Thrombocytopenia in bone metastasis prostate cancer

INTRODUCTION: Metastatic cancer presents a treatment challenge to clinicians, particularly for patients with bone marrow infiltration. For tumor staging, therapy selection, and prognosis risk stratification, the status of the bone marrow should be known for the presence or absence of metastasis. The study aimed to evaluate the hematological findings and comprehensive analysis of bone marrow in cases of nonhematological malignancies with bone marrow metastasis. MATERIALS AND METHODS: This retrospective study comprised a record retrieval of the departmental archives for the past 6 years...

Bone marrow metastasis (BMM) refers to the metastasis of malignant tumours originating from nonhematopoietic tissues to the bone marrow. The nonhematopoietic malignant tumour cells metastasize to the bone marrow via heterogeneous dissemination or direct invasion to form metastases and the bone marrow is infiltrated by tumour cells, resulting in the destruction of its structure and the development of haematopoietic disorders. In the present study, the clinical characteristics, prognosis and treatment of BMMs were investigated...

PURPOSE: Actinium-225-labeled prostate-specific membrane antigen ([225 Ac]Ac-PSMA-617) is safe and effective in the treatment of metastatic castration-resistant prostate cancer (mCRPC). No study has specifically assessed its safety in patients with extensive skeletal metastases of mCRPC. We aimed to investigate the hematologic toxicity and efficacy of [225 Ac]Ac-PSMA-617 therapy in patients with extensive skeletal metastases of mCRPC. METHODS: We retrospectively reviewed the medical record of patients treated with [225 Ac]Ac-PSMA-617 for mCRPC...

A 66-year-old man with a previous history of advanced prostate cancer failing complete androgen blockade, docetaxel chemotherapy, denosumab, and abiraterone acetate as judged by persistent high serum levels of prostate specific antigen presented with exertional dyspnea, normocytic anemia, and thrombocytopenia. Leukoery - throblastosis was noted in his peripheral blood. Bone marrow examination disclosed diffuse bone marrow carcinomatosis from prostate cancer. Prolonged activated partial thromboplastin time, prothrombin time, and an extremely elevated serum level of Ddimer led to a diagnosis of disseminated intravascular coagulation...

Prostate-specific membrane antigen (PSMA)-based imaging seeks to fill some critical gaps in prostate cancer staging and response assessment, and may select patients for treatment with radiolabeled PSMA conjugates. In biochemical recurrence, at prostate-specific antigen (PSA) levels as low as 0.2 ng/dL, 68 Ga-PSMA imaging has demonstrated a 42% detection rate of occult metastatic disease, and detection has been greater than 95% when PSA levels are higher than 2 ng/dL. This may facilitate novel approaches, including salvage lymphadenectomy or metastasis-directed radiation therapy, in patients with oligometastatic disease...

Purpose: The prognosis of metastatic osteosarcoma continues to be poor. We hypothesized that alpha-emitting, bone-targeting radium 223 dichloride (223 RaCl2 ) can be safely administered to patients with osteosarcoma and that early signals of response or resistance can be assessed by quantitative and qualitative correlative imaging studies and biomarkers. Patients and Methods: A 3+3 phase I, dose-escalation trial of 223 RaCl2 (50, 75, and 100 kBq/kg) was designed in patients with recurrent/metastatic osteosarcoma aged ≥15 years...

Because of different physical properties, the β-emitters 177 Lu and 90 Y offer specific radiologic-biologic advantages in dedicated clinical situations. Our objective was to introduce 90 Y-labeled prostate-specific membrane antigen (PSMA)-617 to clinical application, providing additional avenues for personalized medicine. Here, we present our dosimetry estimate for 90 Y-PSMA-617, report first clinical experiences, and discuss the advantages and drawbacks of varying the β-emitter in PSMA-targeting radioligand therapy...

In patients with castration resistant prostate cancer(CRPC), the most frequent site of metastases is bone particularly with osteoblastic change, which accounts for 90% at the late stage of CRPC and is accompanied by symptomatic skeletal symptoms(SSEs)such as bone pain or pathological fractures. Radium-223(Ra-223)dichloride emits α particles and has been proven to improve overall survival(OS)and QOL by reducing SSEs in metastatic CRPC patients. Although hemotoxic adverse events(AEs)of Ra-223 treatment including anemia, neutropenia and thrombocytopenia, and non-hemotoxic AEs including nausea, diarrhea and bone pain have been reported, they were mild and well tolerated...

BACKGROUND: Bone is the most common site of metastatic disease in advanced prostate cancer. Radium-223 (223 Ra) is a calcium-mimetic alpha-particle emitter, which has been shown to have activity in prostate cancer with clinical benefit in patients with symptomatic bone metastasis. The recommended schedule is six cycles of 223 Ra, 5 kBq/kg, at 4-weekly intervals. Although previous studies have assessed clinical outcomes in patients who received six cycles of Ra223 , there is very little information about outcomes of patients receiving fewer courses of treatment...

225 Background: The ALSYMCA (Alpharadin in Symptomatic Prostate Cancer) trial was a phase III, placebo controlled, randomized trial in which 921 men with bone metastasis from hormone refractory prostate cancer (HRPC) were randomly assigned to receive radium-223 (Ra-223) or placebo. Ra-223 produced a 30% survival benefit, with a median survival of 14.9 months compared to 11.3 months for patients treated with a placebo, which led to FDA approval in 2013. METHODS: We identified through the nuclear medicine records 11 patients who started Ra-223 between March 15, 2013 and December 10, 2015...

BACKGROUND: A meta-analysis was conducted to assess the impact of radiopharmaceuticals (RPs) in castration-resistant prostate cancer (CRPC) on pain control, symptomatic skeletal events (SSEs), toxicity profile, quality of life (QoL), and overall survival (OS). MATERIALS AND METHODS: The PubMed/MEDLINE, CANCERLIT, EMBASE, Cochrane Library database, and other search engines were searched to identify randomized controlled trials (RCTs) comparing RPs with control (placebo or radiation therapy) in metastatic CRPC...

The aim of the present study was to evaluate the palliative effects and adverse events of strontium-89 (Sr-89) in patients with bone metastasis from prostate cancer. A total of 18 patients with prostate cancer and painful bone metastases, as diagnosed on bone scintigraphy, who were treated with Sr-89 at the National Kyushu Cancer Center between February, 2008 and April, 2014 were reviewed. Of the 18 subjects, 13 (72.2%) achieved a pain response, whereas 5 were classified as pain non-responders (27.8%). According to a logistic regression analysis, the pre-administration characteristics, including age, prostate-specific antigen (PSA), alkaline phosphatase (ALP), history of bone-modifying agent administration, opioid use or palliative radiation therapy, time after the combined androgen blockade nadir and time since the pain onset, were not found to be significant predictors of the pain response...

BACKGROUND: Bone marrow biopsy is widely used method for diagnosis, follow-up and staging of hemato-oncologic diseases. This procedure is also used for determining the bone marrow metastasis in patients with solid tumors. In this study, clinical, hematological, and pathological features of 58 patients with bone marrow metastases diagnosed by bone marrow biopsies were examined retrospectively MATERIALS AND METHODS: Among 3345 bone marrow biopsies performed in our hospital between January 2006 and August 2013, 58 cases with solid tumor metastasized to bone marrow were included in this study...

BACKGROUND: Radium-223 chloride ((223)Ra; Alpharadin) is an alpha-emitting radioisotope that targets areas of osteoblastic metastasis and is excreted by the small intestine. When compared with beta-emitters (eg, strontium-89, samarium-153), (223)Ra delivers a high quantity of energy per track length with short tissue penetration. OBJECTIVE: This review describes the mechanism, radiobiology, and preclinical development of (223)Ra and discusses the clinical data currently available regarding its safety and efficacy profile...

OBJECTIVES: The objective of this study was to evaluate the significance of docetaxel-based chemotherapy in elderly Japanese men with metastatic castration-resistant prostate cancer (CRPC). MATERIALS AND METHODS: This study included a total of 159 consecutive patients aged≥75 years with mCRPC who were treated with docetaxel-based chemotherapy. The efficacy and tolerability of this therapy were retrospectively analyzed. RESULTS: In these 159 patients, the median age and prostate-specific antigen (PSA) level before docetaxel-based chemotherapy were 78 years and 44...

UNLABELLED: Ixabepilone is an epothilone B analogue with activity in a variety of solid malignancies, including prostate cancer. The main dose-limiting toxicity of ixabepilone is myelosuppression when administered by using an every 3-week schedule. Here we evaluate the activity of a weekly ixabepilone in men with metastatic castrate-resistant prostate cancer to minimize hematologic toxicity. PURPOSE: BMS-247550 (ixabepilone) is an epothilone B analogue with activity in taxane-resistant cancer cell lines...

A 76-year-old man underwent radical prostatectomy under the diagnosis of stage C prostate cancer (cT3bN0M0, Gleason score 3＋4) in 1999. Endocrine treatment for postoperative biochemical failure started in 2001. He was admitted to our hospital because of general fatigue and multiple bone pain with a prostate specific antigen (PSA) level of 1,141 ng/ml in August 2009. On admission, no metastasis was detected on bone scintigraphy or computed tomography. Bone marrow biopsy was finally performed for the assessment of bone metastasis after PSA further increased to 8,679 ng/ml with the manifestation of severe anemia and thrombocytopenia...

Disseminated carcinomatosis of the bone marrow is caused by metastasis to the bone marrow and can cause disseminated intravascular coagulation (DIC), leucoerythroblastosis, and microangiopathic hemolytic anemia (MHA). The prognosis of this syndrome is poor. We report herein two rare cases of disseminated carcinomatosis of the bone marrow in association with prostate cancer. Case 1 involved a 61-year-old man admitted to our department with elevated prostate-specific antigen (PSA) levels. Prostate biopsy revealed prostate cancer, and imaging studies were performed...

BACKGROUND: In the evolution of metastatic castration-resistant prostate cancer (mCRPC), patients present visceral metastases with or without neuroendocrine differentiation in 20% of cases. PATIENTS AND METHODS: We assessed the efficacy and toxicity of a platinum-based chemotherapy regimen in mCRPC patients with either neuroendocrine differentiation defined by high serum levels of chromogranin A (CgA) and neuron-specific enolase (NSE) or visceral metastases. Patients received the combination of carboplatin and etoposide every 3 weeks...

OBJECTIVE: To evaluate the efficacy and toxicity of docetaxel plus prednisolone treatment in Japanese patients with hormone-refractory prostate cancer (HRPC). METHODS: From April 2004 through August 2008, we used docetaxel plus prednisolone to treat 55 HRPC patients (median age, 72 years). Eighteen patients (32.7%) had measurable soft tissue lesions, whereas 52 patients (94.5%) had bone metastases. During the 21-day treatment cycle, docetaxel (70 mg/m(2)) was administered once every 21 days and oral prednisolone (5 mg), twice daily...