutic use , Virus Activation , Allografts , Anthracyclines/adverse effects , Anthracyclines/therapeutic use , Antineoplastic Agents/adverse effects , Antineoplastic Agents/therapeutic use , Antiviral Agents/adverse effects , Hematopoietic Stem Cell Transplantation , Hepatitis B Antigens/blood , Hepatitis B virus/immunology , Hepatitis B virus/physiology , Hepatitis B, Chronic/immunology , Hepatitis B, Chronic/virology , Humans , Rituximab/adverse effects
2.
J Clin Oncol ; 30(35): 4337-43, 2012 Dec 10.
Article in English | MEDLINE | ID: mdl-23109694

ABSTRACT

PURPOSE: To investigate the somatostatin analog lanreotide as symptomatic treatment for inoperable bowel obstruction due to peritoneal carcinomatosis. PATIENTS AND METHODS: In all, 80 patients with peritoneal carcinomatosis, inoperable malignant digestive obstruction, and two or more vomiting episodes per day or nasogastric tube (NGT) who were previously treated with intravenous corticosteroids and proton pump inhibitors were randomly assigned to one 30-mg injection of lanreotide microparticles (n = 43) or placebo (n = 37) in a 10-day, double-blind, parallel-group phase. The primary end point was the proportion of patients responding on day 7 (one or fewer episodes of vomiting per day or no vomiting recurrence after NGT removal [for ≥ 3 consecutive days in both cases]). Vomiting frequency/NGT secretion volumes, nausea, abdominal pain, well-being, and safety were also assessed. Patients could then enter an open-label lanreotide-only phase. The study was conducted at 22 European hospitals. RESULTS: More patients receiving lanreotide than placebo were responders; this difference was not statistically significant for the intent-to-treat (ITT) population on the basis of diary cards (primary analysis; 41.9% [18 of 43] v 29.7% [11 of 37], respectively; odds ratio, 1.75; 95% CI, 0.68 to 4.49; P = .24) but was statistically significant for the corresponding supportive per protocol analysis (57.7% [15 of 26] v 30.4% [seven of 23]; P < .05) and ITT analysis, on the basis of investigators' assessments (50.0% [19 of 38] v 28.6% [10 of 35]; P < .05). Improvements in well-being were significantly greater with lanreotide on days 3, 6, and 7. No significant differences were observed for other secondary end points. Only two (mild/moderate) treatment-emergent adverse events were considered related to lanreotide. CONCLUSION: These results show that lanreotide has some efficacy and is safe in the symptomatic treatment of patients with inoperable bowel obstruction due to peritoneal carcinomatosis.


Subject(s)
Antineoplastic Agents/administration & dosage , Intestinal Obstruction/drug therapy , Intestinal Obstruction/etiology , Peptides, Cyclic/administration & dosage , Peritoneal Neoplasms/complications , Peritoneal Neoplasms/drug therapy , Somatostatin/analogs & derivatives , Adult , Antineoplastic Agents/adverse effects , Double-Blind Method , Female , Humans , Male , Particle Size , Peptides, Cyclic/adverse effects , Placebos , Somatostatin/administration & dosage , Somatostatin/adverse effects
4.
Am J Clin Pathol ; 119(4): 546-55, 2003 Apr.
Article in English | MEDLINE | ID: mdl-12710127

ABSTRACT

Nucleoside reverse transcriptase inhibitors (NRTIs) induce mitochondrial toxic effects resulting in multiple organ disorders. Liver involvement has been associated mainly with severe lactic acidosis and massive steatosis. However, patients with HIV infection who are receiving antiretroviral treatment frequently have mildly abnormal liver test results that, to date, have not been linked unambiguously to the toxic effects of NRTIs. Thirteen patients with HIV infection treated with NRTI-based regimens had low-grade abnormal liver test results associated with digestive and nonspecific general symptoms. Histologic examination of liver samples showed diffuse steatosis in only 6 cases and mild steatosis in the remaining cases, associated with megamitochondria, mild lobular inflammation and necrosis, Mallory bodies, and perisinusoidal fibrosis. In all cases, ultrastructural study disclosed mitochondrial abnormalities. Our work demonstrates that NRTI-induced toxic effects in the liver may occur as indolent nonspecific disease with variable histologic features and emphasizes the diagnostic value of electron microscopy, particularly when diffuse steatosis is absent.


Subject(s)
Anti-HIV Agents/adverse effects , HIV Infections/drug therapy , Liver/drug effects , Mitochondria/drug effects , Reverse Transcriptase Inhibitors/adverse effects , Adult , Fatty Liver/chemically induced , Fatty Liver/pathology , Female , Humans , Liver/pathology , Male , Microscopy, Electron , Middle Aged , Mitochondria/ultrastructure
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