Influence of initial platinum-based chemotherapy on levels of He-4 protein and VEGF-A in primary tumors and metastases from ovarian cancer

Introduction. Recently, the he-4 protein has received great attention due to its diagnostic and prognostic abilities in epithelial ovarian cancer. In addition to its diagnostic value, this protein is involved in the pathogenesis of ovarian cancer. Another significant pathogenetic factor is the vascular endothelial growth factor (vegf) which plays a key role in neoangiogenesis. The purpose of the study focused on the analysis of he-4 and vegf-a levels in tissues of ovarian cancer, in healthy contralateral ovaries and in common metastatic tumors in the omentum and peritoneum to determine the place and role of these tumor markers at the stages of carcinogenesis. Material and methods. The study was performed using the abovementioned tissues of 93 patients with t2-3nхm0-1 ovarian cancer. 51 patients underwent surgery followed by chemotherapy. 42 patients received initial neoadjuvant chemotherapy followed by surgery and adjuvant cytostatic therapy. Tissue samples from 17 patients with benign diseases were used as the control for determining the reference values for he-4 and vegf-a. A comparison was made between groups of patients with and without neoadjuvant therapy, as well as in groups of patients depending on the effectiveness of cytostatic treatment. Results. The levels of he-4 in primary and metastatic tissues affected and not affected by cancer were initially elevated in patients with ovarian cancer. The chemotherapy effectiveness directly correlated with the level of he-4 reduction, which did not change or increased in tumors resistant to medical treatment. The level of vegf-a significantly differed in cancer and non-cancer tissues, which indicated its significant pathogenetic effect not “before”, but at the stages of morphological malignization. The dynamics of vegf-a decrease in this study did not depend on the chemotherapy effect. Conclusion. The he-4 marker is a pathognomonic factor in the development of ovarian cancer, preceding morphological signs of malignancy and reflecting the effectiveness of chemotherapy, while vegf-a is most likely a consequence of the cancer development.

Cytostatic treatment with irinotecan liposomal in a patient with advanced pancreatic adenocarcinoma

Pancreatic cancer is one of the most common malignant neoplasms with a short survival time and a low cure rate. This neoplasm progresses quickly, it is often diagnosed in the advanced stage, which means that systemic treatment regimens are not sufficiently effective. A case of 65-year-old patient with metastatic pancreatic cancer who underwent sequential chemotherapy with the use of liposomal irinotecan was presented.

Immunomodulating properties of the probiotic preparation, VedaBiotic in aging

The homeostatic immunological dialogue between the host and its microbiota is critical to maintaining health. The weakening of the organism occurring with age, its greater dependence on the external life conditions, make old age the period of the greatest morbidity. In the context of a progressive increase in life expectancy, more and more attention is being paid to the possibility of influencing human health through personalized nutritional and therapeutic strategies aimed at modifying the intestinal microbiota, which include the use of pro- and prebiotics. The aim of this work is to study the effect of the VedaBiotic preparation, which is an original complex of probiotics (freeze-dried biomass of live active bifidobacteria, lactobacilli, Streptococcus thermophilus), prebiotics (microcrystalline cellulose, lactulose) and vitamin C, on the cellular immune response and functional activity of immunocytes in age-dependent mammals (male mice at the age of 10 months). It was found that in age-dependent mammals, a course administration of the drug leads to the stimulation of the proliferative activity of immunocytes and the cellular immune response, also including the case of the induced immunosuppression (when the delayed-type hypersensitivity reaction increased to the level observed in intact animals of similar age). The VedaBiotic also has a modulating effect on the cytokines production, causing a decrease in the pro-inflammatory cytokines IL-1β and IFN-γ, and an increase in the anti-inflammatory cytokine IL-10. Thus, the VedaBiotic preparation has a favorable immunomodulatory effect and can be used as a nutritional supplement — as a source of probiotic microorganisms — to reduce the negative side effects of cytostatic treatment, as well as by elderly persons to improve the quality of life and to prevent the development of age-associated pathology.

Langerhans Cell Histiocytosis in Adults: Treatment Opportunities of Today

Langerhans cell histiocytosis (LCH) is an extremely rare disease associated with tissue infiltration by pathological cells which are phenotypically similar to normal Langerhans cells. Standard therapy of LCH in adults has not been developed so far, due to the lack of sufficient evidence base for different treatment methods. In clinical practice, cytostatic treatment is applied along with new approaches using signaling pathway inhibitors involved in LCH pathogenesis. This literature review covers currently existing methods of LCH therapy in adults and their feasibility in clinical practice.

Bilateral Ocular Exophthalmia – A Case of Atypical Acute Myeloblastic Leukemia in a Child

IntroductionIn acute myeloblastic leukaemia (AML) explosive proliferation and accumulation of immature myeloid cell clones take place, replacing the bone marrow, with the possibility of the formation of extramedullary tumour masses composed of myeloid cells. The onset of the disease less frequently consists of symptoms of extramedullary manifestation.Case presentationA Caucasian male child aged three years and 11 months was hospitalized for bilateral exophthalmos and otorrhea, due to an alteration in his general condition. Ocular ultrasound revealed an inhomogeneous thickening of the upper right muscles superior to the eyeball. A complete blood count showed severe anaemia, leucocytosis with neutropenia and thrombocytopenia. A peripheral blood smear evidenced myeloblasts. The result of the cytology of bone marrow confirmed the diagnosis of AML. Following blood product replacements and cytostatic treatment (AML-BFM 2004 HR protocol), the remission of exophthalmos and the correction of haematological parameters were favourable.ConclusionIn a child with a sudden onset of exophthalmia and altered general condition, the diagnosis of acute leukaemia should be considered. The importance of performing a peripheral blood smear and bone marrow examination is emphasized so that diagnosis and initiation of treatment are not delayed.

Internal organ lesions in patients with acute leukemia according to autopsy data

The analysis of the condition of the internal organs in 17 patients with acute leukemia who died before treatment and at various stages of the antitumor cytostatic treatment was performed. In those cases when patients died before the start of cytostatic treatment, almost all internal organs had a specific lesion of blast cells, which was the cause of death in these patients. In patients who died in a state of myelotoxic aplasia of hematopoiesis, the cause of death was gross dystrophic changes in the internal organs, which led to multiple organ failure due to resistant sepsis.

N-glycomic analysis of Z(IgA1) partitioned serum and salivary immunoglobulin A by capillary electrophoresis..

Aims: To apply capillary electrophoresis with laser induced fluorescence detection (CE-LIF) to identify the N-glycosylation structures of serum and saliva IgA from healthy controls and patients with malignant hematological diseases having cytostatic treatment induced mild oral mucosal lesions. Background: Altered N-glycosylation of body fluid glycoproteins can be effective indicators of most inflammatory processes. Immunoglobulin A (IgA) is the second highest abundant of the immunoglobulins and has a major role in the immune-defense against potential pathogen attacks. While IgA is abundant in serum, secretory immunoglobulin A (sIgA) is one of the most prevalent proteins in mucosal surfaces such as in saliva. Objective: Our aim was to investigate the changes of IgA glycosylation in serum and saliva as a response to an administered cytostatic treatment in patients with malignant hematological disorders. Materials: Capillary electrophoresis with laser induced fluorescent detection (CE-LIF) was used to analyze the N-glycosylation profiles of Z(IgA1) partitioned immunoglobulin A in pooled serum and saliva of 10 control subjects and 8 patients with malignant hematological diseases having cytostatic treatment induced mild oral mucosal lesions. Results: Eight of 31 and four of 38 N-glycans in serum and saliva, respectively, showed significant (p<0.05) differences upon comparison to the control group. Thirteen glycans were present in the saliva but not in the serum, on the other hand six structures were found in the serum samples not present in the saliva. Conclusion: The developed Z(IgA1) partitioning and the high resolution CE-LIF based glyocoanalytical methods provided an efficient and sensitive workflow to detect and monitor IgA glycosylation alterations in serum and saliva with the scope for widespread molecular medicinal use.

Considerations on the Hematologic Toxicity of the all IC-BFM 2002/2009 Therapeutic Protocol in Children with Acute Lymphoblastic Leukemia

Acute lymphoblastic leukemia (ALL) is the most frequent malign hematologic disease in children. We studied the hematologic toxicity caused by the cytostatic treatment which was administered to the children diagnosed with ALL, according to the ALL-IC-BFM 2002/2009 protocol. The study included a number of 15 children with ALL who were treated from 2008 to 2018 within the Oncopediatrics Department of the 2nd Pediatric Clinic of the Emergency County Hospital in Craiova. We decided upon the level of toxicity in blood values, taking into account the severity level (G), according to the Common Terminology Criteria for Adverse Events 2010 guideline and we calculated the mean value of the hemoglobin, leukocytes, neutrophils, and thrombocytes in the children with ALL, for every phase of the cytostatic treatment. The most severe toxicity (grade 4 of severity) was registered in neutrophils (7/15 patients), during the induction and re-induction periods; 4 of these patients had severe infections.