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[PMID]:28954297
[Au] Autor:Bandos H; Melnikow J; Rivera DR; Swain SM; Sturtz K; Fehrenbacher L; Wade JL; Brufsky AM; Julian TB; Margolese RG; McCarron EC; Ganz PA
[Ad] Endereço:NRG Oncology and The University of Pittsburgh, Pittsburgh, PA; Center for Healthcare Policy and Research, University of California Davis, Sacramento, CA; Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD; NRG Oncology and The Washington Cancer Institute at
[Ti] Título:Long-term Peripheral Neuropathy in Breast Cancer Patients Treated With Adjuvant Chemotherapy: NRG Oncology/NSABP B-30.
[So] Source:J Natl Cancer Inst;110(2), 2018 Feb 01.
[Is] ISSN:1460-2105
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: The long-term effects of chemotherapy are sparsely reported. Peripheral neuropathy (PN) is one of the most frequent toxicities associated with taxane use for the treatment of early-stage breast cancer. We investigated the impact of the three different docetaxel-based regimens and patient characteristics on long-term, patient-reported outcomes of PN and the impact of PN on long-term quality of life (QOL). Methods: The National Surgical Adjuvant Breast and Bowel Project Protocol B-30 was a randomized trial comparing sequential doxorubicin (A) and cyclophosphamide (C) followed by docetaxel (T) (AC→T), concurrent ACT, or AT in women with node-positive, early-stage breast cancer. The AC→T group had a higher cumulative dose of T. PN was one of the symptoms assessed in a QOL substudy. Statistical methods included simple and mixed ordinal logistic regression and general linear models. All statistical tests were two-sided. Results: Of 1512 patients, 41.9% reported PN two years after treatment initiation. Treatment with AT and ACT was associated with less severe long-term PN compared with AC→T (odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.35 to 0.58; OR = 0.59, 95% CI = 0.46 to 0.75). Preexisting PN, older age, obesity, mastectomy, and greater number of positive nodes were also associated with higher risk of long-term PN. Patients who reported worse PN symptoms at 24 months had statistically significantly worse QOL (Ptrend < .001). Conclusions: The administration of docetaxel is associated with long-term PN. The lower rate of long-term PN in AT and ACT patients might be an important consideration in supporting choosing these therapies for individuals with preexisting neuropathic symptoms or other risk factors for neuropathy.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Neoplasias da Mama/tratamento farmacológico
Doenças do Sistema Nervoso Periférico/induzido quimicamente
[Mh] Termos MeSH secundário: Quimioterapia Adjuvante
Ciclofosfamida/efeitos adversos
Doxorrubicina/administração & dosagem
Doxorrubicina/efeitos adversos
Esquema de Medicação
Feminino
Seres Humanos
Meia-Idade
Qualidade de Vida
Taxoides/administração & dosagem
Taxoides/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Taxoids); 15H5577CQD (docetaxel); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1093/jnci/djx162


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[PMID]:29397599
[Au] Autor:Chen Z; Yang YJ; Li J; Tian XP
[Ad] Endereço:Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing 100730, China.
[Ti] Título:[The clinical characteristics of Takayasu's arteritis with glomerulonephropathy].
[So] Source:Zhonghua Nei Ke Za Zhi;57(2):129-133, 2018 Feb 01.
[Is] ISSN:0578-1426
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To investigate the clinical features of Takayasu's arteritis (TAK) with glomerulonephropathy and to improve physicians' understanding of this complication in patients with TAK. Clinical data were retrospectively collected including manifestations, laboratory tests, image findings and treatment of 8 patients diagnosed as Takayasu's arteritis with glomerulonephropathy from January 2002 to January 2017 in Peking Union Medical College Hospital. Glomerulonephropathy was confirmed based on percutaneous renal biopsy. There were 6 women and 2 men. The median onset age and median disease duration were 24 (18-37) years and 42 (3-360) months, respectively. Five patients had hypertension. The 24 hour urinary protein was 0.18-14.91 g. Red blood cells and casts in urine were tested among 4 and 2 patients, respectively. Three patients had renal artery stenosis. Three patients demonstrated mesangial proliferative glomerulonephritis, two with IgA nephropathy, two with minimal change disease and one with membranoproliferative glomerulonephritis. Seven patients received glucocorticoid combined with cyclophosphamide therapy (glucocorticoid 40-60 mg/d, prednisone or equivalent; cyclophosphamide 0.4 g/week iv. or cyclophosphamide 0.1 g/d po.). Uninary blood cells removed and 24 hour urinary protein decreased from 1.65 g to 0.90 g after treatment for 12 months in one patient. The other 7 patients were missing. Glomerulonephropathy is occasionally observed among TAK patients. Mesangial proliferative glomerulonephritis is the most common pathological subtype. Glucocorticoid combined with cyclophosphamide therapy could be an optional therapy for Takayasu's arteritis with glomerulonephropathy.
[Mh] Termos MeSH primário: Glomerulonefrite Membranoproliferativa/etiologia
Glomerulonefrite/etiologia
Arterite de Takayasu/patologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Ciclofosfamida/administração & dosagem
Ciclofosfamida/uso terapêutico
Eritrócitos
Feminino
Glomerulonefrite/patologia
Glomerulonefrite por IGA
Glomerulonefrite Membranoproliferativa/patologia
Glucocorticoides/administração & dosagem
Glucocorticoides/uso terapêutico
Seres Humanos
Hipertensão
Masculino
Prednisona/administração & dosagem
Prednisona/uso terapêutico
Arterite de Takayasu/complicações
Arterite de Takayasu/tratamento farmacológico
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids); 8N3DW7272P (Cyclophosphamide); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180206
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0578-1426.2018.02.009


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Registro de Ensaios Clínicos
[PMID]:29298160
[Au] Autor:Sullivan KM; Goldmuntz EA; Keyes-Elstein L; McSweeney PA; Pinckney A; Welch B; Mayes MD; Nash RA; Crofford LJ; Eggleston B; Castina S; Griffith LM; Goldstein JS; Wallace D; Craciunescu O; Khanna D; Folz RJ; Goldin J; St Clair EW; Seibold JR; Phillips K; Mineishi S; Simms RW; Ballen K; Wener MH; Georges GE; Heimfeld S; Hosing C; Forman S; Kafaja S; Silver RM; Griffing L; Storek J; LeClercq S; Brasington R; Csuka ME; Bredeson C; Keever-Taylor C; Domsic RT; Kahaleh MB; Medsger T; Furst DE; SCOT Study Investigators
[Ad] Endereço:From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.)
[Ti] Título:Myeloablative Autologous Stem-Cell Transplantation for Severe Scleroderma.
[So] Source:N Engl J Med;378(1):35-47, 2018 01 04.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Despite current therapies, diffuse cutaneous systemic sclerosis (scleroderma) often has a devastating outcome. We compared myeloablative CD34+ selected autologous hematopoietic stem-cell transplantation with immunosuppression by means of 12 monthly infusions of cyclophosphamide in patients with scleroderma. METHODS: We randomly assigned adults (18 to 69 years of age) with severe scleroderma to undergo myeloablative autologous stem-cell transplantation (36 participants) or to receive cyclophosphamide (39 participants). The primary end point was a global rank composite score comparing participants with each other on the basis of a hierarchy of disease features assessed at 54 months: death, event-free survival (survival without respiratory, renal, or cardiac failure), forced vital capacity, the score on the Disability Index of the Health Assessment Questionnaire, and the modified Rodnan skin score. RESULTS: In the intention-to-treat population, global rank composite scores at 54 months showed the superiority of transplantation (67% of 1404 pairwise comparisons favored transplantation and 33% favored cyclophosphamide, P=0.01). In the per-protocol population (participants who received a transplant or completed ≥9 doses of cyclophosphamide), the rate of event-free survival at 54 months was 79% in the transplantation group and 50% in the cyclophosphamide group (P=0.02). At 72 months, Kaplan-Meier estimates of event-free survival (74% vs. 47%) and overall survival (86% vs. 51%) also favored transplantation (P=0.03 and 0.02, respectively). A total of 9% of the participants in the transplantation group had initiated disease-modifying antirheumatic drugs (DMARDs) by 54 months, as compared with 44% of those in the cyclophosphamide group (P=0.001). Treatment-related mortality in the transplantation group was 3% at 54 months and 6% at 72 months, as compared with 0% in the cyclophosphamide group. CONCLUSIONS: Myeloablative autologous hematopoietic stem-cell transplantation achieved long-term benefits in patients with scleroderma, including improved event-free and overall survival, at a cost of increased expected toxicity. Rates of treatment-related death and post-transplantation use of DMARDs were lower than those in previous reports of nonmyeloablative transplantation. (Funded by the National Institute of Allergy and Infectious Diseases and the National Institutes of Health; ClinicalTrials.gov number, NCT00114530 .).
[Mh] Termos MeSH primário: Ciclofosfamida/uso terapêutico
Transplante de Células-Tronco Hematopoéticas
Imunossupressores/uso terapêutico
Escleroderma Sistêmico/terapia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Ciclofosfamida/efeitos adversos
Intervalo Livre de Doença
Feminino
Seguimentos
Transplante de Células-Tronco Hematopoéticas/efeitos adversos
Transplante de Células-Tronco Hematopoéticas/mortalidade
Seres Humanos
Imunossupressores/efeitos adversos
Infecção/etiologia
Análise de Intenção de Tratamento
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Escleroderma Sistêmico/tratamento farmacológico
Escleroderma Sistêmico/mortalidade
Condicionamento Pré-Transplante
Transplante Autólogo
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Immunosuppressive Agents); 8N3DW7272P (Cyclophosphamide)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180304
[Lr] Data última revisão:
180304
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180104
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


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[PMID]:29361623
[Au] Autor:Nagashima Y; Chijimatsu H; Furuya K; Kondo J; Maeda Y; Somura H; Takemoto N; Yahara N; Abe T; Hayashi H; Kubo H; Yamamoto S; Nagano H
[Ad] Endereço:Dept. of Surgery, Kanmon Medical Center.
[Ti] Título:[Effect of Pegfilgrastim Primary Prophylactic Administration on Relative Dose Intensity(RDI)in Postoperative Adjuvant Chemotherapy(TC Therapy)for Breast Cancer - A Single-Center, Retrospective Study].
[So] Source:Gan To Kagaku Ryoho;44(13):2087-2090, 2017 Dec.
[Is] ISSN:0385-0684
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:This study assessed the effect of pegfilgrastim in patients with early stage breast cancer who were receiving docetaxel and cyclophosphamide(TC)therapy(75mg/m / 2 docetaxel plus 600 mg/m2 cyclophosphamide). In total, 17 patients who were to receive 4 planned cycles of TC therapy every 3 weeks were included in this study. Of the 17 patients, 10 who received pegfilgrastim after January 2016 formed the Peg-G group and 7 who did not receive pegfilgrastim until December 2015 formed the control group. We observed a high successful execution rate and relative dose intensity(RDI)with docetaxel in both groups. The successful execution rates were 100% in the Peg-G group and 42.8% in the control group. The RDI was 86.5%(65.4-100%)in the Peg-G group and 52.5%(48.0-58.0%)in the control group. This study showed that the use of pegfilgrastim results in a high successful execution rate and RDI in patients with early stage breast cancer undergoing TC therapy.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Neoplasias da Mama/tratamento farmacológico
Ciclofosfamida/efeitos adversos
Filgrastim/uso terapêutico
Neutropenia/prevenção & controle
Polietilenoglicóis/uso terapêutico
Taxoides/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Idoso
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Neoplasias da Mama/cirurgia
Quimioterapia Adjuvante
Ciclofosfamida/administração & dosagem
Filgrastim/administração & dosagem
Seres Humanos
Meia-Idade
Polietilenoglicóis/administração & dosagem
Estudos Retrospectivos
Taxoides/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Taxoids); 15H5577CQD (docetaxel); 30IQX730WE (Polyethylene Glycols); 3A58010674 (pegfilgrastim); 8N3DW7272P (Cyclophosphamide); PVI5M0M1GW (Filgrastim)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE


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[PMID]:29406049
[Au] Autor:Salim SA; Yousuf T; Patel A; Fülöp T; Agarwal M
[Ad] Endereço:Department of Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi.
[Ti] Título:Hypocomplementemic Urticarial Vasculitis Syndrome With Crescentic Glomerulonephritis.
[So] Source:Am J Med Sci;355(2):195-200, 2018 Feb.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Hypocomplementemic urticarial vasculitis syndrome (HUVS) is a rare autoimmune disease characterized by multiple organ system involvement, including renal disease, with low complement levels. We report the case of a 31-year-old woman who presented with nonspecific symptoms including fatigue, diarrhea, macular rash and abdominal pain with acute renal failure leading to end-stage kidney disease. Laboratory results showed hematuria, nephrotic range proteinuria, worsening creatinine and low C1q levels. Left kidney biopsy showed proliferative glomerulonephritis with crescent formation. She was treated with 6 months of intravenous cyclophosphamide, followed by 2 doses of intravenous rituximab (1g each), thereafter maintained on mycophenolate mofetil and glucocorticoid-based therapy. She experienced a full recovery of renal function after 12 months of dialysis dependence. Hypocomplementemic urticarial vasculitis syndrome with crescentic glomerulonephritis is a rare disease with only 5 other reported cases in literature. In our case, we document a delayed but excellent renal recovery during a 2-year follow-up.
[Mh] Termos MeSH primário: Ciclofosfamida/administração & dosagem
Glomerulonefrite Membranoproliferativa
Ácido Micofenólico/administração & dosagem
Rituximab/administração & dosagem
Urticária
Vasculite
[Mh] Termos MeSH secundário: Adulto
Complemento C1q/metabolismo
Feminino
Glomerulonefrite Membranoproliferativa/complicações
Glomerulonefrite Membranoproliferativa/tratamento farmacológico
Glomerulonefrite Membranoproliferativa/metabolismo
Glomerulonefrite Membranoproliferativa/patologia
Hematúria/complicações
Hematúria/tratamento farmacológico
Hematúria/metabolismo
Hematúria/patologia
Seres Humanos
Falência Renal Crônica/complicações
Falência Renal Crônica/tratamento farmacológico
Falência Renal Crônica/metabolismo
Falência Renal Crônica/patologia
Proteinúria/complicações
Proteinúria/tratamento farmacológico
Proteinúria/metabolismo
Proteinúria/patologia
Síndrome
Urticária/complicações
Urticária/tratamento farmacológico
Urticária/metabolismo
Urticária/patologia
Vasculite/complicações
Vasculite/tratamento farmacológico
Vasculite/metabolismo
Vasculite/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
4F4X42SYQ6 (Rituximab); 80295-33-6 (Complement C1q); 8N3DW7272P (Cyclophosphamide); HU9DX48N0T (Mycophenolic Acid)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE


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[PMID]:29390394
[Au] Autor:Wang G; Chen W; Wu Y; Li Y; Leng Y; Liu A
[Ti] Título:Recombinant human thrombopoietin improves the efficacy of intermediate-dose cyclophosphamide plus granulocyte colony-stimulating factor in mobilizing peripheral blood stem cells in patients with multiple myeloma: A cohort study.
[So] Source:Medicine (Baltimore);96(50):e9302, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The combination of intermediate-dose cyclophosphamide (ID-CTX) and granulocyte colony-stimulating factor (G-CSF) fails to mobilize peripheral blood stem cells (PBSCs) in approximately 20% of treated patients with multiple myeloma (MM).In this cohort study, patients with MM underwent PBSC mobilization with either an ID-CTX plus G-CSF plus recombinant human thrombopoietin (rhTPO) regimen (72 patients; TPO group), or an ID-CTX plus G-CSF regimen (70 patients; non-TPO group).In the TPO group, the median CD34+ harvest was 5.36 × 10 per kg of body weight (0.50-22.39 × 10 per kg of body weight), with a harvest success rate of 91.7% (66/72), and an excellence rate of 55.6% (40/72). In the non-TPO group, the median CD34+ harvest was 3.30 × 10 per kg of body weight (0.20-21.14 × 10 per kg of body weight), with a harvest success rate of 75.7% (53/70), and an excellence rate of 25.7% (18/70). The median count of the CD34+ cells collected, success rate of collection, and excellence rate of collection were significantly higher in the TPO group than in the non-TPO group (P=.0001, P=.01, and P = .0001, respectively). Time to granulocyte and platelet engraftment was faster among patients in the TPO group than that in those from the non-TPO group. No platelet engraftment delay (>21 days) was observed among patients in the TPO group, while 3 patients in the non-TPO group displayed delayed platelet engraftment.Adding rhTPO to the ID-CTX chemotherapy plus G-CSF regimen improved treatment efficacy in mobilizing PBSCs for autologous hematopoietic stem cell transplantation.
[Mh] Termos MeSH primário: Antineoplásicos Alquilantes/uso terapêutico
Ciclofosfamida/uso terapêutico
Sinergismo Farmacológico
Fator Estimulador de Colônias de Granulócitos/uso terapêutico
Transplante de Células-Tronco Hematopoéticas
Mieloma Múltiplo/tratamento farmacológico
Células-Tronco de Sangue Periférico/efeitos dos fármacos
Trombopoetina/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Idoso
Quimioterapia Combinada
Feminino
Seres Humanos
Masculino
Meia-Idade
Mieloma Múltiplo/patologia
Estadiamento de Neoplasias
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents, Alkylating); 143011-72-7 (Granulocyte Colony-Stimulating Factor); 8N3DW7272P (Cyclophosphamide); 9014-42-0 (Thrombopoietin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009302


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[PMID]:29390275
[Au] Autor:Li J; Zhou C; Liu W; Sun X; Meng X
[Ad] Endereço:From the Department of Gastroenterology, First Hospital of Jilin University.
[Ti] Título:Synchronous diffuse large B-cell lymphoma of the stomach and small cell lung carcinoma: A case report.
[So] Source:Medicine (Baltimore);96(50):e8873, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: The synchronous occurrence of lung cancer in patients with gastric neoplasms is relatively uncommon, especially the cases of synchronous coexistence of small cell lung carcinoma and diffuse large B-cell lymphoma of the stomach. PATIENT CONCERNS: We encountered a case of synchronous primary small cell lung carcinoma and diffuse large B-cell lymphoma of the stomach. A 63-year-old patient with a 7.5 × 5.09 cm mass in the superior lobe of the right lung diagnosed with small cell lung cancer and synchronous diffuse large B-cell lymphoma of the stomach. DIAGNOSES: The diseases were diagnosed by the pathological biopsy and immunohistochemical methods. INTERVENTIONS: As the patient received CHOP chemotherapy, pulmonary function deterioraed. Etoposide was added to the chemotherapy. OUTCOMES: However, after the first treatment, chest computed tomography showed that the mass in the superior lobe of the right lung had increased to 8.5 × 5.2 cm. LESSONS: This report draws attention to the fact that the treatment of synchronous tumors is a challenge.
[Mh] Termos MeSH primário: Carcinoma de Células Pequenas/diagnóstico
Neoplasias Pulmonares/diagnóstico
Linfoma Difuso de Grandes Células B/diagnóstico
Neoplasias Primárias Múltiplas/diagnóstico
Neoplasias Gástricas/diagnóstico
[Mh] Termos MeSH secundário: Protocolos de Quimioterapia Combinada Antineoplásica
Biópsia
Carcinoma de Células Pequenas/tratamento farmacológico
Carcinoma de Células Pequenas/patologia
Ciclofosfamida
Doxorrubicina
Feminino
Gastroscopia
Seres Humanos
Imuno-Histoquímica
Neoplasias Pulmonares/tratamento farmacológico
Neoplasias Pulmonares/patologia
Linfoma Difuso de Grandes Células B/tratamento farmacológico
Linfoma Difuso de Grandes Células B/patologia
Meia-Idade
Neoplasias Primárias Múltiplas/tratamento farmacológico
Neoplasias Primárias Múltiplas/patologia
Prednisona
Neoplasias Gástricas/tratamento farmacológico
Neoplasias Gástricas/patologia
Tomografia Computadorizada por Raios X
Vincristina
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
5J49Q6B70F (Vincristine); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008873


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[PMID]:29297205
[Au] Autor:Barnes H; Holland AE; Westall GP; Goh NS; Glaspole IN
[Ad] Endereço:Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Commercial Rd, Melbourne, Australia, 3004.
[Ti] Título:Cyclophosphamide for connective tissue disease-associated interstitial lung disease.
[So] Source:Cochrane Database Syst Rev;1:CD010908, 2018 Jan 03.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Approximately one-third of individuals with interstitial lung disease (ILD) have associated connective tissue disease (CTD). The connective tissue disorders most commonly associated with ILD include scleroderma/systemic sclerosis (SSc), rheumatoid arthritis, polymyositis/dermatomyositis, and Sjögren's syndrome. Although many people with CTD-ILD do not develop progressive lung disease, a significant proportion do progress, leading to reduced physical function, decreased quality of life, and death. ILD is now the major cause of death amongst individuals with systemic sclerosis.Cyclophosphamide is a highly potent immunosuppressant that has demonstrated efficacy in inducing and maintaining remission in autoimmune and inflammatory illnesses. However this comes with potential toxicities, including nausea, haemorrhagic cystitis, bladder cancer, bone marrow suppression, increased risk of opportunistic infections, and haematological and solid organ malignancies.Decision-making in the treatment of individuals with CTD-ILD is difficult; the clinician needs to identify those who will develop progressive disease, and to weigh up the balance between a high level of need for therapy in a severely unwell patient population against the potential for adverse effects from highly toxic therapy, for which only relatively limited data on efficacy can be found. Similarly, it is not clear whether histological subtype, disease duration, or disease extent can be used to predict treatment responsiveness. OBJECTIVES: To assess the efficacy and adverse effects of cyclophosphamide in the treatment of individuals with CTD-ILD. SEARCH METHODS: We performed searches on CENTRAL, MEDLINE, Embase, CINAHL, and Web of Science up to May 2017. We handsearched review articles, clinical trial registries, and reference lists of retrieved articles. SELECTION CRITERIA: We included randomised controlled parallel-group trials that compared cyclophosphamide in any form, used individually or concomitantly with other immunomodulating therapies, versus non-cyclophosphamide-containing therapies for at least six months, with follow-up of at least 12 months from the start of treatment. DATA COLLECTION AND ANALYSIS: We imported studies identified by the search into a reference manager database. We retrieved the full-text versions of relevant studies, and two review authors independently extracted data. Primary outcomes were change in lung function (change in forced vital capacity (FVC) % predicted and diffusing capacity of the lung for carbon monoxide (DLCO) % predicted), adverse events, and health-related quality of life measures. Secondary outcomes included all-cause mortality, dyspnoea, cough, and functional exercise testing. When appropriate, we performed meta-analyses and subgroup analyses by severity of lung function, connective tissue disease diagnosis, and radiological pattern of fibrosis. We assessed the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and created 'Summary of findings' tables. MAIN RESULTS: We included in the analysis four trials with 495 participants (most with systemic sclerosis). We formed two separate comparisons: cyclophosphamide versus placebo (two trials, 195 participants) and cyclophosphamide versus mycophenolate (two trials, 300 participants). We found evidence to be of low quality, as dropout rates were high in the intervention groups, and as we noted a wide confidence interval around the effect with small differences, which affected the precision of results.The data demonstrates significant improvement in lung function with cyclophosphamide compared with placebo (post-treatment FVC % mean difference (MD) 2.83, 95% confidence interval (CI) 0.80 to 4.87; P = 0.006) but no significant difference in post-treatment DLCO (% MD -1.68, 95% CI -4.37 to 1.02; P = 0.22; two trials, 182 participants).Risk of adverse effects was increased in the cyclophosphamide treatment groups compared with the placebo groups, in particular, haematuria, leukopenia, and nausea, leading to a higher rate of withdrawal from cyclophosphamide treatment. The data demonstrates statistically significant improvement in one-measure of quality of life in one trial favouring cyclophosphamide over placebo and clinically and statistically significant improvement in breathlessness in one trial favouring cyclophosphamide compared with placebo, with no significant impact on mortality.Trialists reported no significant impact on lung function when cyclophosphamide was used compared with mycophenolate at 12 months (FVC % MD -0.82, 95% CI -3.95 to 2.31; P = 0.61; two trials, 149 participants; DLCO % MD -1.41, 95% CI -10.40 to 7.58; P = 0.76; two trials, 149 participants).Risk of side effects was increased with cyclophosphamide versus mycophenolate, in particular, leukopenia and thrombocytopenia.The data demonstrates no significant impact on health-related quality of life, all-cause mortality, dyspnoea, or cough severity in the cyclophosphamide group compared with the mycophenolate group. No trials reported outcomes associated with functional exercise tests.We performed subgroup analysis to determine whether severity of lung function, connective tissue disease diagnosis, or radiological pattern had any impact on outcomes. One trial reported that cyclophosphamide protected against decreased FVC in individuals with worse fibrosis scores, and also showed that cyclophosphamide may be more effective in those with worse lung function. No association could be made between connective tissue disease diagnosis and outcomes. AUTHORS' CONCLUSIONS: This review, which is based on studies of varying methodological quality, demonstrates that overall, in this population, small benefit may be derived from the use of cyclophosphamide in terms of mean difference in % FVC when compared with placebo, but not of the difference in % DLCO, or when compared with mycophenolate. Modest clinical improvement in dyspnoea may be noted with the use of cyclophosphamide. Clinical practice guidelines should advise clinicians to consider individual patient characteristics and to expect only modest benefit at best in preserving FVC. Clinicians should carefully monitor for adverse effects during treatment and in the years thereafter.Further studies are required to examine the use of cyclophosphamide; they should be adequately powered to compare outcomes within different subgroups, specifically, stratified for extent of pulmonary infiltrates on high-resolution computed tomography (HRCT) and skin involvement in SSc. Studies on other forms of connective tissue disease are needed. Researchers may consider comparing cyclophosphamide (a potent immunosuppressant) versus antifibrotic agents, or comparing both versus placebo, in particular, for those with evidence of rapidly progressive fibrotic disease, who may benefit the most.
[Mh] Termos MeSH primário: Doenças do Tecido Conjuntivo/tratamento farmacológico
Ciclofosfamida/uso terapêutico
Imunossupressores/uso terapêutico
Doenças Pulmonares Intersticiais/tratamento farmacológico
[Mh] Termos MeSH secundário: Doenças do Tecido Conjuntivo/complicações
Ciclofosfamida/efeitos adversos
Seres Humanos
Imunossupressores/efeitos adversos
Pulmão/efeitos dos fármacos
Doenças Pulmonares Intersticiais/complicações
Qualidade de Vida
Ensaios Clínicos Controlados Aleatórios como Assunto
Escleroderma Sistêmico
Capacidade Vital/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Immunosuppressive Agents); 8N3DW7272P (Cyclophosphamide)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD010908.pub2


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[PMID]:27770345
[Au] Autor:Whitworth P; Beitsch P; Mislowsky A; Pellicane JV; Nash C; Murray M; Lee LA; Dul CL; Rotkis M; Baron P; Stork-Sloots L; de Snoo FA; Beatty J
[Ad] Endereço:Nashville Breast Center, Nashville, TN, USA. patwhitworth@gmail.com.
[Ti] Título:Chemosensitivity and Endocrine Sensitivity in Clinical Luminal Breast Cancer Patients in the Prospective Neoadjuvant Breast Registry Symphony Trial (NBRST) Predicted by Molecular Subtyping.
[So] Source:Ann Surg Oncol;24(3):669-675, 2017 Mar.
[Is] ISSN:1534-4681
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Hormone receptor-positive (HR+) tumors have heterogeneous biology and present a challenge for determining optimal treatment. In the Neoadjuvant Breast Registry Symphony Trial (NBRST) patients were classified according to MammaPrint/BluePrint subtyping to provide insight into the response to neoadjuvant endocrine therapy (NET) or neoadjuvant chemotherapy (NCT). OBJECTIVE: The purpose of this predefined substudy was to compare MammaPrint/BluePrint with conventional 'clinical' immunohistochemistry/fluorescence in situ hybridization (IHC/FISH) subtyping in 'clinical luminal' [HR+/human epidermal growth factor receptor 2-negative (HER2-)] breast cancer patients to predict treatment sensitivity. METHODS: NBRST IHC/FISH HR+/HER2- breast cancer patients (n = 474) were classified into four molecular subgroups by MammaPrint/BluePrint subtyping: Luminal A, Luminal B, HER2, and Basal type. Pathological complete response (pCR) rates were compared with conventional IHC/FISH subtype. RESULTS: The overall pCR rate for 'clinical luminal' patients to NCT was 11 %; however, 87 of these 474 patients were reclassified as Basal type by BluePrint, with a high pCR rate of 32 %. The MammaPrint index was highly associated with the likelihood of pCR (p < 0.001). Fifty-three patients with BluePrint Luminal tumors received NET with an aromatase inhibitor and 36 (68 %) had a clinical response. CONCLUSIONS: With BluePrint subtyping, 18 % of clinical 'luminal' patients are classified in a different subgroup, compared with conventional assessment, and these patients have a significantly higher response rate to NCT compared with BluePrint Luminal patients. MammaPrint/BluePrint subtyping can help allocate effective treatment to appropriate patients. In addition, accurate identification of subtype biology is important in the interpretation of neoadjuvant treatment response since lack of pCR in luminal patients does not portend the worse prognosis associated with residual disease in Basal and HER2 subtypes.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Neoplasias da Mama/classificação
Neoplasias da Mama/tratamento farmacológico
Perfilação da Expressão Gênica
Tipagem Molecular/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Inibidores da Aromatase/uso terapêutico
Neoplasias da Mama/genética
Neoplasias da Mama/metabolismo
Hidrocarbonetos Aromáticos com Pontes/administração & dosagem
Quimioterapia Adjuvante
Tomada de Decisão Clínica
Ciclofosfamida/administração & dosagem
Doxorrubicina/administração & dosagem
Feminino
Seres Humanos
Imuno-Histoquímica
Hibridização in Situ Fluorescente
Mastectomia Segmentar
Meia-Idade
Terapia Neoadjuvante
Nitrilos/administração & dosagem
Estudos Prospectivos
Receptor ErbB-2/metabolismo
Receptores Estrogênicos/metabolismo
Receptores de Progesterona/metabolismo
Sistema de Registros
Tamoxifeno/administração & dosagem
Taxoides/administração & dosagem
Resultado do Tratamento
Triazóis/administração & dosagem
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE IV; COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Aromatase Inhibitors); 0 (Bridged-Ring Compounds); 0 (Nitriles); 0 (Receptors, Estrogen); 0 (Receptors, Progesterone); 0 (Taxoids); 0 (Triazoles); 094ZI81Y45 (Tamoxifen); 15H5577CQD (docetaxel); 1605-68-1 (taxane); 2Z07MYW1AZ (anastrozole); 7LKK855W8I (letrozole); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide); EC 2.7.10.1 (ERBB2 protein, human); EC 2.7.10.1 (Receptor, ErbB-2)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE
[do] DOI:10.1245/s10434-016-5600-x


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[PMID]:29325312
[Au] Autor:Wang WJ; Sun YQ; Tang FF; Han TT; Mo XD; Wang JZ; Zhang XH; Huang XJ; Xu LP
[Ad] Endereço:Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China.
[Ti] Título:[Outcomes of alternative donor allogeneic hematopoietic stem cell transplantation for Fanconi anemia: a five cases report].
[So] Source:Zhonghua Nei Ke Za Zhi;57(1):54-56, 2018 Jan 01.
[Is] ISSN:0578-1426
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Five patients with Fanconi anemia who received hematopoietic cell transplantation were retrospectively analyzed. The conditioning regimens included fludarabine, cyclophosphamide and anti-thymocyte globulin. Two patients received both bone marrow and peripheral blood stem cells as the source of stem cell grafts from haploidentical matched related donors, while the others received peripheral blood stem cells from unrelated donors. All patients tolerated well and reached hematopoietic reconstitution. One patient died of intracranial infection. During follow-up, 4 patients survived independent of transfusion with full donor chimerism.
[Mh] Termos MeSH primário: Anemia de Fanconi/terapia
Doença Enxerto-Hospedeiro/prevenção & controle
Transplante de Células-Tronco Hematopoéticas
Condicionamento Pré-Transplante
[Mh] Termos MeSH secundário: Soro Antilinfocitário/administração & dosagem
Soro Antilinfocitário/uso terapêutico
Medula Óssea
Ciclofosfamida/administração & dosagem
Ciclofosfamida/uso terapêutico
Seres Humanos
Estudos Retrospectivos
Resultado do Tratamento
Doadores não Relacionados
Vidarabina/análogos & derivados
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antilymphocyte Serum); 8N3DW7272P (Cyclophosphamide); FA2DM6879K (Vidarabine); P2K93U8740 (fludarabine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180112
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0578-1426.2018.01.010



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