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https://www.readbyqxmd.com/read/28434043/early-whole-brain-radiotherapy-in-primary-cns-lymphoma-negative-impact-on-quality-of-life-in-the-randomized-g-pcnsl-sg1-trial
#1
Ulrich Herrlinger, Niklas Schäfer, Rolf Fimmers, Frank Griesinger, Michael Rauch, Heinz Kirchen, Patrick Roth, Martin Glas, Michael Bamberg, Peter Martus, Eckhard Thiel, Agnieszka Korfel, Michael Weller
PURPOSE: In the randomized G-PCNSL-SG-1 trial, the addition of whole brain radiotherapy (45 Gy) to high-dose methotrexate (HD-MTX)-based chemotherapy (early WBRT arm) did not prolong overall survival (OS) as compared to HD-MTX-based chemotherapy alone (no early WBRT arm) in primary CNS lymphoma (PCNSL) patients. To determine whether WBRT might lead to quality of life (QoL)-relevant late neurotoxicity, this trial prospectively monitored QoL. METHODS: QoL measurements were performed using the EORTC-QLQ-C30 and BN20 questionnaires and combined with repeated Mini Mental State Examinations (MMSE)...
April 22, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28432587/rituximab-methotrexate-procarbazine-vincristine-and-intensified-cytarabine-consolidation-for-primary-central-nervous-system-lymphoma-pcnsl-in-the-elderly-a-loc-network-study
#2
Caroline Houillier, Hervé Ghesquières, Cécile Chabrot, Carole Soussain, Guido Ahle, Sylvain Choquet, Emmanuelle Nicolas-Virelizier, Jacques-Olivier Bay, Jacques Vargaftig, Claude Gaultier, Valérie Touitou, Nadine Martin-Duverneuil, Nathalie Cassoux, Magali Le Garff-Tavernier, Myrto Costopoulos, Pierre Faurie, Khê Hoang-Xuan
Primary CNS lymphoma (PCNSL) is chemosensitive to high-dose methotrexate-based chemotherapy. However, responses in the elderly are short-lasting and outcome is poor. Given that radiotherapy and intensive chemotherapy expose elderly to severe toxicities, alternative consolidation approaches need to be evaluated. In this multicenter study, we retrospectively analyzed consecutive patients with newly-diagnosed PCNSL, aged >60, treated with a (R)-MPV-AAA regimen. The regimen consisted of three 28-day cycles of methotrexate (3...
April 21, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28427529/primary-central-nervous-system-lymphoma
#3
REVIEW
Giovanni Citterio, Michele Reni, Gemma Gatta, Andrés José Maria Ferreri
Primary CNS lymphomas (PCNSL) represent a subgroup of malignancies with specific characteristics, aggressive course, and unsatisfactory outcome in contrast with other lymphomas comparable for tumour burden and/or histological type. Despite a high chemo- and radiosensitivity, remissions are frequently shortlasting, mainly because the blood brain-barrier limits the access of many drugs to the CNS. Moreover, survivor patients are at high risk of developing severe treatment-related toxicity, mainly disabling neurotoxicity, raising the question of how to balance therapy intensification with side-effects control...
May 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28426924/high-dose-pulsed-corticosteroid-therapy-combined-with-methotrexate-for-severe-alopecia-areata-of-childhood
#4
J H Chong, A Taïeb, F Morice-Picard, A S Dutkiewicz, C Léauté-Labrèze, F Boralevi
Alopecia areata (AA) in childhood can run a chronic course and worsen over time(1). Spontaneous hair regrowth is rarely appreciated in chronic severe AA(2-4). Our centre described the ineffective use of high dose pulsed corticosteroid therapy (HDPCT) in the long term(1). Methotrexate (MTX) as a maintenance therapy following HDPCT showed some success in adults(5). Although the evidence for using either drug individually was weak(6), the combination of using both was not well studied. This article is protected by copyright...
April 20, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28423235/hepatic-sinusoidal-obstruction-syndrome-during-maintenance-therapy-of-childhood-acute-lymphoblastic-leukemia-is-associated-with-continuous-asparaginase-therapy-and-mercaptopurine-metabolites
#5
Linea Natalie Toksvang, Silvia De Pietri, Stine N Nielsen, Jacob Nersting, Birgitte K Albertsen, Peder S Wehner, Steen Rosthøj, Päivi M Lähteenmäki, Daniel Nilsson, Tove A Nystad, Kathrine Grell, Thomas L Frandsen, Kjeld Schmiegelow
BACKGROUND: Hepatic sinusoidal obstruction syndrome (SOS) during treatment of childhood acute lymphoblastic leukemia (ALL) has mainly been associated with 6-thioguanine. The occurrence of several SOS cases after the introduction of extended pegylated asparaginase (PEG-asparaginase) therapy in the Nordic Society of Paediatric Haematology and Oncology (NOPHO) ALL2008 protocol led us to hypothesize that PEG-asparaginase, combined with other drugs, may trigger SOS during 6-thioguanine-free maintenance therapy...
April 19, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28413626/non-infectious-chemotherapy-associated-acute-toxicities-during-childhood-acute-lymphoblastic-leukemia-therapy
#6
REVIEW
Kjeld Schmiegelow, Klaus Müller, Signe Sloth Mogensen, Pernille Rudebeck Mogensen, Benjamin Ole Wolthers, Ulrik Kristoffer Stoltze, Ruta Tuckuviene, Thomas Frandsen
During chemotherapy for childhood acute lymphoblastic leukemia, all organs can be affected by severe acute side effects, the most common being opportunistic infections, mucositis, central or peripheral neuropathy (or both), bone toxicities (including osteonecrosis), thromboembolism, sinusoidal obstruction syndrome, endocrinopathies (especially steroid-induced adrenal insufficiency and hyperglycemia), high-dose methotrexate-induced nephrotoxicity, asparaginase-associated hypersensitivity, pancreatitis, and hyperlipidemia...
2017: F1000Research
https://www.readbyqxmd.com/read/28407841/cardiovascular-comorbidity-in-inflammatory-rheumatological-conditions
#7
Jürgen Braun, Klaus Krüger, Bernhard Manger, Matthias Schneider, Christof Specker, Hans Joachim Trappe
BACKGROUND: Approximately 1.5 million adults in Germany suffer from an inflammatory rheumatological condition. The most common among these are rheumatoid arthritis and spondyloarthritis-above all axial spondyloarthritis, including ankylosing spondylitis (Bekhterev's disease) and psoriatic arthritis. These systemic inflammatory diseases often affect the heart as well. METHODS: This review is based on pertinent articles retrieved by a selective literature search, on current European guidelines, and on the authors' clinical experience...
March 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28400632/management-strategies-for-mycosis-fungoides-in-india
#8
Tanumay Raychaudhury
Mycosis fungoides is the most common primary cutaneous T-cell lymphoma. The approach to diagnosis and further follow-up is outlined. Evidence for interventions is based classically on a Tumor Node Metastasis Blood TNMB "stage-based" approach. The treatment options in India are limited. The options as per risk stratification and prognostic index are discussed. Early stages and low-risk patients can be managed with expectant policy or skin-directed therapies including topical steroids and phototherapy; intermediate-risk patients can be opted for interferons or retinoids or low dose methotrexate along with radiotherapy including total skin electron beam therapy while high-risk patients are managed most often with single agent or multiagent palliative chemotherapy...
March 2017: Indian Journal of Dermatology
https://www.readbyqxmd.com/read/28395637/safety-and-effectiveness-of-high-dose-methotrexate-over-8%C3%A2-mg-week-in-2838-japanese-patients-with-rheumatoid-arthritis-a-postmarketing-surveillance-report
#9
Yasuo Suzuki, Naonobu Sugiyama, Yuri Fukuma, Noriko Sugiyama, Takeshi Kokubo
OBJECTIVES: To confirm the safety and effectiveness of high-dose (>8 mg/week) methotrexate (MTX) for the treatment of rheumatoid arthritis in Japan. METHODS: A postmarketing surveillance program enrolled Japanese patients with rheumatoid arthritis starting on high-dose MTX followed up for either 24- or 52-weeks. Analyses for safety, risk factors affecting safety, and effectiveness were conducted. RESULTS: The safety/effectiveness analysis sets included 2838/2779 and 335/326 patients in the 24-weeks and 52-weeks follow-up groups, respectively...
April 11, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28394433/outcomes-associated-with-reducing-the-urine-alkalinization-threshold-in-patients-receiving-high-dose-methotrexate
#10
Sarah A Drost, Jason R Wentzell, Pierre Giguere, Darcy L McLurg, Mitchell Sabloff, Salmaan Kanji, Tiffany T Nguyen
STUDY OBJECTIVES: Urine alkalinization increases methotrexate solubility and reduces the risk of nephrotoxicity. The objectives of this study were to determine whether a reduction in the urine pH threshold from 8 to 7 in patients receiving high-dose methotrexate (HDMTX) results in a shorter length of hospital stay, delayed methotrexate clearance, or higher rates of nephrotoxicity; and to determine whether specific factors were associated with prolonged methotrexate clearance. DESIGN: Retrospective cohort study...
April 10, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28393093/choriocarcinoma-with-brain-lung-and-vaginal-metastases-successfully-treated-without-brain-radiation-or-intrathecal-chemotherapy-a-case-report
#11
Anja S Frost, Jonathan H Sherman, Katayoon Rezaei, Alivia Aron, Micael Lopez-Acevedo
•There is no consensus on optimal treatment for GTN and brain metastases.•Brain metastasis treated with craniotomy and intravenous, EMA-CO chemotherapy•Intravenous high-dose methotrexate may be adequate to treat brain metastases.
May 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28391422/osteogenic-sarcoma-systemic-chemotherapy-options-for-localized-disease
#12
REVIEW
Douglas J Harrison, Cindy L Schwartz
Treatment for osteosarcoma, the most common malignant tumor of bone in children and adolescents, has not changed in decades. Treatment is multimodal, employing neoadjuvant chemotherapy followed by aggressive and complete surgical resection to achieve negative margins and a prolonged course of adjuvant chemotherapy. The primary tumor is usually successfully managed via surgery, but micrometastases are likely present in most patients at diagnosis. Death is the result of tumor recurrence in the lungs or more rarely in other bones despite aggressive treatment regimens and is likely attributable to innate resistance to chemotherapy...
April 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28390107/post-transplant-lymphoproliferative-disorder-following-clinical-islet-transplantation-report-of-the-first-two-cases
#13
Anthea Peters, Tolu Olateju, Jean Deschenes, Santosh H Shankarnarayan, Neil Chua, A M James Shapiro, Peter Senior
We report the first two cases of post-transplant lymphoproliferative disorder (PTLD) in recipients of islet transplants worldwide. First, a 44-year old recipient of 3 islet infusions developed PTLD 80 months after his initial transplant, presenting with abdominal pain and diffuse terminal ileum thickening on imaging. He was treated with surgical excision, reduction of immunosuppression and rituximab. Seven months later he developed central nervous system PTLD, presenting with vertigo and diplopia; immunosuppression was discontinued, resulting in graft loss, and he was given high-dose methotrexate and consolidative autologous stem cell transplant...
April 8, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28388359/crocin-reduces-the-inflammation-response-in-rheumatoid-arthritis
#14
Xiang Li, Chao Jiang, Wenyong Zhu
This study is to determine the role and mechanism of crocin in rheumatoid arthritis (RA). Totally 60 Wistar SD rats were randomly divided into control group, RA model group, methotrexate group, crocin high dose, middle dose, and low dose groups. The paw swelling degree, arthritis score, thymus and spleen index, the mRNA and protein levels of iNOS, and the serum content of TNF-α, IL-1β, and IL-6 were evaluated. Crocin treatment significantly alleviated the paw swelling of RA rats. The arthritis score in crocin treatment groups was significantly lower than that in RA model group...
May 2017: Bioscience, Biotechnology, and Biochemistry
https://www.readbyqxmd.com/read/28386850/therapeutic-approaches-in-clippers
#15
REVIEW
Guillaume Taieb, Thibaut Allou, Pierre Labauge
CLIPPERS for chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids, is a steroid-sensitive and steroid-dependent brainstem inflammatory disease of unknown origin. Since its first description in 2010, about 60 cases have been reported throughout the world. The mean age at onset is 50 years and men seem to be more frequently affected. In patients without chronic corticosteroid therapy or immunosuppressive agents, the disease had a relapsing remitting course, and the mean annualized relapse rate was 0...
May 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28378140/management-of-non-hodgkin-lymphoma-icmr-consensus-document
#16
Nirav Thacker, Sameer Bakhshi, Girish Chinnaswamy, Tushar Vora, Maya Prasad, Deepak Bansal, Sandeep Agarwala, Gauri Kapoor, Venkatraman Radhakrishnan, Siddharth Laskar, Tanvir Kaur, G K Rath, Rupinder Singh Dhaliwal, Brijesh Arora
Hitherto poor outcomes, paucity of data and heterogeneity in International approach to Pediatric NHL (Non-Hodgkin Lymphoma) prompted the need for guidelines for Indian population with vast variability in access, affordability and infrastructure across the country. These guidelines are based on consensus among the experts and best available evidence applicable to Indian setting. Evaluation of NHL should consist of easily doable and rapid tissue diagnosis (biopsy or flow cytometry of peripheral blood/malignant effusions), St Jude/IPNHLSS (International Pediatric Non-Hodgkin Lymphoma Staging System) and risk grouping with CSF (Cerebro-spinal fluid), bone marrow, whole body imaging [CECT (Contrast enhanced computerized tomography) ± MRI (Magnetic resonance imaging)] and blood investigations for LDH (Lactate dehydrogenase), TLS (Tumor lysis syndrome) and organ functions...
April 5, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28369839/high-dose-chemotherapy-with-thiotepa-busulfan-and-cyclophosphamide-and-autologous-stem-cell-transplantation-for-patients-with-primary-central-nervous-system-lymphoma-in-first-complete-remission
#17
Zachariah DeFilipp, Shuli Li, Areej El-Jawahri, Philippe Armand, Lakshmi Nayak, Nancy Wang, Tracy T Batchelor, Yi-Bin Chen
BACKGROUND: High-dose chemotherapy and autologous stem cell transplantation (HDC-ASCT) is a therapeutic option for patients with primary central nervous system lymphoma (PCNSL). To the authors' knowledge, data are limited regarding its use among patients in first complete remission (CR1) with the CNS-directed conditioning regimen of thiotepa, busulfan, and cyclophosphamide (TBC). METHODS: A retrospective analysis of patients with PCNSL in CR1 who underwent transplantation using a TBC-based conditioning regimen at 2 academic institutions was performed...
April 3, 2017: Cancer
https://www.readbyqxmd.com/read/28364381/adalimumab-with-methotrexate-in-treatment-na%C3%A3-ve-japanese-patients-with-rheumatoid-arthritis-at-risk-of-progressive-structural-joint-damage-a-postmarketing-observational-study
#18
Yukiko Ito, Kaori Hozumi, Yukiko Okada, Sarina Kurimoto
INTRODUCTION: The objective of this study was to evaluate the real-world safety and effectiveness of adalimumab with methotrexate (MTX) in disease-modifying antirheumatic drug (DMARD)- and biologic-naïve Japanese patients with rheumatoid arthritis (RA) at risk of progressive structural joint damage. METHODS: This multicenter, prospective, observational, postmarketing surveillance study was conducted between February 2013 and April 2015 at 84 centers in Japan. Patients with RA at risk of progressive structural joint damage were enrolled and initiated treatment with adalimumab and MTX...
March 31, 2017: Rheumatology and Therapy
https://www.readbyqxmd.com/read/28363832/primary-cns-lymphomas-of-the-brain-a-retrospective-analysis-in-a-single-institute
#19
Tzu-Kang Lin, Tu-Hsueh Yeh, Peng-Wei Hsu, Chih-Cheng Chuang, Po-Hsun Tu, Pin-Yuang Chen, Shih-Ming Jung, Kuo-Chen Wei, Yin-Cheng Huang
Primary CNS lymphomas (PCNSL) are relatively rare brain tumors. Their accurate diagnosis is mainly by surgical biopsy. In addition to surgical biopsy/decompression, treatment options include high dose methotrexate/chemotherapy and radiation therapy and stem cell therapy. Due to the rarity of this disease, guidelines for PCNSL diagnosis and treatment usually form from a large series of experiences. As a tertiary referral center, we retrospectively reviewed 79 patients during a 13-year period. All patients with PCNSL underwent surgical procedures/bone marrow biopsy procedures, and diagnoses were confirmed by hematologists/neuropathologists...
March 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28361455/development-of-albumin-coupled-cholesterol-stabilized-lipid-nanoemulsion-of-methotrexate-and-tnf-%C3%AE-inhibitor-for-improved-in-vivo-efficacy-against-rheumatoid-arthritis
#20
Xiao-Yan Li, Hui Li, Yan Zhang, Shan Gao, Chun-Ping Dong, Gui-Fu Wu
Methotrexate (MTX; an anti-folate) and etanercept (ET; a TNF-α inhibitor) are used against arthritis; however, limitations like short biological half-life, low cutaneous absorption, and acidic instability limit their clinical relevance. Therefore, the aim of the investigation was to develop albumin coupled lipid nanoemulsion of MTX and ET for improved efficacy by virtue of their controlled release and specificity at the arthritic site. This emulsion was prepared by high-speed homogenization and stabilized using cholesterol...
March 30, 2017: AAPS PharmSciTech
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