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Prolonged chronic phase in chronic myelogenous leukemia after homoharringtonine therapy.
Li, YF, Deng, ZK, Xuan, HB, Zhu, JB, Ding, BH, Liu, XN, Chen, BA
Chinese medical journal. 2009;(12):1413-7
Abstract
BACKGROUND Homoharringtonine (HHT) is effective in treating late stage chronic myelogenous leukaemia (CML), but little is known about long term maintenance during complete cytogenetic response. Long term efficacy and toxicity profiles of low dose HHT were evaluated in this study. METHODS One hundred and six patients with CML received 1.5 mg/m(2) of HHT alone by continuous daily infusion for seven to nine days every four weeks. Of 79 patients in the control group, 31 were treated with interferon alpha (IFN-alpha) and 48 with hydroxycarbamide. For 17 patients who failed to achieve cytogenetic response within 12 months' treatment of IFN-alpha, HHT was administered. Quantitative RT-PCR was used to detect the BCR-ABL mRNA expression in 36 Philadelphia positive CML patients enrolled after 2007. Haematological and cytogenetic responses were evaluated in all patients at the 12th month of follow-up. Long term efficacy was assessed in a follow-up with a median time of 54 months (12 months-98 months). RESULTS After 12 months of therapy, cytogenetic response rate of the HHT, IFN-alpha and hydroxycarbamide groups were 39/106, 14/31 and 3/48, and corresponding molecular cytogenetic response rates 6/18, 3/8 and 0. Of the 17 patients who received HHT as salvage treatment, 6 achieved cytogenetic response (3 major). At the 48 months' follow-up, cytogenetic response was maintained in 32/39 patients treated with HHT. Patients who had cytogenetic response in HHT group or treated with IFN-alpha also showed longer median chronic durations, which were 45 months (12 months-98 months) and 49 months (12 months-92 months) respectively, indicating a longer survival time. CONCLUSIONS Low dose HHT alone showed considerable short term and long term efficacy in the treatment of late stage CML. It may also be a good choice for patients who have failed imatinib, IFN-alpha treatment or haematopoietic stem cell transplantation or cannot afford these treatments.
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Peripheral neuropathy due to paclitaxel: study of the temporal relationships between the therapeutic schedule and the clinical quantitative score (QST) and comparison with neurophysiological findings.
Augusto, C, Pietro, M, Cinzia, M, Sergio, C, Sara, C, Luca, G, Scaioli, V
Journal of neuro-oncology. 2008;(1):89-99
Abstract
Peripheral neuropathy (PN) is one of the most common and dose-limiting side effects of paclitaxel, a chemiotherapeutic drug of proven efficacy in various tumours. We investigated the pathophysiological features of the PN and the temporal relationships between the development of the symptoms and signs associated with paclitaxel administration in two groups of patients with breast cancer: group A received paclitaxel alone (total cumulative dose range: 950-2,475 mg/m2), and group B paclitaxel and adriamycin (total cumulative dose range: 700-2,800 mg/m2). A codified assessment scoring clinical sensory and motor functions according to the Common Toxicity Scale and neurophysiological measurements were made before treatment, after the third and sixth cycles, and at the end of therapy. A total neuropathy score (TNS) included selected clinical and neurophysiological parameters. Both positive and negative sensory and motor symptoms and signs of PN developed during therapy, the most common being painful paresthesias, global areflexia and distal weakness. The neurophysiological study showed an early onset, length-independent and progressive sensory defect, and delayed, distal and length-dependent motor deficits. The neuropathy progressed faster in group A than in group B but, after therapy, most of the patients were TNS grade 2 regardless of their group. The temporal relationships between the PN and paclitaxel were robustly characterised, and thus provide reference data and a model for testing the efficacy of drugs designed to provide neuroprotection.
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3.
[Role of immunomodulatory treatment with Iscador QuS and Intron A of women with CIN1 with concurrent HPV infection].
Jach, R, Basta, A, Szczudrawa, A
Ginekologia polska. 2003;(9):729-35
Abstract
OBJECTIVE The paper presents the role of immunomodulatory treatment with Iscador QuS and Intron A of women with CIN1 and CIN2 with concurrent HPV infection. MATERIAL AND METHODS Clinical material consisted of 96 women aged 18-52 years of life. The women were divided into three groups. Group A (35 women) treated with Iscador QuS administered s.c. twice a week for 3 months, group B (30 women) treated with Intron A, administered twice a week in the cervical injections for 3 months and control group K (31 women) without treatment followed up with cytology and colposcopy. RESULTS In the group A (Iscador QuS) CIN remission was observed in slightly higher percentage (non significant) comparing to the control group. In the group B (Intron A) remission CIN was observed in 24 (80%) cases which was statistically significant comparing to the control and A groups. There were no progression of CIN in the group B and the stationery process was observed statistically more frequent comparing to the control and A groups. There was observed statistically higher percentage of cases without HPV infection in all groups during the experiment. The remission concerned both high and low oncogenic potency viruses. In the highest percentage CIN with concurrent HPV infection remission was observed in the B (Intron A) group. CONCLUSIONS 1/Iscador QuS and specially Intron A increases the CIN1 and CIN2 remission rate. 2/These two agents may also affect the HPV remission.
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4.
Effects of paclitaxel on CA-125 serum levels in ovarian cancer patients.
Paulsen, T, Marth, C, Kaern, J, Nustad, K, Kristensen, GB, Tropé, C
Gynecologic oncology. 2000;(3):326-30
Abstract
OBJECTIVE As in vitro activation of ovarian carcinoma cells in terms of CA-125 secretion by taxanes has been demonstrated, we were interested in whether taxanes also modulate CA-125 expression in vivo. METHODS Serum CA-125 was determined immediately before and 24 h after paclitaxel-containing chemotherapy in 53 ovarian carcinoma patients. To test the quality of the analysis methods and the biological variation of untreated patients, serum CA-125 levels of two control groups were analyzed. RESULTS Median CA-125 concentration was 107 kU/liter 24 h after chemotherapy treatment compared with 99 kU/liter the day before paclitaxel treatment. Changes in CA-125 serum levels observed immediately after paclitaxel treatment were not correlated to treatment response. However, overall change in CA-125 serum concentration was a good predictor of response to paclitaxel containing treatment. Patients achieving a complete or partial response had a significant reduction of median CA-125 levels, whereas tumor progression was associated with increased CA-125 levels. Only for the group of patients obtaining a complete response was a decrease in the median relative CA-125 value observed. CONCLUSION Paclitaxel-induced modulation of CA-125 expression could not be confirmed in vivo.
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5.
Irinotecan(Campto R): efficacy as third/forth line therapy in advanced pancreatic cancer.
Klapdor, R, Fenner, C
Anticancer research. 2000;(6D):5209-12
Abstract
Following the concept that the actual survival of pancreatic cancer patients can only be significantly improved by sequential poly-chemotherapy (EOSPC) in order to add one or two further progression free-survival times (PFST), in addition to the potential antitumoral effects of a first- or second-line therapy we studied the therapeutic efficacy of a third- or fourth-line chemotherapy with irinotecan alone, or in combination with oxaliplatin and high dose 5-FU/FA respectively, in a pilot study in 17 patients. Follow-up was performed on the basis of clinical investigations, imaging methods and the course of tumor markers, mainly CT and CA 19-9. The overall response rate in these cases of third/fourth-line therapies was 1 PR, 4 MR, 6 SD in the imaging methods compared to 5 PR, 2 MR and 5 SD on the basis of the tumor marker courses in the serum. The median PFST amounted to 4 months. Side effects could be seen as reported in the literature. Only in 1 patient did treatment have to be stopped due to irinotecan-induced gastrointestinal symptoms. Our data might suggest that combinations are more effective than irinotecan alone. However, further studies have to demonstrate whether irinotecan alone or in combination with e.g. oxaliplatin and 5-FU/FA will be more effective. The results suggested that irinotecan alone or in combination might also be used as third- and fourth-line therapeutical trials in exocrine pancreatic cancer in order to improve the survival time of these patients based on efficacy orientated sequential poly-chemotherapy (EOSPC).