RESUMEN
PURPOSE: Chemotherapy-induced peripheral neuropathy (CIPN) commonly involves hand dexterity impairment. However, the factors affecting hand dexterity impairment are unknown and there is currently no established treatment. The purpose of the current study was to clarify factors influencing hand dexterity impairment in taxane-induced peripheral neuropathy using subjective and objective assessments. METHODS: We assessed patient characteristics, treatment-related factors, subjective symptoms of CIPN (Patient Neurotoxicity Questionnaire [PNQ]), psychological symptoms, and upper limb dysfunction (Quick Disabilities of the Arm, Shoulder and Hand [Quick DASH]). Quantitative assessments were pinch strength, sensory threshold, hand dexterity impairment, and grip force control. Multiple regression analysis was performed using hand dexterity impairment as the dependent variable and age and PNQ, Quick DASH, and control of grip force as independent variables. RESULTS: Forty-three breast cancer patients were included in the analysis. Hand dexterity impairment in taxane-induced peripheral neuropathy patients was significantly correlated with age, grip force control, and PNQ sensory scores (p < 0.008). Multiple regression analysis demonstrated that PNQ sensory scores and grip force control were significantly associated with hand dexterity impairment (p < 0.01). CONCLUSION: Subjective symptoms (numbness and pain) and grip force control contributed to impaired hand dexterity in taxane-induced peripheral neuropathy.
Asunto(s)
Antineoplásicos , Neoplasias de la Mama , Fuerza de la Mano , Mano , Enfermedades del Sistema Nervioso Periférico , Taxoides , Humanos , Femenino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso Periférico/inducido químicamente , Enfermedades del Sistema Nervioso Periférico/fisiopatología , Fuerza de la Mano/fisiología , Taxoides/efectos adversos , Anciano , Adulto , Mano/fisiopatología , Neoplasias de la Mama/tratamiento farmacológico , Encuestas y Cuestionarios , Antineoplásicos/efectos adversos , Análisis de Regresión , Evaluación de la Discapacidad , Hidrocarburos Aromáticos con Puentes/efectos adversosRESUMEN
BACKGROUND: Persistent post-surgical pain (PPSP) is associated with upper limb dysfunction and decreased quality of life and causes long-term suffering for breast cancer survivors after surgery. However, the predictors of PPSP remain unclear. The purpose of this study was to examine predictors of PPSP intensity and interference at 1 year postoperatively, focusing on treatment-related factors, pre- and postoperative central sensitization (CS), CS-related symptoms (e.g., muscle stiffness, fatigue, sleep disturbances), and psychological factors. METHODS: Eighty-eight women with planned unilateral breast cancer surgery were included in this longitudinal study. CS, CS-related symptoms, and psychological factors were assessed preoperatively, 1 month postoperatively, and 1 year postoperatively. Analysis of covariance was used to compare the groups with and without PPSP, accounting for treatment-related factors. Multiple regression analysis was performed to identify predictors of PPSP intensity and interference at 1 year postoperatively. RESULTS: Even after adjusting for covariates, preoperative and 1-month postoperative Central Sensitization Inventory scores in the PPSP group were significantly higher than scores in the group without PPSP. Multiple regression analysis showed that axillary lymph node dissection (ALND) and 1-month postoperative CS-related symptoms were independent predictors of PPSP intensity and interference at 1 year postoperatively (p < 0.01). CONCLUSION: We found that ALND and 1-month postoperative CS-related symptoms were predictors of PPSP intensity and interference at 1 year postoperatively.
Asunto(s)
Neoplasias de la Mama , Humanos , Femenino , Neoplasias de la Mama/cirugía , Sensibilización del Sistema Nervioso Central , Estudios Longitudinales , Calidad de Vida , Dolor Postoperatorio/etiologíaRESUMEN
We report that granulocyte transfusion (GTX) was effective for prolonged pneumonia at allogeneic bone marrow transplantation. A 58-year-old man with MDS-RAEB-2 was admitted to our hospital for allogeneic bone marrow transplantation. He was complicated with pneumonia, which was not improved with G-CSF and antibiotics. We therefore decided to perform a GTX transplantation. During the period of neutropenia, pneumonia did not deteriorate. A combination of allogeneic stem cell transplantation and GTX is expected not only to improve transplantation results but also to expand the adaptation for transplantation. However, detailed investigation of the effect of GTX in allogeneic stem cell transplantation should be performed, and more cases should be accumulated.
Asunto(s)
Granulocitos/trasplante , Trasplante de Células Madre Hematopoyéticas , Síndromes Mielodisplásicos/terapia , Neumonía/terapia , Humanos , Masculino , Persona de Mediana Edad , Síndromes Mielodisplásicos/complicaciones , Neumonía/complicaciones , Trasplante Homólogo , Resultado del TratamientoRESUMEN
Aleukemic leukemia cutis is a rare condition characterized by the invasion of leukemic blasts into the skin before their appearance in the peripheral blood. Leukemia cutis usually occurs in patients with myeloid leukemia, especially the myelomonocytic and monocytic types of acute myeloblastic leukemia. We describe the case of a 62-year-old woman with aleukemic leukemia cutis who developed Philadelphia-positive acute leukemia 1 month after skin involvement. Leukemic cells expressed both myeloid and B-cell lineage surface markers, and monoclonal rearrangement of the immunoglobulin heavy chain was detected by Southern blot analysis. This report is the first of a case of aleukemic leukemia cutis preceding Philadelphia-positive biphenotypic leukemia.
Asunto(s)
Leucemia/patología , Cromosoma Filadelfia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Linfocitos B/patología , Crisis Blástica , Linaje de la Célula , Femenino , Reordenamiento Génico , Humanos , Cadenas Pesadas de Inmunoglobulina/genética , Leucemia/tratamiento farmacológico , Leucemia/genética , Persona de Mediana Edad , Células Mieloides/patología , Fenotipo , SepsisRESUMEN
A patient with Non-Hodgkin's lymphoma is reported, in which reactivation of the hepatitis B virus was achieved from treatment with rituximab. The patient's HBs antigens were positive on admission, and she tested positive for HBs, HBe, and HBc antibodies, and negative for the HBe antigens. She was treated with a regimen of three courses of rituximab-containing anti-cancer drugs and one course of combined anti-cancer drugs. Throughout these chemotherapy courses, prednisolone was not given. After the fourth course of chemotherapy with the third rituximab she developed hepatic dysfunction, and the serum titers of HBs and HBc antibodies suddenly decreased. After administration of lamivudine, however, she gradually recovered from liver failure.
Asunto(s)
Anticuerpos Monoclonales/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Virus de la Hepatitis B/fisiología , Linfoma no Hodgkin/tratamiento farmacológico , Activación Viral/efectos de los fármacos , Anciano , Anticuerpos Monoclonales/uso terapéutico , Anticuerpos Monoclonales de Origen Murino , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Femenino , Hepatitis B/inducido químicamente , Hepatitis B/tratamiento farmacológico , Hepatitis B/prevención & control , Humanos , Lamivudine/uso terapéutico , Fallo Hepático/inducido químicamente , Fallo Hepático/virología , Linfoma no Hodgkin/complicaciones , Rituximab , Pruebas SerológicasAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Linfoma de Células B/terapia , Linfoma de Células B Grandes Difuso/terapia , Neoplasias Primarias Secundarias/terapia , Neoplasias de la Parótida/terapia , Timoma/terapia , Ciclofosfamida/administración & dosificación , Doxorrubicina/administración & dosificación , Humanos , Linfoma de Células B/sangre , Linfoma de Células B/patología , Linfoma de Células B Grandes Difuso/sangre , Linfoma de Células B Grandes Difuso/patología , Masculino , Persona de Mediana Edad , Neoplasias Primarias Secundarias/sangre , Neoplasias Primarias Secundarias/patología , Neoplasias de la Parótida/patología , Prednisona/administración & dosificación , Timoma/sangre , Timoma/patología , Vincristina/administración & dosificaciónAsunto(s)
Hemorragia Cerebral/etiología , Demencia Vascular/etiología , Pancreatitis/inducido químicamente , Trasplante de Células Madre de Sangre Periférica/efectos adversos , Tacrolimus/efectos adversos , Enfermedad Aguda , Anciano , Demencia Vascular/inducido químicamente , Demencia Vascular/patología , Células Endoteliales/patología , Humanos , Masculino , Síndromes de Neurotoxicidad/etiología , Trasplante de Células Madre de Sangre Periférica/métodos , Trasplante HomólogoAsunto(s)
Arsenicales/efectos adversos , Arsenicales/uso terapéutico , Leucemia-Linfoma de Células T del Adulto/tratamiento farmacológico , Leucemia-Linfoma de Células T del Adulto/patología , Infiltración Leucémica/inducido químicamente , Pulmón/patología , Óxidos/efectos adversos , Óxidos/uso terapéutico , Anciano , Trióxido de Arsénico , Arsenicales/administración & dosificación , Anticuerpos Antideltaretrovirus/sangre , Resultado Fatal , Humanos , Pulmón/inmunología , Masculino , Óxidos/administración & dosificaciónAsunto(s)
Cromosomas Humanos X , Leucemia/genética , Aberraciones Cromosómicas Sexuales , Enfermedad Aguda , Anciano , Humanos , MasculinoAsunto(s)
Antineoplásicos/sangre , Tumores del Estroma Gastrointestinal/tratamiento farmacológico , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Leucemia Mieloide Aguda/tratamiento farmacológico , Piperazinas/sangre , Pirimidinas/sangre , Adulto , Anciano , Antineoplásicos/administración & dosificación , Benzamidas , Estatura , Peso Corporal , Relación Dosis-Respuesta a Droga , Humanos , Mesilato de Imatinib , Japón , Persona de Mediana Edad , Piperazinas/administración & dosificación , Pirimidinas/administración & dosificación , Resultado del TratamientoAsunto(s)
Músculo Esquelético/efectos de los fármacos , Compuestos de Piridinio/efectos adversos , Rabdomiólisis/inducido químicamente , Anciano , Anticolesterolemiantes/efectos adversos , Resina de Colestiramina/efectos adversos , Interacciones Farmacológicas , Femenino , Humanos , Pravastatina/efectos adversos , Rabdomiólisis/diagnóstico , Retención Urinaria/tratamiento farmacológicoRESUMEN
A 47-year-old woman who underwent allogenic peripheral blood stem cell transplant developed withdrawal symptoms soon after Fentanyl 25 mcg/h patch was stopped, which has not been reported at this dose. Possible causes, such as the inhibition of CYP3A4 induced by cyclosporine causing elevations of serum fentanyl, are discussed.
Asunto(s)
Fentanilo/efectos adversos , Trastornos Relacionados con Opioides/etiología , Trasplante de Células Madre de Sangre Periférica/efectos adversos , Síndrome de Abstinencia a Sustancias/etiología , Administración Cutánea , Analgésicos Opioides/administración & dosificación , Analgésicos Opioides/efectos adversos , Analgésicos Opioides/metabolismo , Dolor de Espalda/complicaciones , Dolor de Espalda/tratamiento farmacológico , Ciclosporina/efectos adversos , Citocromo P-450 CYP3A , Inhibidores Enzimáticos del Citocromo P-450 , Sistema Enzimático del Citocromo P-450/metabolismo , Interacciones Farmacológicas/fisiología , Femenino , Fentanilo/administración & dosificación , Fentanilo/metabolismo , Humanos , Inmunosupresores/efectos adversos , Desplazamiento del Disco Intervertebral/complicaciones , Desplazamiento del Disco Intervertebral/tratamiento farmacológico , Leucemia Mieloide Aguda/complicaciones , Leucemia Mieloide Aguda/terapia , Persona de Mediana Edad , Trastornos Relacionados con Opioides/fisiopatología , Síndrome de Abstinencia a Sustancias/fisiopatologíaRESUMEN
We report 3 cases of reduced cardiac function with complications in non-Hodgkin's lymphoma patients who were treated with rituximab. Patients experienced reduced cardiac functions after the administration of rituximab; there was no evidence of any preceding infusion reactions. Reticulin fiber was observed diffusely in cardiac muscles. Transforming growth factor-beta levels were elevated after the administration of rituximab. We believe that continuous elevation of transforming growth factor-beta may promote the growth of reticulin fiber in cardiac muscles. Reduction in cardiac functions is a severe complication that must be considered when rituximab is administered.
Asunto(s)
Anticuerpos Monoclonales/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Linfoma no Hodgkin/tratamiento farmacológico , Disfunción Ventricular Izquierda/inducido químicamente , Anciano , Anciano de 80 o más Años , Anticuerpos Monoclonales de Origen Murino , Hipersensibilidad a las Drogas/etiología , Humanos , Masculino , Persona de Mediana Edad , Miocardio/metabolismo , Miocardio/patología , Reticulina/efectos de los fármacos , Reticulina/metabolismo , Rituximab , Factor de Crecimiento Transformador beta/sangre , Factor de Crecimiento Transformador beta/efectos de los fármacos , Disfunción Ventricular Izquierda/metabolismo , Disfunción Ventricular Izquierda/patologíaRESUMEN
Rituximab has become a useful drug for the treatment of non-Hodgkin's lymphoma (NHL) and such autoimmune diseases as idiopathic thrombocytopenic purpura and rheumatoid arthritis. When combined with cytotoxic agents, rituximab showed synergistic effects for the treatment of NHL. In such treatment, hepatitis B virus (HBV) reactivation is a crucial complication when patients are treated with immunosuppressive or chemotherapeutic agents. Despite its treatment efficacy, several studies have pointed out unusual viral infections after its administration that resulted in fatal hepatitis due to HBV reactivation. In the cases at the authors' institute, the authors analysed the kinetics of HBV antibodies, HBV-reactivation timing, and the prophylactic efficacy of lamivudine. The authors reviewed their cases and the previous literature to clarify the characteristics of HBV-reactivated patients who were administered rituximab.
Asunto(s)
Anticuerpos Monoclonales/efectos adversos , Antineoplásicos/efectos adversos , Virus de la Hepatitis B/patogenicidad , Hepatitis B/patología , Anticuerpos Monoclonales/uso terapéutico , Anticuerpos Monoclonales de Origen Murino , Anticuerpos Antivirales , Antineoplásicos/uso terapéutico , Antivirales/uso terapéutico , Enfermedades Autoinmunes/tratamiento farmacológico , Humanos , Cinética , Lamivudine/uso terapéutico , Linfoma no Hodgkin/tratamiento farmacológico , RituximabRESUMEN
A 47-year-old man was diagnosed with non-Hodgkin's lymphoma (NHL) follicular B-cell type (stage IVB). Although partial remission was observed after the administration of several combination chemotherapeutic agents, no more improvement was observed. After we finished the FND (fludarabine, mitoxantrone, dexamethasone) regimen, the patient's status improved. After the administration of the FND regimen, thrombocytopenia developed, and the platelet count did not recover to previous levels. After rituximab was administered for the treatment of thrombocytopenia, the platelet count recovered. Then we combined fludarabine and rituximab for the treatment of NHL. Although fludarabine was administered, the platelet count did not decrease when combined with rituximab. In the discussion, we analyze the characteristics and the treatment outcome of the thrombocytopenia induced by fludarabine reviewed in the literature.
Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Linfoma Folicular/tratamiento farmacológico , Trombocitopenia/tratamiento farmacológico , Vidarabina/análogos & derivados , Vidarabina/efectos adversos , Anticuerpos Monoclonales de Origen Murino , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Humanos , Linfoma Folicular/complicaciones , Masculino , Persona de Mediana Edad , Rituximab , Trombocitopenia/inducido químicamente , Trombocitopenia/inmunología , Trombocitopenia/prevención & control , Resultado del Tratamiento , Vidarabina/uso terapéuticoRESUMEN
Helicobacter pylori (HP) eradication therapy is a useful treatment for idiopathic thrombocytopenic purpura (ITP). Some investigators have also reported the effects of proton pump inhibitor (PPI) monotherapy on ITP. We performed a randomized study of HP eradication therapy and PPI monotherapy on ITP. Four of nine patients achieved complete remission (CR), two of nine achieved partial remission (PR) in HP eradication therapy, three of eight achieved CR, and two of eight achieved PR in PPI monotherapy. No significant differences were observed in the CR + PR of these patients between HP eradication therapy and PPI monotherapy. As for cost comparisons, HP eradication therapy is cheaper than PPI monotherapy, but it is less effective.
Asunto(s)
Amoxicilina/administración & dosificación , Antibacterianos/administración & dosificación , Antiulcerosos/administración & dosificación , Claritromicina/administración & dosificación , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Omeprazol/análogos & derivados , Púrpura Trombocitopénica Idiopática , 2-Piridinilmetilsulfinilbencimidazoles , Anciano , Amoxicilina/economía , Antibacterianos/economía , Antiulcerosos/economía , Claritromicina/economía , Quimioterapia Combinada , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/economía , Infecciones por Helicobacter/enzimología , Humanos , Lansoprazol , Masculino , Persona de Mediana Edad , Omeprazol/administración & dosificación , Omeprazol/economía , Inhibidores de la Bomba de Protones , Púrpura Trombocitopénica Idiopática/complicaciones , Púrpura Trombocitopénica Idiopática/economía , Púrpura Trombocitopénica Idiopática/enzimología , Inducción de Remisión , Resultado del TratamientoRESUMEN
Interferon (IFN) is one of several drugs effective in treating multiple myeloma (MM), and propagermanium is an IFN inducer. We report on 10 MM patients who were treated with propagermanium at doses from 10 to 40 mg. Two patients achieved complete remission (CR), two patients achieved partial remission (PR), and the condition of four patients was stable (stable disease, SD). After discontinuation of propagermanium, the status of MM progressed in two patients who were in SD and in two patients who had achieved PR. The administration of propagermanium was restarted in one patient resulting in a decrease in her paraprotein.