179 research outputs found
Application of wastewater-based epidemiology to investigate stimulant drug, alcohol and tobacco use in Lithuanian communities
High Impact Of Human Leukocyte Antigen Matching On Overall Survival And Transplant Related Mortality In Allogeneic Hematopoietic Stem Cell Transplantation For CLL: Long-Term Study From The EBMT Registry
Effect of priming with granulocyte colony-stimulating factor on the outcome of chemotherapy for acute myeloid leukemia
BACKGROUND: Sensitization of leukemic cells with hematopoietic growth
factors may enhance the cytotoxicity of chemotherapy in acute myeloid
leukemia (AML). METHODS: In a multicenter randomized trial, we assigned
patients (age range, 18 to 60 years) with newly diagnosed AML to receive
cytarabine plus idarubicin (cycle 1) and cytarabine plus amsacrin (cycle
2) with granulocyte colony-stimulating factor (G-CSF) (321 patients) or
without G-CSF (319). G-CSF was given concurrently with chemotherapy only.
Idarubicin and amsacrin were given at the end of a cycle to allow the
cell-cycle-dependent cytotoxicity of cytarabine in the context of G-CSF to
have a greater effect. The effect of G-CSF on disease-free survival was
assessed in all patients and in cytogenetically distinct prognostic
subgroups. RESULTS: After induction chemotherapy, the rates of response
were not significantly different in the two groups. After a median
follow-up of 55 months, patients in complete remission after induction
chemotherapy plus G-CSF had a higher rate of disease-free survival than
patients who did not receive G-CSF (42 percent vs. 33 percent at four
years, P=0.02), owing to a reduced probability of relapse (relative risk,
0.77; 95 percent confidence interval, 0.61 to 0.99; P=0.04). G-CSF did not
significantly improve overall survival (P=0.16). Although G-CSF did not
improve the outcome in the subgroup with an unfavorable prognosis, the 72
percent of patients with standard-risk AML benefited from G-CSF therapy
(overall survival at four years, 45 percent, as compared with 35 percent
in the group that did not receive G-CSF [relative risk of death, 0.75; 95
percent confidence interval, 0.59 to 0.95; P=0.02]; disease-free survival,
45 percent vs. 33 percent [relative risk, 0.70]; 95 percent confidence
interval, 0.55 to 0.90; P=0.006). CONCLUSIONS: Sensitization of leukemic
cells with growth factors is a clinically applicable means of enhancing
the efficacy of chemotherapy in patients with AML
A phase 2 pilot study of pegfilgrastim and filgrastim for mobilizing peripheral blood progenitor cells in patients with non-Hodgkin's lymphoma receiving chemotherapy
Fluconazole for empiric antifungal therapy in cancer patients with fever and neutropenia
BACKGROUND: Several clinical trials have demonstrated the efficacy of fluconazole as empiric antifungal therapy in cancer patients with fever and neutropenia. Our objective was to assess the frequency and resource utilization associated with treatment failure in cancer patients given empiric fluconazole antifungal therapy in routine inpatient care. METHODS: We performed a retrospective cohort study of cancer patients treated with oral or intravenous fluconazole between 7/97 and 6/01 in a tertiary care hospital. The final study cohort included cancer patients with neutropenia (an absolute neutrophil count below 500 cells/mm(3)) and fever (a temperature above 38°C or 100.4°F), who were receiving at least 96 hours of parenteral antibacterial therapy prior to initiating fluconazole. Patients' responses to empiric therapy were assessed by reviewing patient charts. RESULTS: Among 103 cancer admissions with fever and neutropenia, treatment failure after initiating empiric fluconazole antifungal therapy occurred in 41% (95% confidence interval (CI) 31% – 50%) of admissions. Patients with a diagnosis of hematological malignancy had increased risk of treatment failure (OR = 4.6, 95% CI 1.5 – 14.8). When treatment failure occurred the mean adjusted increases in length of stay and total costs were 7.4 days (95% CI 3.3 – 11.5) and $18,925 (95% CI 3,289 – 34,563), respectively. CONCLUSION: Treatment failure occurred in more than one-third of neutropenic cancer patients on fluconazole as empiric antifungal treatment for fever in routine clinical treatment. The increase in costs when treatment failure occurs is substantial
Using psychodynamic small group work in nurse education: Closing the theory–practice gap?
Breast tumour angiogenesis
The central importance of tumour neovascularization has been emphasized by clinical trials using antiangiogenic therapy in breast cancer. This review gives a background to breast tumour neovascularization in in situ and invasive breast cancer, outlines the mechanisms by which this is achieved and discusses the influence of the microenvironment, focusing on hypoxia. The regulation of angiogenesis and the antivascular agents that are used in an antiangiogenic dosing schedule, both novel and conventional, are also summarized
Erythropoiesis-stimulating agents in oncology: a study-level meta-analysis of survival and other safety outcomes
BACKGROUND: Cancer patients often develop the potentially debilitating condition of anaemia. Numerous controlled studies indicate that erythropoiesis-stimulating agents (ESAs) can raise haemoglobin levels and reduce transfusion requirements in anaemic cancer patients receiving chemotherapy. To evaluate recent safety concerns regarding ESAs, we carried out a meta-analysis of controlled ESA oncology trials to examine whether ESA use affects survival, disease progression and risk of venous-thromboembolic events
Purine Nucleoside Phosphorylase Targeted by Annexin V to Breast Cancer Vasculature for Enzyme Prodrug Therapy
Conceived and designed the experiments: JJK OD RGH. Performed the experiments: JJK OD. Analyzed the data: JJK OD RGH. Wrote the paper: JJK OD RGH.Background and PurposeThe targeting of therapeutics is a promising approach for the development of new cancer treatments that seek to reduce the devastating side effects caused by the systemic administration of current drugs. This study evaluates a fusion protein developed as an enzyme prodrug therapy targeted to the tumor vasculature. Cytotoxicity would be localized to the site of the tumor using a protein fusion of purine nucleoside phosphorylase (PNP) and annexin V. Annexin V acts as the tumor-targeting component of the fusion protein as it has been shown to bind to phosphatidylserine expressed externally on cancer cells and the endothelial cells of the tumor vasculature, but not normal vascular endothelial cells. The enzymatic component of the fusion, PNP, converts the FDA-approved cancer therapeutic, fludarabine, into a more cytotoxic form. The purpose of this study is to determine if this system has a good potential as a targeted therapy for breast cancer.MethodsA fusion of E. coli purine nucleoside phosphorylase and human annexin V was produced in E. coli and purified. Using human breast cancer cell lines MCF-7 and MDA-MB-231 and non-confluent human endothelial cells grown in vitro, the binding strength of the fusion protein and the cytotoxicity of the enzyme prodrug system were determined. Endothelial cells that are not confluent expose phosphatidylserine and therefore mimic the tumor vasculature.ResultsThe purified recombinant fusion protein had good enzymatic activity and strong binding to the three cell lines. There was significant cell killing (p<0.001) by the enzyme prodrug treatment for all three cell lines, with greater than 80% cytotoxicity obtained after 6 days of treatment.ConclusionThese results suggest that this treatment could be useful as a targeted therapy for breast cancer.Yeshttp://www.plosone.org/static/editorial#pee
Efficacy and safety of micafungin versus intravenous itraconazole as empirical antifungal therapy for febrile neutropenic patients with hematological malignancies: a randomized, controlled, prospective, multicenter study
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