Renal tolerance of cisplatin in patients more than 80 years old.

1994 ◽  
Vol 12 (10) ◽  
pp. 2121-2125 ◽  
Author(s):  
A Thyss ◽  
L Saudes ◽  
J Otto ◽  
A Creisson ◽  
M H Gaspard ◽  
...  
Keyword(s):  
Renal Function ◽  
Hematologic Toxicity ◽  
Severe Renal Insufficiency ◽  
Gault Formula ◽  
Before And After ◽  
Good General Condition ◽  
The Difference ◽  
Grade 3 ◽  
Number Of Cycles ◽  
Renal Tolerance

PURPOSE Assessment of cisplatin (CDDP) tolerance in patients more than 80 years old in good general condition who may benefit from CDDP-based treatment. PATIENTS AND METHODS Data on 35 patients older than 80 years who received one to six chemotherapy cycles (median, three cycles; total number of cycles, 98) including CDDP (60 to 100 mg/m2) were analyzed retrospectively. Before treatment, all patients had normal renal function as defined by serum creatinine (SC) levels below 132 mumol/L. Renal function was evaluated by measurement of SC and creatinine clearance (CC) before and after each course of chemotherapy. CC was calculated according to the Cockroft and Gault formula, where CC = (140 - age) x weight kg/0.814 x SC mumol/L. Renal toxicity was evaluated by the difference between prechemotherapy SC and the maximum SC level observed (delta SC) and by the difference between prechemotherapy CC and the minimal CC observed after treatment with CDDP (delta CC). The evolution of SC and CC during repeated courses of CDDP was analyzed, as were any extrarenal toxicities. RESULTS Renal function remained stable in 19 patients (54%) with delta SC less than 18 mumol/L and 18 of 35 patients (51%) with delta CC less than 9 mL/min. A slight deterioration in renal function was observed in 13 patients (37%) with delta SC greater than 18 mumol/L and less than 60 mumol/L, and with a delta CC greater than 11 mL/min and less than 21 mL/min. In three patients (9%), delta SC was greater than 60 mumol/L (71, 73, 115 mumol/L) and delta CC was greater than 21 mL/min (25, 26, 36 mL/min). There were no cases of severe renal insufficiency, clinical ototoxicity, or neurotoxicity > or = grade 2. Treatment was terminated after one or two courses in three patients because of grade 2 or 3 hematologic toxicity and in two patients for grade 3 nausea or vomiting. CONCLUSION CDDP at moderate doses can reasonably be administered to patients older than 80 years who may benefit from antineoplastic chemotherapy.

The Pentostatin, Cyclophosphamide, and Rituximab Regimen (PCR) Is Highly Active and Well Tolerated Regardless of Patient Age, Creatinine Clearance, and Performance Status: Analysis of a Multi-Center Phase II Trial.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 36-36 ◽  
Author(s):  
Tait D. Shanafelt ◽  
John C. Byrd ◽  
Susan M. Geyer ◽  
Debra Bowen ◽  
Betsy LaPlant ◽  
...  
Keyword(s):  
Renal Function ◽  
Elderly Patients ◽  
Creatinine Clearance ◽  
Performance Status ◽  
Infectious Complications ◽  
Hematologic Toxicity ◽  
Number Of Patients ◽  
Grade 3 ◽  
Number Of Cycles ◽  
Dose Delay

Abstract Background: CLL is a disease of the elderly and at least half of the patients requiring therapy are over age 70. While chemoimmunotherapy (CIT) has dramatically improved response rates in patients with CLL, some CIT regimens are not well tolerated by elderly patients. The MD Anderson group has reported that the fludarabine, cyclophosphamide, rituximab (FCR) regimen is not well tolerated in individuals ≥age 70 (Ferrajoli Leuk Lymph 46:S86). The German CLL Study Group has postulated that physiologic health is more important than chronologic age and have conducted a trial of FCR that permits enrollment of patients ≥age 70 provided they have a creatinine clearance (CrCl) ≥70 and good performance status (PS). While this approach expands the number of individuals who can receive CIT, it still excludes large percentages of CLL patients in need of treatment. Here, we examine how age, CrCl, and PS relate to the efficacy and tolerability of the pentostatin, cyclophosphamide, and rituximab (PCR) regimen. Methods: We treated 64 previously untreated CLL patients meeting NCI 96 criteria for treatment with pentostatin (2mg/m2), cyclophosphamide (600 mg/m2) and rituximab (375mg/m2) (Kay ASH 2006). All medications were administered on day 1 of every 3 week cycle with the intent of administering 6 cycles. We measured ECOG PS at study entry and used age, weight, and baseline creatinine to calculate the CrCl of all patients at study entry using the Cockroft-Gault equation. Results: Eighteen of 64 patients (28%) were ≥age 70. Although individuals ≥age 70 were more likely to have a dose delay of >1 week at some point during the trial (7% vs. 28%; p=0.03), there was no difference in the average number of cycles administered, the number of patients requiring dose reductions, or the number of patients with grade 3/4 hematologic toxicity, infectious complications, or other non-hematologic toxicity. No difference in OR (93% vs 83%; p=0.34) or CR (41% vs. 39%; p=0.86) was observed between patients <age 70 compared to those ≥70. We next evaluated whether CrCl related to the efficacy and tolerability of PCR. 25 patients (39%) had a CrCl<70, including 15 (23%) with a CrCl<60 and 5 (8%) with CrCl<50. Although individuals with CrCl<70 were more likely to have a dose reduction (5% vs. 24%; p=0.05), there was no difference in the average number of cycles administered, the number of patients requiring a dose delay, or the number of patients with grade 3/4 hematologic toxicity, infectious complications, or other non-hematologic toxicity. No difference in OR (89% vs 92%; p=1.0) or CR (45% vs. 36%; p=0.60) was observed between patients with CrCl≥70 and those with CrCl<70. We next evaluated how PS related to the efficacy and tolerability. 34 patients (53%) were PS 0 and 30 (47%) were PS≥1. This analysis suggested PCR was well tolerated among those with PS≥1. Again no difference in the OR or CR was observed between patients with PS 0 and those with PS≥1. Conclusions: In this phase II clinical trial, the PCR regimen was well tolerated by patients ≥age70, those with higher PS, and the 25 individuals with CrCl≤70 (range 34–67). The efficacy of PCR was also not significantly affected by age, renal function, or performance status. These findings suggest the PCR regimen may be superior to the FCR regimen for elderly patients and those with decreased renal function.

scholarly journals INNV-28. TEMOZOLOMIDE IN RENAL DYSFUNCTION

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii122-ii122
Author(s):  
Kayla Garzio ◽  
Kelly McElroy ◽  
Stuart Grossman ◽  
Matthias Holdhoff ◽  
Byram Ozer ◽  
...  
Keyword(s):  
Renal Function ◽  
Medical Records ◽  
Alkylating Agent ◽  
Primary Cns Lymphoma ◽  
Cns Lymphoma ◽  
High Grade ◽  
Secondary Endpoints ◽  
Grade 3 ◽  
Number Of Cycles ◽  
Experienced Grade

Abstract BACKGROUND Temozolomide (TMZ) is a cytotoxic DNA alkylating agent. It is the only chemotherapy known to improve survival in patients with high grade astrocytomas. The active alkylating species, methylhydrazine, is not recovered in the urine and thus renal function is not expected to affect clearance of this agent. It has never been formally evaluated in adults with eGFR &lt; 36 mL/min/1.73 m2, and it is often recommended to administer with caution, dose reduce, or withhold therapy. However, lacking other effective therapies, we have elected to administer TMZ at full dose to these patients. This IRB approved retrospective study was conducted to evaluate the safety of this practice. METHODS The primary endpoint was to characterize the incidence and severity of thrombocytopenia in patients with renal impairment defined as eGFR &lt; 60 mL/min/1.73 m2 who received TMZ for the treatment of their high grade gliomas (HGG) or primary CNS lymphoma (PCNSL). Secondary endpoints included incidence and severity of neutropenia, lymphocytopenia, hepatotoxicity, and number of cycles administered. Medical records were reviewed for adult patients with HGG or PCNSL treated with TMZ from October 1, 2016-September 30, 2019. RESULTS Thirty-four patients met criteria for inclusion. Of the 7 patients with eGFR &lt; 36 mL/min/1.73m2, 33/34 cycles (97%) were completed successfully without grade 3–4 thrombocytopenia. No patients experienced grade 3–4 neutropenia, and grade 3–4 lymphocytopenia occurred in 5 cycles (15%). One patient required discontinuation of TMZ 7 days prior to completion of radiation due to thrombocytopenia. CONCLUSION The side effect profile from TMZ administered to patients with eGFR &lt; 36 mL/min/1.73 m2 appears to be similar to that of patients with normal renal function. This is not an unanticipated finding given what is known about the metabolism of the drug.

scholarly journals DIFFERENCE IN BLOOD FUNCTION TOXICITY BETWEEN STADIUM IIB-IIIB SQUAMOUS CELL CERVICAL CANCER PATIENTS WITH PACLITAXEL CISPLATIN AND PACLITAXEL CARBOPLATIN CHEMOTHERAPY AT SANGLAH HOSPITAL, DENPASAR.

2018 ◽  
Vol 11 (1) ◽  
pp. 224
Author(s):  
Indrayathi Pa ◽  
Noviyani R ◽  
Niruri R ◽  
Budiana Ing ◽  
Tunas K
Keyword(s):  
Cervical Cancer ◽  
Observational Research ◽  
Hematologic Toxicity ◽  
Inclusion Criteria ◽  
Cancer Treatments ◽  
Exclusion Criteria ◽  
Consecutive Sampling ◽  
Normality Test ◽  
Before And After ◽  
The Difference

 Objective: Paclitaxel cisplatin and paclitaxel carboplatin were chemotherapy regimens used for cervical cancer treatments at Sanglah Hospital, Denpasar. They came with hematologic toxicity side effects. This could be monitored from hemoglobin, thrombocyte, and leukocyte parameter. Data that compared the toxicity of these two regimens were still limited at Sanglah Hospital, Denpasar. Therefore, it was necessary to conduct a research about the difference in blood function toxicity between patients who underwent paclitaxel cisplatin chemotherapy and those who underwent paclitaxel carboplatin chemotherapy based on those three parameters.Methods: This was a prospective observational research with consecutive sampling, inclusion, and exclusion criteria. It was carried out from January to August 2016 at Sanglah Hospital, Denpasar. Patients were categorized into two groups based on their chemotherapy regimens. Next, blood samples from both groups were tested for its hemoglobin, thrombocyte, and leukocyte level before and after chemotherapy. The data underwent normality test using either Shapiro–Wilk or Mann–Whitney test with SPSS.Results: There were 17 patients who fulfilled the inclusion criteria. The result showed a decrease in hemoglobin, thrombocyte, as well as leukocyte values in patients who underwent paclitaxel cisplatin and paclitaxel carboplatin chemotherapy.Conclusion: The decrease of both hemoglobin and leukocyte level was not meaningful in both groups (p>0.05). Meanwhile, the decrease of thrombocyte level was meaningful in both groups (*p<0.05) in which patients who belong to paclitaxel carboplatin chemotherapy group showed a higher decrease of thrombocyte values.

Chemoradiation for locally advanced perihilar cholangiocarcinoma.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 372-372
Author(s):  
Seungtaek Lim ◽  
Hye Jin Choi ◽  
Jinsil Seong
Keyword(s):  
Therapeutic Option ◽  
External Beam Radiotherapy ◽  
Objective Response ◽  
Locally Advanced ◽  
Predictive Marker ◽  
Hematologic Toxicity ◽  
Dismal Prognosis ◽  
The Difference ◽  
Grade 3 ◽  
Rare Malignancy

372 Background: Locally advanced perihilar cholangio-carcinoma (LA-PHC) is a rare malignancy with dismal prognosis, and chemoradiation (CRT) is used to palliate symptoms and extend survival. However, its role has not been established due to the rarity of these tumors. We intended to investigate the efficacy of chemo-concurrent radiotherapy (CRT) for patients with LA-PHC. Methods: This study included 52 patients who received CRT for LAPHC in a single institue. Patients received external beam radiotherapy with a median dose of 50.4Gy (range, 720-5400) with gemcitabine or 5-FU (or its analogues). The objective response rate (ORR), disease control rate (DCR), and overall survival (OS) were evaluated. All statistical analysis were performed by SPSS program version 18.0. Results: The median OS was 14.2 months (95% CI, 8.9~19.5). The ORR and DCR was 12% and 85%, respectively. Thirteen patients (19%) whose disease were converted to resectable after CRT had a significant survival advantage compared to patients who underwent CRT alone (29.2 vs. 10.8 months, P=0.005). CA 19-9 response (defined as more than 30% decrease in the CA 19-9 level compared to baseline) at 1month after CRT predicted prolonged survival (Table). CRT was generally well tolerated. Although gemcitabine-based CRT had a higher ORR, DCR, and CA 19-9 response at 1 month than 5FU-based CRT, the difference was not statistically different, and there was no difference in OS between two regimens. Moreover, patients treated with gemcitabine based CRT suffered more severe hematologic toxicity (grade 3 or 4 neutropenia, 20% vs. 4%). Conclusions: This study suggested that CRT is a good therapeutic option in the treatment of LA-PHC. Also, CA 19-9 response 1 month after completion of CRT was identified as a predictive marker of survival in patients who underwent CRT. Further research is warranted regarding optimal chemotherapy regimen, and schedule of radiation. [Table: see text]

FOLFIRINOX in pancreatic cancer patients age 75 years or older.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 362-362 ◽  
Author(s):  
Jonathan Mizrahi ◽  
Jane Rogers ◽  
Kenneth R. Hess ◽  
Robert A. Wolff ◽  
Gauri Rajani Varadhachary ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Progression Free Survival ◽  
Standard Of Care ◽  
Initial Study ◽  
Similar Efficacy ◽  
Median Number ◽  
Hematologic Toxicity ◽  
Grade 3 ◽  
Md Anderson ◽  
Number Of Cycles

362 Background: Although FOLFIRINOX (5-Fluorouracil + leucovorin + irinotecan + oxaliplatin) is now the standard of care for patients (pts) with metastatic pancreatic cancer (PC) based on the 2011 study by Conroy et al. which demonstrated improved median overall survival (mOS) (11.1 vs 6.8 months [m] with gemcitabine, P < 0.001), pts > 75 yrs old were excluded from this study. As per SEER 2011-2015 data, 38% of new PC cases are diagnosed in pts age > 75. The purpose of this study was to assess the safety and efficacy of FOLFIRINOX in this group of pts. Methods: We retrospectively analyzed unresectable PC pts, age ≥ 75, treated with FOLFIRINOX at MD Anderson since 2011. Data obtained include demographics, line of treatment (tx), starting dose, progression free survival (PFS), OS and toxicities. Response was determined by chart documentation. Primary outcomes were mOS and rates of grade 3/4 hematologic toxicity (HT). Results: A total of 24 pts (19 male) were included with median age of 76 (range 75 to 84). 18 had metastatic disease, and FOLFIRINOX was the 1st line of tx for 18 of the 24 pts. The median number of cycles administered was 4 (range 1 to 12). The most frequent starting doses of infusional 5-FU, irinotecan and oxaliplatin were 2400, 150 and 75 mg/m2, respectively. Bolus 5-FU and leucovorin were omitted in all but 3 pts. Median PFS was 3.7 m (95% CI: 3.0-5.7) with mOS of 11.6 m (95% CI: 6.14-15.7). 16 pts (67%) experienced disease control (response to tx or stable disease). Grade 3 or 4 HT occurred in 11 pts (46%), and 9 (38%) were supported with granulocyte colony-stimulating factor at some point during tx. 6 pts (25%) required hospital admission for any toxicity, most commonly infection (3 pts), and 10 (42%) stopped FOLFIRINOX due to toxicity, most commonly fatigue (6 pts). Conclusions: In this single-center retrospective analysis of 24 unresectable PC pts age 75 or older given FOLFIRINOX, OS outcomes were similar to those reported by Conroy et al in the original trial which excluded pts older than 75. In our review, toxicities including incidences of grade 3 or 4 HT were similar to those reported in the initial study. These data indicate that the use of modified dosing FOLFIRINOX in advanced PC pts older than 75 appears to maintain similar efficacy and toxicity when compared to younger pts.

Bortezomib + Low Dose Cytarabine in Int-2 and High Risk MDS. Interim Results of a Phase I/II Trial by the GFM.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1453-1453 ◽  
Author(s):  
Shanti Natarajan ◽  
Pierre Fenaux ◽  
Norbert Vey ◽  
A. Guerci ◽  
I. Coulibaly ◽  
...  
Keyword(s):  
High Risk ◽  
Phase I ◽  
Low Dose ◽  
Specific Inhibitor ◽  
Median Number ◽  
Infectious Complications ◽  
High Risk Population ◽  
Hematologic Toxicity ◽  
Grade 3 ◽  
Number Of Cycles

Abstract Background: We (Blood.2006;107:1156) and others showed that marrow cells from high-risk MDS patients exhibit constitutive NF-kB activation. Bortezomib (BOR) is a specific inhibitor of NF-kB with limited efficacy when used alone in AML but which is potentiated by its association with chemotherapy especially Cytarabine (AraC) (Cancer Chem Pharm.2006;58:13). Methods: The GFM performed a phase I–II study of BOR in association with low dose AraC (LDAraC) in MDS patients (pts) with intermediate-2 or high IPSS (including RAEB-T). Pts received BOR 1.5 mg/m2 on d 1,4,8,11 and AraC 10mg/m2 d1-14, q 28 days for 4 cycles. In the absence of DLT AraC was increased to 20mg/m2 after cycle 1. Dose reductions were made to BOR (1.3 and 1.0 mg/m2) for NCI-CTCAE &gt;Grade 2 non and &gt;Grade 3 hematologic toxicity. Response was evaluated after 2 and 4 cycles (IWG 2006 criteria). Responding pts could receive up to 4 additional cycles. Results: 44 pts were included between June 2006 and July 2007 (total 49 planned). 37 pts included &gt;8 weeks before date of first interim analysis (1 Jul 2007), were evaluable. Median age 72 yrs (range 54–88) and M:F ratio 25:12. Diagnosis: 2 RA, 3 RAEB-1, 23 RAEB-2, 7 RAEB-T and 2 MDS with myelofibrosis. Prior treatment: 4 LDAraC, 2 intensive chemotherapy, 3 Azacytidine. IPSS: 18 int-2; 19 high. Karyotype was good, intermediate, poor and not done in 14, 4, 18 and 1 pt, respectively (resp). 25 pts had either poor karyotype or were pretreated. Plts were &lt;100 G/L in 30 pts and ANC &lt;1.5 G/L in 30 pts. Median number of cycles received 2.4 (range 1–8). Five responding pts received 2–4 additional cycles. There were 9 AraC dose escalations and 22 BOR reductions. Death with no evidence of progression (&lt; 8 weeks) occurred in 2 pts (sepsis). Nine of the 37 pts (24%), had responses including 3 CR, 2 PR, 1 marrow CR (mCR) with HI and 3 HI. Of the remaining 26 pts 3 were stable after 4 cycles and 23 had progressed. Responses were seen after 3 or more cycles in 8 pts. 3 of 18 pts (17%) with poor karyotype achieved responses (1CR, 1mCR and 1HI) vs 2 of 4 pts with intermediate karyotype (2CR) and 4 of 14 pts (29%) with favourable karyotype (2PR and 2HI). All 9 responses were seen in the 28 previously untreated pts (32%) vs no responses in the 9 pretreated pts. Duration of CR was 9+, 8+ and 8+ mos, PR was 9+ and 6+ mos, mCR was 5+ mos, and HI was 10+,11+ and 12+ mos resp. 27 patients were alive. The 10 deaths were due to 8 progressions and 2 infectious complications. Hospitalization was required in 22 pts during treatment. Non fatal SAEs were mainly due to infections (14), bleeding (7) and skin eruptions (2). Neurotoxicity was seen in 4 pts (1 Gr 3 and 3 Gr 2). Conclusion: In this high risk population BOR + LDAraC gave a 24% response rate (32% in previously untreated pts). Responses were seen including in pts with unfavourable karyotype who generally fail LDAraC alone. Neurotoxicity was only seen in 4 patients. However, there was significantly more myelosupression than with LDAraC alone. An update will be given.

Phase I study of docetaxel and 153Sm repetitively administered for castrate metastatic prostate cancer (CMPC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5152-5152
Author(s):  
M. J. Morris ◽  
N. Pandit-Taskar ◽  
A. J. Amodio ◽  
G. A. Gignac ◽  
E. Flatts ◽  
...  
Keyword(s):  
Optimal Dose ◽  
Time Frame ◽  
Hematologic Toxicity ◽  
Toxicity Profile ◽  
Treatment Delays ◽  
The Mean ◽  
Grade 3 ◽  
Number Of Cycles ◽  
Baseline Psa ◽  
Final Cohort

5152 Background: Docetaxel (Tax) prolongs survival in patients (pts) with CMPC. Early clinical data suggest that Tax combined with bone seeking radiopharmaceuticals may improve survival relative to chemotherapy alone. 153Sm-lexidronam (Sam) (Quadramet, Cytogen Inc.) is a radiopharmaceutical with a short T1/2 and a favorable toxicity profile. Methods: Pts with progressive CMPC are treated in cohorts of 3–6. Prior treatment with taxanes is permissible. Cohorts are defined by dose escalations of: Tax 65, 70, 75, 75, 75 mg/m2 and Sam 0.5, 0.5, 0.5, 0.75, 1 mCi/kg. Each cycle is 6 weeks. Tax is given day 1 and 22 and Sam day -1 to 1 of each cycle. DLT is defined as cycle 1 = grade 3 non-hematologic toxicity, grade 3 neutropenia that lasts for >29 days, or grade 3- 4 anemia or thrombocytopenia of = 5 days. Pts with an ANC of grade 0–1 or platelet count (PLT) of >100,000/mm3 at the end of cycle 1 may receive additional cycles. Pts are treated until progression or toxicity. Results: 18 pts have been treated in 5 cohorts of 3 pts to date. 6 pts were treated in cohort 2. Two pts have not yet received enough treatment to be evaluable. DLT has not yet been reached. The mean number of cycles/pt is 3 (range 1–6). As anticipated, toxicities have primarily been hematologic (see table ). Two pts came off study for hematologic toxicity; one in cohort 2 had grade 3 PLT after 5 cycles and has not recovered at >175 days and 1 pt (cohort 2) failed to recover PLT in the allotted time frame during cycle 4 prohibiting further treatment. No other pts required treatment delays for hematologic toxicity. Mean baseline PSA was 294.6ng/ml with 7/16 (44%) pts achieving = 50% decline in PSA. Conclusions: Coadministration of Tax and Sam has been well tolerated. Repetitive dosing is feasible. Standard approved doses of each drug are being tested in the present (and final) cohort. DLT has not yet been reached. Accrual continues, to refine the optimal dose and schedule in preparation for phase II. Support: Cytogen, Inc., NIH CA102544 [Table: see text] No significant financial relationships to disclose.

scholarly journals DIFFERENCE IN BLOOD FUNCTION TOXICITY BETWEEN STADIUM IIB-IIIB SQUAMOUS CELL CERVICAL CANCER PATIENTS WITH PACLITAXEL CISPLATIN AND PACLITAXEL CARBOPLATIN CHEMOTHERAPY AT SANGLAH HOSPITAL, DENPASAR.

2018 ◽  
Vol 11 (1) ◽  
pp. 224
Author(s):  
Indrayathi Pa ◽  
Noviyani R ◽  
Niruri R ◽  
Budiana Ing ◽  
Tunas K
Keyword(s):  
Cervical Cancer ◽  
Observational Research ◽  
Hematologic Toxicity ◽  
Inclusion Criteria ◽  
Cancer Treatments ◽  
Exclusion Criteria ◽  
Consecutive Sampling ◽  
Normality Test ◽  
Before And After ◽  
The Difference

 Objective: Paclitaxel cisplatin and paclitaxel carboplatin were chemotherapy regimens used for cervical cancer treatments at Sanglah Hospital, Denpasar. They came with hematologic toxicity side effects. This could be monitored from hemoglobin, thrombocyte, and leukocyte parameter. Data that compared the toxicity of these two regimens were still limited at Sanglah Hospital, Denpasar. Therefore, it was necessary to conduct a research about the difference in blood function toxicity between patients who underwent paclitaxel cisplatin chemotherapy and those who underwent paclitaxel carboplatin chemotherapy based on those three parameters.Methods: This was a prospective observational research with consecutive sampling, inclusion, and exclusion criteria. It was carried out from January to August 2016 at Sanglah Hospital, Denpasar. Patients were categorized into two groups based on their chemotherapy regimens. Next, blood samples from both groups were tested for its hemoglobin, thrombocyte, and leukocyte level before and after chemotherapy. The data underwent normality test using either Shapiro–Wilk or Mann–Whitney test with SPSS.Results: There were 17 patients who fulfilled the inclusion criteria. The result showed a decrease in hemoglobin, thrombocyte, as well as leukocyte values in patients who underwent paclitaxel cisplatin and paclitaxel carboplatin chemotherapy.Conclusion: The decrease of both hemoglobin and leukocyte level was not meaningful in both groups (p>0.05). Meanwhile, the decrease of thrombocyte level was meaningful in both groups (*p<0.05) in which patients who belong to paclitaxel carboplatin chemotherapy group showed a higher decrease of thrombocyte values.

Preparation of Targeted Drug-Loaded Nanobubbles and Its Effect in Improvement of Renal Function in Patients with Hyperuricemia

2021 ◽  
Vol 13 (3) ◽  
pp. 509-515
Author(s):  
Han Xia ◽  
Yujing Zhang ◽  
Gengxin Guo ◽  
Aixiang Liu ◽  
Jing Liu
Keyword(s):  
Renal Function ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Effective Rate ◽  
Control Group ◽  
Before And After ◽  
Targeted Drug ◽  
The Difference ◽  
Experimental Group

The effects of targeted drug-loaded nanobubble (DLNB) on the treatment of patients with hyperuricemia (HUA) and the improvement of renal function were explored by constructing targeted DLNB. G250 targeted allopurinol-loaded NB (ANBs) was prepared by filming-rehydration method and its physicochemical properties were investigated. A total of 80 patients with HUA admitted to the hospital from July 2017 to July 2019 were selected and divided into control group and experimental group, with 40 patients in each group, treated for 4 weeks. Blood UA (UA), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), alanine transaminase (ALT), aspartate transaminase (AST), blood urea nitrogen (BUN), blood creatinine (Cr) and other related indicators were compared before and after treatment. Targeted ANBs was successfully constructed and its targeting in vitro was guaranteed. The effective rate of control group was 65.00%, and that of experimental group was 77.50%, with evident difference (P < 0.05). In contrast to control group, UA, TC, TG, HDL, and LDL were notably decreased in the experimental group after treatment, and the difference was evident (P < 0.05). ALT, AST, BU, and Cr also showed notable improvement (P < 0.05). Targeted ANBs had good therapeutic effect on patients with HUA, and it also played a certain role in improving liver function and kidney function in HUA patients.

Dasatinib (D) vs high dose imatinib (IM) in patients (pts) with chronic phase chronic myeloid leukemia (CP-CML) resistant to imatinib. Results of CA180017 START-R randomized trial

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6507-6507 ◽  
Author(s):  
N. P. Shah ◽  
P. Rousselot ◽  
R. Pasquini ◽  
N. Hamerschlak ◽  
J. Holowiecki ◽  
...  
Keyword(s):  
Dose Reduction ◽  
Kinase Inhibitor ◽  
Chronic Phase ◽  
Cytogenetic Response ◽  
High Dose ◽  
Hematologic Toxicity ◽  
Inadequate Response ◽  
The Difference ◽  
Grade 3

6507 Background: High dose imatinib (800 mg/day) has been shown to have efficacy in a subset of CML patients with resistance to IM, although the durability of responses is not well-established. Dasatinib (BMS-354825) is a novel, highly potent, oral multi-targeted kinase inhibitor of BCR-ABL and SRC with activity against 18/19 imatinib resistant BCR-ABL mutants tested in vitro. Methods: START-R is a multicenter randomized (2:1 ratio) trial of D 70 mg twice daily (bid) and IM 800 mg/day in pts with CP-CML resistant to prior IM 400 to 600 mg/day. Cross-over was allowed for lack of response or intolerance (grade 3–4 non hematologic toxicity). D dose escalation to 90 mg bid was allowed for inadequate response at 12 wks, and dose reduction to 50 or 40 mg bid for drug toxicity. IM dose reduction to 600 mg/day was allowed. Evaluations consisted of weekly blood counts for the first 12 wks, bone marrow cytology and cytogenetics every 12 wks. The primary endpoint was major cytogenetic response (MCyR) rate at wk 12. Results: From February 2005 to November 2005, 150 pts were randomized of whom the first 36 pts (D 22, IM 14) are reported. Median age was 57 yrs, with 12 males and 24 females. Treatment groups were balanced with respect to CML characteristics; median time from initial diagnosis was 61 months for D and IM; prior interferon 64% and 79%; no prior CyR on IM 36% and 57%. BCR-ABL mutations were documented in 10 D pts and 1 IM pt. Dose reductions were required in 8 D pts and 1 IM pt. Complete hematologic response was documented in 21 D and 13 IM pts. MCyR rate at 12 wks was 45% for D and 21% for IM (7 complete for D and 1 for IM). With a 95% CI on the difference between D and IM was - 9.9 to +51.2. Two (9%) D and 11 (79%) IM pts crossed over for intolerance (1 D and 6 IM) or no MCyR (1 D and 5 IM). Grade 3–4 neutropenia or thrombopenia occurred in 8 and 9 dasatinib pts and in 8 and 2 IM pts. Most common grade 1–2 non-hematologic toxicities in D and IM groups were diarrhea (7 and 1 pts), nausea (7 and 7 pts), and facial/peripheral edema (8 and 7 pts). Conclusions: Dasatinib was effective in pts with CP-CML resistant to IM 400 to 600 mg/day. Preliminary data suggest that D is more effective and better tolerated than high dose IM. An updated analysis of all randomized pts will be presented. [Table: see text]

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