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high dose methotrexate

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https://www.readbyqxmd.com/read/29050116/-correlation-study-of-blood-drug-concentration-and-nephrotoxicity-on-high-dose-methotrexate-therapy-in-suggestion-of-diagnosis-and-treatment-of-childhood-acute-lymphoblastic-leukemia-in-the-4th-revised-edition
#1
D H Cheng, H Lu, X Q Zou
Objective: To explore the influence of the 4th revised treatment recommendations in childhood acute lymphoblastic leukemia (ALL) on high dose methotrexate(HD-MTX)-induced nephrotoxicity and MTX blood concentrations. Method: The clinical data from 330 ALL children who received 1 242 courses of HD-MTX therapies from September 2012 to November 2016 was collected. The courses were divided into two groups based on the chemotherapies: original scheme group was treated with the 3rd revised regimen, and new scheme group was treated with the 4th revised regimen...
October 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29049862/primary-mediastinal-large-b-cell-lymphoma-outcome-of-a-series-of-pediatric-patients-treated-with-high-dose-methotrexate-and-cytarabine-plus-anti-cd20
#2
Marta Pillon, E Carraro, L Mussolin, V Conter, A Tondo, M Aricò, R Mura, A Sala, L Vinti, S Buffardi, P Pierani, E S G d'Amore, G Basso
Between 2007 and 2013, 13 children diagnosed with primary mediastinal large B-cell lymphoma (PMLBL) were treated according to a modified version of AIEOP (Associazione Italiana Ematologia Oncologia Pediatrica) LNH-97 protocol based on high-dose methotrexate, anthracyclines, and addition of anti-CD20. Ten patients achieved a continuous complete remission with front-line therapy. The overall 5-year survival was 91.7%, and event-free survival was 83.9%, with only one patient dying of progressive disease. Despite the few cases, these results demonstrate that this therapy, which includes anti-CD20, given in a multicenter setting, is feasible with acceptable toxicity in children with PMLBL...
October 19, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29047158/hyper-cvad-plus-nelarabine-in-newly-diagnosed-adult-t-cell-acute-lymphoblastic-leukemia-and-t-lymphoblastic-lymphoma
#3
Yasmin Abaza, Hagop M Kantarjian, Stefan Faderl, Elias Jabbour, Nitin Jain, Deborah Thomas, Tapan Kadia, Gautam Borthakur, Joseph D Khoury, Jan Burger, William Wierda, Susan O'Brien, Marina Konopleva, Alessandra Ferrajoli, Partow Kebriaei, Bouthaina Dabaja, Steven Kornblau, Yesid Alvarado, Naval Daver, Naveen Pemmaraju, Prithviraj Bose, Philip Thompson, Hind Al Azzawi, Mary Kelly, Rebecca Garris, Preetesh Jain, Guillermo Garcia-Manero, Jorge Cortes, Farhad Ravandi
Nelarabine, a water soluble prodrug of 9-β-D-arabinofuranosylguanine (ara-G), is a T-cell specific purine nucleoside analogue. Given its activity in relapsed and refractory T acute lymphoblastic leukemia (T-ALL) and T lymphoblastic lymphoma (T-LBL), we sought to define its role in the frontline treatment of adult patients. Therefore, we conducted a single arm phase 2 study to determine the safety and efficacy of nelarabine in combination with hyper-CVAD in newly diagnosed patients. For induction/consolidation, patients received eight cycles of hyper-CVAD alternating with high-dose methotrexate and cytarabine plus two cycles of nelarabine given at a dose of 650 mg/m(2) intravenously daily for 5 days...
October 19, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/29046900/us-intergroup-study-of-chemotherapy-plus-dasatinib-and-allogeneic-stem-cell-transplant-in-philadelphia-chromosome-positive-all
#4
Farhad Ravandi, Megan Othus, Susan M O'Brien, Stephen J Forman, Chul S Ha, Jeffrey Y C Wong, Martin S Tallman, Elisabeth Paietta, Janis Racevskis, Geoffrey L Uy, Mary Horowitz, Naoko Takebe, Richard Little, Uma Borate, Partow Kebriaei, Laura Kingsbury, Hagop M Kantarjian, Jerald P Radich, Harry P Erba, Frederick R Appelbaum
This multicenter trial was conducted to determine whether the addition of dasatinib to chemotherapy followed by an allogeneic hematopoietic cell transplant (HCT) in patients with Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL) was feasible. Patients ≥ 18 and ≤ 60 years of age with newly diagnosed Ph+ ALL received up to 8 cycles of alternating hyperCVAD and high dose cytarabine and methotrexate with dasatinib. Patients with an available matched sibling or unrelated donor underwent an allogeneic HCT in first complete remission (CR1) followed by daily dasatinib starting from day 100...
December 27, 2016: Blood Advances
https://www.readbyqxmd.com/read/29043230/advances-in-the-treatment-of-newly-diagnosed-primary-central-nervous-system-lymphomas
#5
REVIEW
Liren Qian, Ciprian Tomuleasa, Ioan-Alexandru Florian, Jianliang Shen, Ioan-Stefan Florian, Mihnea Zdrenghea, Delia Dima
Primary central nervous system lymphoma (PCNSL) is a type of highly invasive non-Hodgkin lymphoma. With a growing number of organ transplantation and immunosuppressant therapy, the incidence of PCNSL has been growing rapidly in recent years, which is attributed to the increased incidence of HIV/AIDS, a prominent risk factor for developing PCNSL. The rising rate of PCNSL incidence is the highest among the intracranial tumors. In the past 20 years, dozens of clinical trials related to PCNSL have been registered, but adequate therapeutics are still challenging...
September 2017: Blood Research
https://www.readbyqxmd.com/read/29041951/a-new-bioassay-for-measuring-the-strength-of-il-6-stat3-signal-inhibition-by-tocilizumab-in-patients-with-rheumatoid-arthritis
#6
Shuntaro Saito, Katsuya Suzuki, Keiko Yoshimoto, Yuko Kaneko, Yoshihiro Matsumoto, Kunihiro Yamaoka, Tsutomu Takeuchi
BACKGROUND: Interleukin-6 (IL-6) transduces signals via phosphorylation of STAT3 (pSTAT3). Tocilizumab (TCZ) is an IL-6 receptor blocker, which, when administered intravenously every 4 weeks, efficiently ameliorates rheumatoid arthritis (RA). Since IL-6 signal strength varies among patients with RA, the intensity necessary for appropriate IL-6 signal inhibition by TCZ might vary between individuals. In a previous study, we have examined the clinical utility of increasing (dosing interval shortened to 3 weeks) and decreasing (interval extended to 5 weeks) the dose frequency of TCZ...
October 17, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/29037464/-ocular-sarcoidosis-what-the-internist-should-know
#7
P Sève, L Kodjikian, Y Jamilloux
Sarcoidosis is one of the leading causes of inflammatory eye disease. Any part of the eye and its adnexal tissues can be involved. Uveitis and optic neuropathy are the main manifestations, which the internists face. This review reports the state of knowledge for these two ocular involvements and proposes an assessment-algorithm for sarcoidosis in patients with suspected sarcoid uveitis. Two groups of patients with sarcoid uveitis can be distinguished: one young and multiethnic group in which ophthalmological findings are various and another group of elderly Caucasian women with mostly chronic posterior uveitis...
October 13, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29031010/evaluation-of-aprepitant-for-acute-chemotherapy-induced-nausea-and-vomiting-in-children-and-adolescents-with-acute-lymphoblastic-leukemia-receiving-high-dose-methotrexate
#8
Femi Felix-Ukwu, Kate Reichert, M Brooke Bernhardt, Eric S Schafer, Amanda Berger
BACKGROUND: Chemotherapy-induced nausea and vomiting (CINV) negatively impacts patients' quality of life. The emetogenicity of high-dose methotrexate in children and adolescents with cancer is incompletely characterized. At our institution, a number of patients with acute lymphoblastic leukemia (ALL) have received aprepitant with courses of high-dose methotrexate after poor CINV control with prior courses. PROCEDURE: We conducted a retrospective cohort analysis on patients with ALL who received methotrexate 5 g/m(2) /dose with and without concomitant aprepitant at Texas...
October 14, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29030660/tofacitinib-improves-atherosclerosis-despite-up-regulating-serum-cholesterol-in-patients-with-active-rheumatoid-arthritis-a-cohort-study
#9
Kensuke Kume, Kanzo Amano, Susumu Yamada, Toshikatsu Kanazawa, Hiroyuki Ohta, Kazuhiko Hatta, Kuniki Amano, Noriko Kuwaba
Patients with rheumatoid arthritis (RA) have an increased cardiovascular (CV) risk. This study aimed to analyze the effects of Tofacitinib treatment, a Janus kinase inhibitor, on atherosclerosis in patients with RA. Patients with an active RA (28-joint disease activity score-erythrocyte sedimentation rate > 3.2) despite methotrexate (MTX) treatment 12 mg/week were included in this open-label prospective study and started on Tofacitinib (10 mg/day, 5 mg twice/day). Japanese guideline does not allow high dose of MTX...
October 14, 2017: Rheumatology International
https://www.readbyqxmd.com/read/29024886/a-case-study-to-identify-priority-cytostatic-contaminants-in-hospital-effluents
#10
A Olalla, N Negreira, M López de Alda, D Barceló, Y Valcárcel
This study analyses the presence of 17 cytostatic agents from seven different groups, based on their different mechanisms of action, in the effluent from a medium-sized hospital located in eastern Spain. Analysis of the compounds found in the effluents studied involved solidphase extraction (SPE) coupled on-line to a high performance liquid chromatograph tandem mass spectrometer (HPLC-MS/MS). The environmental risk of the compounds studied was then assessed by calculating the hazard quotient (HQ), combining the measured environmental concentrations (MECs) with dose-response data based on the predicted no effect concentrations (PNECs)...
September 28, 2017: Chemosphere
https://www.readbyqxmd.com/read/29021442/the-relationship-between-the-serum-oxytocin-levels-disease-activity-the-adls-and-the-qol-in-patients-with-rheumatoid-arthritis
#11
Yusuke Miwa, Hidekazu Furuya, Ryo Yanai, Tsuyoshi Kasama, Kenji Sanada
Objective To investigate the factors associated with depression, including the serum oxytocin (OXT) levels, disease activity, activities of daily living (ADLs) and quality of life (QOL), and their effects on rheumatoid arthritis (RA). Methods This study included 42-RA-patients. We measured the following variables before and after 6 months of treatment with biological disease-modifying anti rheumatic drugs (bDMARDs): the baseline characteristics (including age, sex, disease duration, smoking, and body mass index), the doses of prednisolone and methotrexate, the serum level of matrix metalloprotease-3, the erythrocyte sedimentation rate and the C-reactive protein level...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28989565/risk-of-liver-disease-in-methotrexate-treated-patients
#12
REVIEW
Richard Conway, John J Carey
Methotrexate is the first line drug treatment for a number of rheumatic and non-rheumatic diseases. It is effective in controlling disease activity and preventing disease-related damage, and significantly cheaper than many alternatives. Use in rheumatoid arthritis infers a significant morbidity and mortality benefit. Methotrexate is generally well tolerated but can cause symptomatic adverse events. Multiple serious adverse events have been attributed to methotrexate, based largely on older reports using high or daily doses, and subsequent case reports and circumstantial evidence...
September 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28984175/primary-central-nervous-system-lymphoma-retrospective-analysis-of-34-cases-in-a-single-centre
#13
Huafeng Wang, Ming Wang, Juying Wei, Lei Wang, Liping Mao, Jie Jin
Objective To retrospectively analyse outcomes in patients with primary central nervous system lymphoma (PCNSL), which is a malignant CNS non-Hodgkin's lymphoma with a poor prognosis. Methods This study retrospectively analysed the treatment and outcomes of patients with PCNSL, which were divided into two groups: surgery (S) group and surgery/biopsy+chemotherapy (SC) group. The latter group was further subdivided into four cohorts based on the treatment regimen: cyclophosphamide, epidoxorubicin, vincristine and prednisone (CHOP), high-dose methotrexate (HDM)+dexamethasone+rituximab (HDM+D+R), HDM+D+temozolomide (HDM+D+T), and HDM+D+R+T...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28983943/delayed-methotrexate-elimination-incidence-interaction-with-antacid-drugs-and-clinical-consequences
#14
Florence Ranchon, Nicolas Vantard, Emilie Henin, Emmanuel Bachy, Clémentine Sarkozy, Lionel Karlin, Fadhela Bouafia-Sauvy, Aurore Gouraud, Verane Schwiertz, Estelle Bourbon, Amandine Baudouin, Anne Gaelle Caffin, Thierry Vial, Gilles Salles, Catherine Rioufol
The aim of this retrospective cohort study was to investigate the incidence of delayed methotrexate elimination in patients treated with high-dose methotrexate (≥1 g/m(2) ) for haematological malignancy and to identify the impact of interacting drugs, especially proton-pump inhibitors (PPIs) and ranitidine. All patients treated with high-dose methotrexate over a 6 year period in the haematology department of the Lyon Sud University Hospital (Hospices Civils de Lyon, France) were included. Potential risk factors for delayed methotrexate elimination were tested in a generalized linear model by univariate analysis: patient age, gender, methotrexate dose, administration of PPI or ranitidine, and concomitant nephrotoxic drugs...
October 6, 2017: Hematological Oncology
https://www.readbyqxmd.com/read/28981733/prognostic-factors-for-primary-central-nervous-system-lymphomas-treated-with-high-dose-methotrexate-based-chemo-radiotherapy
#15
Jeunghun Lee, Yukiko Shishido-Hara, Kaori Suzuki, Saki Shimizu, Keiichi Kobayashi, Hiroshi Kamma, Yoshiaki Shiokawa, Motoo Nagane
Background: Primary central nervous system lymphoma (PCNSL) remains an aggressive and refractory tumor despite high-dose methotrexate-based chemo-radiotherapy. Age and performance status have been shown to be important clinical prognostic factors, however others, especially molecular factors, affecting the prognosis are still uncertain. Methods: We investigate clinical, neuroimaging and immunohistochemical data in tissue from 41 PCNSL patients treated primarily with methotrexate-based chemo-radiotherapy and evaluate the influence of potential prognostic factors on clinical outcome as well as correlation among these factors...
October 1, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28981729/immunochemotherapy-using-rituximab-rtx-and-high-dose-methotrexate-hd-mtx-an-evaluation-of-the-addition-of-rtx-to-hd-mtx-in-recurrent-primary-central-nervous-system-lymphoma-pcnsl
#16
Yasuji Miyakita, Makoto Ohno, Masamichi Takahashi, Yoshihiro Muragaki, Hitoshi Katai, Yoshitaka Narita
Background: There is increasing evidence that MTX-based chemotherapy is superior to HD-MTX alone. Rituximab (RTX) is effective in a variety of B-cell lymphomas and may enter the brain. The purpose of this study is to evaluate the addition of RTX to HD-MTX in recurrent primary central nervous system lymphoma (PCNSL). Methods: Patients diagnosed with recurrent PCNSL at our institution between 2004 and 2009 were treated with HD-MTX (3.5-5.5 g/m2) every 2 weeks. From 2010, RTX (375 mg/m2) was administered every 2 weeks along with HD-MTX...
October 1, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28973509/whole-brain-radiation-dose-reduction-for-primary-central-nervous-system-lymphoma-patients-who-achieved-partial-response-after-high-dose-methotrexate-based-chemotherapy
#17
Jun Su Park, Do Hoon Lim, Yong Chan Ahn, Won Park, Seok Jin Kim, Won Seog Kim, Kihyun Kim
Background: The whole brain radiotherapy (WBRT) dose for primary central nervous system lymphoma (PCNSL) patients who achieved complete response after induction chemotherapy was recently reduced to 23.4 Gy, but the optimal radiation dose for patients who achieved partial response (PR) is controversial. The aim of this study was to investigate the feasibility of reduced-dose WBRT for patients who achieved PR. Method: We retrospectively reviewed the medical records of PCNSL patients who were treated with high-dose methotrexate based chemotherapy...
August 30, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28962586/further-treatment-intensification-in-undifferentiated-and-rheumatoid-arthritis-patients-already-in-low-disease-activity-has-limited-benefit-towards-physical-functioning
#18
Sytske Anne Bergstra, Otto Olivas, Gülşah Akdemir, Naghmeh Riyazi, Gerard Collée, Johannes H L M van Groenendael, Robert B M Landewé, Cornelia F Allaart
BACKGROUND: It is recommended to optimise treatment as long as a predefined treatment target is not met, but should the aim be remission if patients are in low disease activity (LDA)? The aim of this study was to assess if, in patients with rheumatoid arthritis (RA) or patients with undifferentiated arthritis (UA) with Disease Activity Score (DAS) ≤ 2.4 (LDA), treatment intensification results in better functional ability. METHODS: In the IMPROVED study 610 patients with early RA or UA were treated with methotrexate + tapered high-dose prednisone...
September 30, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28959507/a-regional-multicenter-retrospective-analysis-of-patients-with-primary-central-nervous-system-lymphoma-diagnosed-from-2000-2012-treatment-patterns-and-clinical-outcomes
#19
Eric C Burton, Beatrice Ugiliweneza, Murali K Kolikonda, Tanuj Saaraswat, Shiao Woo, Maxwell Boakye, Lennea Coombs, Renato LaRocca, Aaron Spalding
Introduction Primary central nervous system lymphoma (PCNSL) is a rare tumor without a well-defined standard of care. For immunocompetent patients, therapeutic regimens have largely evolved from treatment with whole-brain radiation therapy (WBRT) to treating initially with systemic chemotherapy regimens that include high-dose (HD) methotrexate (MTX) with or without WBRT. Looking at population-based treatment trends may help define which therapies are most effective. This study was conducted to determine treatment patterns and outcomes for patients with PCNSL in the Louisville, KY metropolitan area during the period 2000 to 2012...
July 25, 2017: Curēus
https://www.readbyqxmd.com/read/28950405/diagnosis-and-management-of-primary-central-nervous-system-lymphoma
#20
REVIEW
Catherine H Han, Tracy T Batchelor
Primary central nervous system lymphoma (PCNSL) is a rare and aggressive extranodal non-Hodgkin lymphoma (NHL) that is confined to the brain, eyes, spinal cord, or leptomeninges without systemic involvement. The overall prognosis, diagnosis, and management of PCNSL differ from those for other types of NHL. Prompt diagnosis and initiation of treatment are vital for improving clinical outcomes. PCNSL is responsive to radiation therapy; however, whole-brain radiotherapy (WBRT) inadequately controls the disease when it is used alone, and its delayed neurotoxicity causes neurocognitive impairment, especially in elderly patients...
September 26, 2017: Cancer
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