Cellular Oxidative Stress in Pediatric Leukemia and Lymphoma Patients Undergoing Treatment Is Associated with Protein Consumption.

Over and under nutrition are associated with worse outcomes for children with leukemia and lymphoma; however, the molecular basis for this clinical observation is not well understood. Many chemotherapeutics used for leukemia treatment are known to generate oxidative stress in vitro; therefore, we evaluated redox status and diet in pediatric leukemia patients during therapy in order to ascertain relationships between nutrition and oxidative stress. Dietary intake and redox measures in peripheral blood mononuclear cells from 32 pediatric leukemia and lymphoma patients were collected over six months during treatment. Baseline measures when patients were off chemotherapy and subsequent assessments were collected after one, two and six months. Oxidative stress increased over time in all patients, consistent with chemotherapy-induced redox effects. Older and younger children showed significantly different baseline levels of reactive oxygen species, which increased over time in all age ranges. Diet was assessed at points proximal to oxidative stress measurements and revealed a novel association with consumption of animal protein, vegetable protein, and total protein intake. Our findings demonstrate that chemotherapy increases oxidative stress in pediatric leukemia patients, and raises the possibility that dietary protein or altered protein metabolism could contribute to clinical outcomes.

ABO non-O type as a risk factor for thrombosis in patients with pancreatic cancer.

ABO blood type has previously been identified as a risk factor for thrombosis and pancreatic cancer (PC). The aim of the study is to demonstrate the associations between ABO blood type and other clinical factors with the risk of thromboembolism (TE) in patients with PC. We conducted a retrospective study in 670 patients with pathologically confirmed pancreatic adenocarcinoma at the University of Texas MD Anderson Cancer Center. Clinical information was retrieved from medical records. ABO blood type was determined serologically and/or genetically. Logistic regression models, Kaplan-Meier plot, log-rank test, and Cox proportional hazard regression models were employed in data analysis. The incidence of TE was 35.2% in 670 patients who did not have TE prior to cancer diagnosis. Pulmonary embolism (PE) and deep vein thrombosis (DVT) consisted 44.1% of the TE events. Non-O blood type, pancreatic body/tail tumors, previous use of antithrombotic medication, and obesity (body mass index >30 kg/m(2) ) were significant predictors for TE in general. Blood type A and AB, low hemoglobin level (≤ 10 g/dL), obesity, metastatic tumor, and pancreatic body/tail tumors were significant predictors for PE and DVT. Patients with metastatic tumor or pancreatic body/tail tumors had a much higher frequency of early TE events (≤ 3 months after cancer diagnosis); and early TE occurrence was a significant independent predictor for increased risk of death. These observations suggest that ABO non-O blood type is an independent predictor for TE in PC. A better understanding of the risk factors for TE in PC may help to identify patients who are most likely to benefit from prophylactic anticoagulation therapy.

Compiled report on clinical efficacy and safety of nifedipine retard 10/20/nifedipine CD 30, as a first-line/add-on therapy in patients of hypertension: ENHANS trial.

The effectiveness of long acting nifedipine (Nicardia retard 10/20/30 CD) was evaluated on Indian patients in multiple centres. This was an open, prospective, clinical multicentric trial. Nearly 1632 patients satisfying the inclusion criteria were selected and given long acting nifedipine and assessed regularly for a period of one month. The reduction in the arterial blood pressure was significant from the 3rd day onwards and the target systolic and diastolic blood pressures were reached by the 14th day and the 7th day respectively, without notable changes in other parameters. At the final visit 18.6% and 16.1% reduction from the baseline was witnessed in the systolic and diastolic blood pressures respectively; 67.3% and 76% of individual patients had achieved target systolic and diastolic pressures respectively at end of one month. The heart rate was also found to be significantly reduced in the course of the trial (2.1% from the baseline). No other physical and investigational parameters were affected. Moreover 56.3% and 55.8% patients and physicians respectively rated the treatment as "very good" or "excellent" at the end of the study period. Thus, from this trial it is clear that long acting nifedipine is very efficacious as a first-line drug in the armamentarium against hypertension, while controlling other modifiable risk factors for cardiovascular disease.