Haematological toxicity of clozapine and some other drugs used in psychiatry

2011 ◽  
Vol 26 (2) ◽  
pp. 112-119 ◽  
Author(s):  
Patty M. M. Nooijen ◽  
Felix Carvalho ◽  
Robert J. Flanagan
Keyword(s):  
Haematological Toxicity

scholarly journals To assess the role of addition of bevacizumab therapy to carboplatin and paclitaxel as frontline treatment of epithelial ovarian cancer

2016 ◽  
Author(s):  
Richa Vatsa ◽  
Sunesh Kumar ◽  
Lalit Kumar
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Disease Progression ◽  
Safety Profile ◽  
Haematological Toxicity ◽  
Progression Free Survival ◽  
New Drugs ◽  
Secondary Outcome ◽  
Vegf Receptor ◽  
Persistent Proteinuria

Introduction: Efforts are going on for development of new drugs for epithelial ovarian cancer (EOC). We assessed safety profile of bevacizumab, a VEGF receptor blocking antibody in treatment of EOC. Methods: We assigned women with EOC to carboplatin (area under curve, 5 or 6) and paclitaxel (175 mg/square meter of body-surface area), given every 3 weeks for 6 cycles, or to this regimen plus bevacizumab (15 mg/kilogram body weight), given concurrently every 3 weeks for 5 or 6 cycles and continued for 30 additional cycles. Primary outcome measures was safety profile of bevacizumab and secondary outcome was to see progression free survival (PFS). Results: Out of 30 patients, 10 were in Bevacizuma arm (Arm A) and 20 in conventional chemotherapy arm (Arm B). Haematological toxicity, GI perforation and proteinuria was similar in both. Other toxicities e.g. bleeding complication (p = 0.002) and hypertension (p = 0.04) was more in Arm A. PFS was similar in both arms; 24 months in Arm A and 22 months in Arm B (p = 0.565). 4 (40%) patients in arm A discontinued treatment, two (20%) because of disease progression after PFS of 9 and 6 months, two because of development of toxicity considered to be due to bevacizumab; of which one developed jejenal perforation and disease progression after PFS of 6 months and 1 because of development of persistent proteinuria of grade 3 after 18 months. Conclusion: Bevacizumab therapy does not improve PFS in EOC but increases toxicity spectrum of chemotherapy.

Haematological toxicity compromises MOPP/ABVD chemotherapy in Hodgkin's disease

1991 ◽  
Vol 3 (3) ◽  
pp. 151-154
Author(s):  
M.J. Goodrick ◽  
F. Daniel ◽  
A.G. Prentice ◽  
J.A. Copplestone ◽  
C.J. Tyrrell
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Haematological Toxicity ◽  
Abvd Chemotherapy

Toxicity And Surface Modification Of Dendrimers: A Critical Review

2021 ◽  
Vol 18 ◽  
Author(s):  
Rohini Kharwade ◽  
Payal Badole ◽  
Nilesh Mahajan ◽  
Sachin More
Keyword(s):  
Surface Modification ◽  
Positive Charge ◽  
Haematological Toxicity ◽  
Three Dimensional ◽  
Different Types ◽  
Hemolytic Toxicity ◽  
High Degree ◽  
Core Functionality ◽  
Polymeric Structures

: As compared to other nano polymers, dendrimers have novel three dimensional, synthetic hyperbranched, nano-polymeric structures. The characteristic of these supramolecular dendritic structures has a high degree of significant surface as well as core functionality in the transportation of drugs for targeted therapy, specifically in host-guest response, gene transfer therapy and imaging of biological systems. However, there are conflicting shreds of evidence regarding biological safety and dendrimers toxicity due to their positive charge at the surface. It includes cytotoxicity, hemolytic toxicity, haematological toxicity, immunogenicity and in vivo toxicity. Therefore to resolve these problems surface modification of the dendrimer group is one of the methods. From that point, this review involves different strategies which reduce the toxicity and improve the biocompatibility of different types of dendrimers. From that viewpoint, we broaden the structural and safe characteristics of the dendrimers in the biomedical and pharmaceutical fields.

scholarly journals UPLC-MS/MS Determination of Linezolid and Heme in Plasma of Infected Patients and Correlation Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yingying Wang ◽  
Xuemei Ye ◽  
Qin Lan ◽  
Xiaofang Ke ◽  
Lufeng Hu ◽  
...  
Keyword(s):  
Correlation Analysis ◽  
Healthy Subjects ◽  
Haematological Toxicity ◽  
Diagnostic Value ◽  
High Concentration ◽  
High Positive Correlation ◽  
Positive Correlation ◽  
Early Diagnose ◽  
The Relationship

Linezolid can cause serious haematological toxicity, such as thrombocytopenia and aneamia. Heme, composed of iron and porphyrin, is an important component of hemoglobin. In order to investigate the relationship between the concentration of linezolid and heme in the plasma of infected patients, a UPLC-MS/MS method that can determine the concentrations of linezolid and heme simultaneously was developed and validated. A total of 96 healthy subjects and 81 infected patients, who received blood routine blood tests, were included and determined by the UPLC-MS/MS method. The results showed that the concentration of linezolid was 5.08 ± 3.46   μ g / mL in infected patients who were treated with linezolid. The heme in healthy subjects was 7.05 ± 8.68   μ g / mL , and it was significantly decreased to 0.88 ± 0.79   μ g / mL in infected patients ( P < 0.01 ). Spearman correlation analysis showed that linezolid had a high negative correlation with platelet (PLT) ( R = − 0.309 ). Heme had a high positive correlation with hemoglobin (Hb) ( R = 0.249 ) in healthy subjects and infected patients. The ROC analysis showed that heme had diagnostic value to distinguish low Hb (110 g/L). In conclusion, there was a positive correlation between heme and Hb, and this correlation was also observed in infected patients. A high concentration of linezolid was inclined to decrease PLT. Monitoring of heme and linezolid helps in the early diagnose of low Hb and PLT.

P14.13 Severe hematological toxicity during chemoradiation for glioblastoma: Identification of clinical and pharmacological risk factors and consequences for the individual patient

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii40-ii40
Author(s):  
N Grun ◽  
C A den Otter ◽  
M Sintemaartensdijk ◽  
J Osinga ◽  
F E L van den Elzen ◽  
...  
Keyword(s):  
Risk Factors ◽  
De Novo ◽  
Tumour Progression ◽  
Haematological Toxicity ◽  
Female Gender ◽  
Hematological Toxicity ◽  
Severe Toxicity ◽  
Cell Counts ◽  
Adjuvant Temozolomide ◽  
Hospital Visits

Abstract BACKGROUND Besides early tumour progression, standard first-line radiation with concurrent and adjuvant temozolomide in de novo glioblastoma patients is abrogated frequently by severe haematological toxicity. This leads to treatment delays with unknown effect on efficacy and to more hospital visits with increased disease burden. In the present study, we identified clinical and pharmacological risk factors for temozolomide induced severe hematological toxicity. Furthermore, we describe the burden of toxicity for patients and evaluate the effect of severe toxicity on prognosis. METHODS A retrospective cohort study of adult patients with a histological confirmed glioblastoma (n=363), treated with standard treatment regimen at the Brain Tumor Center Amsterdam between 2000 and -2020. Severe haematological toxicity was defined as a CTCAE (version 5.0) grade ≥3. We used Pearson Chi-Square test to analyze differences in patient characteristics between the groups (no vs. severe toxicity) and paired samples T- Test to analyze fluctuations in cell counts. Univariate and multivariate logistic regression were used to identify patient- and treatment characteristics associated with severe hematological toxicity. Cox Proportional Hazards models were used to estimate Hazard Ratio’s for the association between survival and severe hematological toxicity. RESULTS Female gender (OR 8.05, 95%CI 2.96–21.89, p&lt;0.001) and older age (age &gt; 70 years; OR 2.44, 95%CI 1.12–5.31, p=0.025) were independent risk factors for severe toxicity. Concurrent and adjuvant temozolomide was discontinued in respectively 56% and 35% of the patients. In general, patients with severe hematological toxicity had a treatment delay of 22 ± 48 days. Of all patients with severe hematological toxicity during chemoradiation, 96% developed toxicity after ≥4 weeks of treatment (p&lt;0.001). Females who received highest temozolomide-doses (4th quartile) had a longer survival than females with low cumulative temozolomide doses (1st quartile). Patients, who developed severe toxicity had much more hospital visits (20; range 12–26), and were admitted more frequently to the hospital. Severe haematological toxicity was not related to survival (HR 1.04; 95%CI 0.74–1.45). CONCLUSION Female gender and age &gt;70 years are risk factors for severe hematological toxicity. Severe hematological toxicity relates to temozolomide exposure and results in a significant treatment burden for patients. Low temozolomide exposure results in decreased survival. Patient tailored therapy may result in better treatment outcomes.

Pegfilgrastim Versus Filgrastim in the Supportive Care of Heavily Pretreated Multiple Myeloma in Treatment with Pomalidomide-Dexamethasone

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 18-18
Author(s):  
Claudio Cerchione ◽  
Lucio Catalano ◽  
Davide Nappi ◽  
Anna Emanuele Pareto ◽  
Gerardo Musuraca ◽  
...  
Keyword(s):  
Neutrophil Count ◽  
Haematological Toxicity ◽  
Median Number ◽  
Severe Neutropenia ◽  
Consequent Reduction ◽  
Heavily Pretreated ◽  
Domestic Setting ◽  
Long Acting ◽  
Scheduled Time ◽  
Anti Fungal

Background Pegfilgrastim is a pegylated long-acting recombinant form of G-CSF that extends the half-life and allows for once-per-cycle dosing, requiring less frequent dosing than nonpegylated G-CSF. Aims The objective of this study was to compare the efficacy and safety of pegfilgrastim in patients affected by heavily pretreated MM, treated with pomalidomide-dexamethasone, in order to determine whether a single subcutaneous injection of pegfilgrastim is as effective as daily injections of standard filgrastim, in terms of haematological toxicity, febrile neutropenic episodes, antibiotic usage and hospedalization duration. Methods 57 patients (31 M and 26 F) were enrolled, median age at diagnosis 69 years (r. 52-84), and median age at start of treatment 76 years (r.56-90) treated with several lines of treatments (median 7, r. 2-12), every refractory to all the drugs previously received, received Pomalidomide-Dexamethasone (P 4 mg for 21 days, D 40 mg days 1,8,15,22, pegfilgrastim day +8) every 28 days, until progression. Results Since first course, received in domestic setting, with a very good compliance, patients performed blood counts once weekly and received, from day +8 to day +19, prophylactic oral chinolonic antibiotics and anti-fungal drugs. During neutropenia after first cycle, Filgrastim (5 μgr/kg/day for 3 days) was given if neutrophils count was &lt;1500 x 10^9 cells/L. Median number of filgrastim administrations was 4.6 (r. 3-6); nadir neutropenia was registered after a median of 10.4 days (r. 7-14); median of nadir neutrophil count was 1.13 x 10^9 cells/L (r.0.3 - 1.5), with maximum duration of 14 days. From the second course, all patients switched to prophylaxis with pegfilgrastim (6 mg), injected subcutaneously with a single administration on day +3 independently from the neutrophil count at that time. During pegfilgrastim, neutropenia was never longer than 8 days, with a consequent reduction of neutropenia-related infections. Median nadir neutrophil count, evaluated for every patients for at least three courses of therapy (r. 3-6) registered at day +11, was 1.28 (r.0.9-2.2). Only 4 patients needed a supplement of 3 administrations of filgrastim. Pegfilgrastim was well tolerated in all patients: main side effects in our patients were mild fever and bone pain (21.2%). Conclusions In patients affected by heavily pretreated MM treated with pomalidomide-dexamethasone, pegfilgrastim seems to reduce the incidence of severe neutropenia and infections and may increase the possibility to maintain the scheduled time of treatment. Disclosures Lucchesi: Novartis: Honoraria; Incyte: Honoraria; Pfizer: Honoraria.

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