New, emerging and re-emerging fungal diseases on medicinal and aromatic plants in European domain

Plant diseases cause agricultural and economic loss and impact negatively on human and animal health through mycotoxins and allergens produced by them. They also have consequences for biodiversity conservation. The pathogens could be classified in five categories: new - detected within the last five years; emerging - have always been present in an area but have grown in importance over the years; re-emerging - have been previously controlled but are once more a major problem associated with chemical resistance or changes in management or cultivars; threatening - not reported or limited in distribution in Europe and chronic-spreading – known for longer than 20 years and causing increased concern. Diseases emerge or re-emerge due to changes in farming practices, development of new strains of the pathogen, climate change, introduction of the pathogen to new geographical locations, or introduction of more efficient pathogen vectors. During the last years emerging infectious diseases (EIDs) are of special concern to researchers. Among all pathogens fungi are responsible for the greatest damage to plants in both agricultural and natural ecosystems. They represent over 70 % of all plant pathogens and over 30 % of plant EIDs. Surveys on fungal diseases of medicinal and aromatic plants have been carried out in the framework of several research projects between Germany, Bulgaria, Lithuania and Poland in the last two decades. EIDs have been reported, either as novel pathogens or as familiar pathogens affecting new host species. The importance of the problem could be illustrated by such examples as some phytopathogenic fungi on Apiaceae and Lamiaceae hosts discussed in the present work

Does chemotherapy-induced leukopenia predict a response in small cell lung cancer?

The correlation between chemotherapy-induced toxicity and treatment outcome in cancer patients has not been studied thoroughly. Our aim was to evaluate whether there is any relationship between chemotherapy-induced leukopenia and response to treatment in small-cell lung cancer (SCLC). Data derived from records of 228 patients treated within two prospective multicentre phase II studies were analysed. In the first study (101 patients) chemotherapy included vincristine, epirubicin and cyclophosphamide and, in the second (127 patients), cyclophosphamide, etoposide and epirubicin; both regimens were given every 3 weeks. In the present analysis, the correlation between treatment outcome (response rate and survival) and highest scores of leukopenia within the first two and up to the fourth chemotherapy cycle, respectively, was evaluated. The objective response rate for the entire group was 66%; 53% in patients whose white blood cells remained normal and 85% in those who developed leukopenia within the first two cycles (P = 0.000). In multifactorial analysis, also including other treatment- and patient-related factors, independent correlation with response to chemotherapy was found for leukopenia (P = 0.001), chemotherapy regimen (P = 0.002) and the combined relative dose intensity (P = 0.018), but not for patient sex, age, performance status, pre-study weight loss, extent of disease and initial white blood cell count. Leukopenia within the first two cycles of chemotherapy was not correlated with survival, whereas such correlation for leukopenia occurring up to the fourth cycle was at the borderline level (P = 0.06). These findings suggest a relationship between chemotherapy-induced leukopenia and tumour response in SCLC

Combination chemotherapy with cyclophosphamide, epirubicin and etoposide in Small Cell Lung Cancer

From March 1987 to February 1991, 136 patients with untreated small cell lung cancer (64 patients with limited disease and 72 with extensive disease), were treated as part of a prospective multi-center study, with a combination of cyclophosphamide 1000 mg/m2 i.v. on day 1, epirubicin 70 mg/m2 i.v. on day 1 and etoposide 100 mg/m2 i.v. on days 1, 3 and 5. Courses were repeated every 3 weeks. One-hundred thirty-four patients were evaluable. There were 42 (31%) complete responses and 66 (49%) partial responses for an overall response rate of 80% (95% confidence interval 71-87%). A complete response was seen in 24 patients (38%) with limited disease and in 18 patients (26%) with extensive disease, while a partial response was observed for 31 (48%) and in 35 (50%) patients, respectively. The median duration of response for all patients was 8.9 months (range, 1-60+ months). The median duration of survival for the entire group was 11.4 months (12.5 months for limited disease and 9.8 months for extensive disease). The 2-year survival rate for the whole group was 13%. The main side-effects were myelosupression, alopecia, nausea and vomiting. Grade 4 toxicity was seen in 8.5% of patients. In conclusion, the studied regimen was found to be active and well tolerated and may be considered as an alternative to standard chemotherapy combinations in SCLC