ABSTRACT
BACKGROUND: Lurbinectedin was approved on June 15, 2020 by the Food and Drug Administration with the brand name ZEPZELCA as the first systematic approved therapy for patients having Small Cell Lung Cancer (SCLC). OBJECTIVES: In this review, an attempt is made to summarize different aspects of Lurbinectedin, including the pathophysiology, chemistry, chemical synthesis, mechanism of action, adverse reactions, and pharmacokinetics. Special attention is given to various reported clinical trials of lurbinectedin. METHODS: A comprehensive literature search was conducted in the relevant databases like ScienceDirect, PubMed, ResearchGate and Google Scholar to identify studies. After a thorough study of these reports, significant findings/data were collected and compiled under suitable headings. Important findings related to clinical trials have been tabulated. CONCLUSION: Lurbinectedin is known to act by inhibiting the active transcription of encoding genes, thereby suppressing tumor-related macrophages with an impact on tumour atmosphere. Lurbinectedin has emerged as a potential drug candidate for the treatment of Small-Cell Lung Cancer (SCLC).
Subject(s)
Lung Neoplasms , Small Cell Lung Carcinoma , Carbolines/pharmacology , Carbolines/therapeutic use , Heterocyclic Compounds, 4 or More Rings/pharmacology , Heterocyclic Compounds, 4 or More Rings/therapeutic use , Humans , Lung Neoplasms/chemically induced , Lung Neoplasms/drug therapy , Small Cell Lung Carcinoma/drug therapy , Small Cell Lung Carcinoma/pathologyABSTRACT
BACKGROUND: Macroscopic hematuria after wasp sting has been reported in Asia to occur before acute kidney injury (AKI), and is often used by clinicians as a sign indicating the need for intensive care and blood purification therapy. However, there is no study on the clinical characteristics and prognosis of this symptom. METHODS: The clinical data of 363 patients with wasp sting admitted to Suining Central Hospital from January 2016 to December 2018 were retrospectively analyzed. At admission, the poisoning severity score (PSS) was used as the criterion for severity classification. According to the presence of macroscopic hematuria, the patients were divided into macroscopic hematuria and non-macroscopic hematuria group. RESULTS: Of the 363 wasp sting patients, 219 were male and 144 were female, with a mean age of 55.9 ± 16.3 years. Fifty-one (14%) had macroscopic hematuria, 39 (10.7%) had AKI, 105 (28.9%) had rhabdomyolysis, 61 (16.8%) had hemolysis, 45 (12.4%) went on to received hemodialysis, and 14 (3.9%) died. The incidence of AKI in macroscopic hematuria group was 70.6%, and oliguric renal failure accounted for 72.2%. Patients with macroscopic hematuria had significantly higher PSS (2.2 ± 0.5 vs. 1.1 ± 0.3, p < .001). CONCLUSION: Macroscopic hematuria can be regarded as a surrogate marker of deteriorating clinical outcome following wasp stings. In wasp sting patients with symptoms of macroscopic hematuria or serum LDH higher than 463.5 u/L upon admission, the risk of AKI increases significantly, therefore hemodialysis should be considered. The PSS is helpful in early assessment of the severity of wasp sting patients.
Subject(s)
Acute Kidney Injury/etiology , Hematuria/etiology , Insect Bites and Stings/complications , L-Lactate Dehydrogenase/blood , Wasp Venoms/toxicity , Acute Kidney Injury/blood , Acute Kidney Injury/epidemiology , Acute Kidney Injury/therapy , Adult , Aged , Animals , China/epidemiology , Female , Hematuria/epidemiology , Hematuria/therapy , Humans , Logistic Models , Male , Middle Aged , Multivariate Analysis , Renal Dialysis/statistics & numerical data , Retrospective Studies , Rhabdomyolysis/epidemiology , Severity of Illness Index , WaspsABSTRACT
INTRODUCTION: Primary mucosa-associated lymphoid tissue (MALT) lymphomas originating in thymus is rare. And, there have been few reports of patients with MALT coexisting with amyloidosis. As far as we know, this was the first case report on MALT lymphoma associated with renal amyloidosis. PATIENT CONCERNS: A 57-year-old man presented with nephrotic syndrome. Further workup revealed IgM-Lambda type monoclonal gammopathy. Bone marrow biopsy showed 8% clonal plasma cells. Renal biopsy confirmed the diagnosis of Lambda light chain AL amyloidosis. positron emission tomography/computed tomography showed thymic lesions which upon biopsy were diagnosed as MALT lymphoma of the thymus. DIAGNOSIS: Primary thymic MALT lymphoma complicated with renal amyloidosis. INTERVENTIONS: The patient underwent surgical resection of the thymus mass and 2 courses of chemotherapy. OUTCOMES: Follow-up data showed that the patient survived 18 months after surgical excision and chemotherapy. CONCLUSION: The case highlights the importance of screening for malignancy in patients with renal amyloidosis.
