Pyridoxine Is Effective for Preventing Hand-Foot Syndrome Induced by Pegylated Liposomal Doxorubicin for Multiple Myeloma: The Results of a Randomized Study.

PURPOSE: Pegylated liposomal doxorubicin (PLD) is highly effective for treating multiple myeloma (MM). Hand-foot syndrome (HFS) is a dose-limiting adverse event of PLD that may reduce a patient's quality of life or prevent certain patients from receiving PLD. Several researchers have discovered that pyridoxine, an activated form of vitamin B6, may prevent PLD-associated HFS. We designed a prospective randomized trial to examine whether prophylactic pyridoxine might prevent the incidence or delay the occurrence of PLD-induced HFS in patients with MM. METHODS: Patients who met the trial's eligibility requirements were randomized and then administered either pyridoxine 100 mg twice daily or no pyridoxine, in both cases accompanied by their PLD-containing chemotherapeutic agent. Follow-up of patients was performed until the completion of induction therapy, the development of HFS or disease progression. RESULTS: Between January 1, 2017, and January 1, 2019, 105 patients were randomly assigned to the pyridoxine group (n = 52) or the no pyridoxine group (n = 53). In the pyridoxine and no pyridoxine groups, HFS developed after a median of 4 (range, 1-8 cycles) and 3 (range, 1-7 cycles) chemotherapeutic cycles, respectively. There were no grade 3 incidents recorded. Overall, 13.3% of patients experienced HFS. A 11 of 53 (20.8%) patients in the no pyridoxine group experienced HFS, compared to 3 of 52 (5.8%) patients in the pyridoxine group (P = .042); there was no difference in HFS grades (P = .725). CONCLUSIONS: The findings of benefit from prophylactic pyridoxine in this open-label trial have suggested its promise as a treatment for reducing HFS in MM patients. Further research with a placebo-controlled design is recommended. CLINICAL TRIAL REGISTRATION: ChiCTR2100050294.

Regionalization of Chinese Material Medical Quality Based on Maximum Entropy Model: A case study of Atractylodes lancea.

Atractylodes is an East-Asiatic endemic genera that distributed in China, Japan and Russian Far Eastern. As an important resource of medicinal plant, atractylodes has long been used as herbal medicine. To example the significant features in its trueborn quality and geographical distribution, we explored the relationships between medicine quality and habitat suitability in two classifications-lower atractylodin content than the standard of Chinese Pharmacopoeia (2010) and the other has higher content. We found that the atractylodin content is negatively related to the habitat suitability for atractylodes with lower atractylodin, while the atractylodin content is positively related to the habitat suitability for those with higher atractylodin. By analyzing the distribution of atractylodeswith lower atractylodin content than the standard of Pharmacopeia, we discovered that the main ecological factors that could inhibit the accumulation of atractylodin were soil type (39.7%), soil clay content (26.7%), mean temperature in December (22.3%), Cation-exchange capacity (6%), etc. And these ecological factors promoted the accumulation of atractylodin for the atractylodes with higher atractylodin. By integrating the two classifications, we finally predicted the distribution of atractylodin content in China.Our results realized the query of atractylodes quality in arbitrary coordinates, and satisfied the actually cultivation demands of "Planting area based on atractylodin quality".

Three patients with multiple myeloma developing secondary lymphoblastic leukemia: case reports and review of the literature.

INTRODUCTION: Secondary lymphoblastic leukemia has been rarely reported in patients with multiple myeloma. CASE REPORTS: We report 3 cases of secondary lymphoblastic leukemia in multiple myeloma patients. They shared a similar phenotype of myeloma cells and secondary lymphoblasts. The chemotherapy treatments in the 3 patients were complex due to various factors. CONCLUSIONS: Multiple immune defects caused by exposure to a variety of agents can play an important role in the development of secondary lymphoblastic leukemia. Microscopic morphology and flow cytometry are important means to detect secondary malignancies in multiple myeloma. Further clinical, experimental and genetic studies of secondary malignancies in multiple myeloma will be necessary in the future.