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From Biology to Treatment of Monoclonal Gammopathies of Neurological Significance.

Monoclonal gammopathy and peripheral neuropathy are common diseases of elderly patients, and almost 10% of patients with neuropathy of unknown cause have paraprotein. However, growing evidence suggests that several hematological malignancies synthesize and release monoclonal proteins that damage the peripheral nervous system through different mechanisms. The spectrum of the disease varies from mild to rapidly progressive symptoms, sometimes affecting not only sensory nerve fibers, but also motor and autonomic fibers. Therefore, a multidisciplinary approach, mainly between hematologists and neu

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… Two CLL patients with concurrent anti-MAG antibody polyneuropathy were treated with six cycles of chlorambucil–obinutuzumab [ 40 ], showing persistent hematological and neurological remissions ( Table 1 ). However, both developed pneumonia that required hospitalization [ 40 ]. … Obinutuzumab, a new anti-CD20 antibody, and chlorambucil are active and effective in anti-myelin-associated glycoprotein antibody polyneuropathy. Eur. J. Neurol. 2019;26:371–375. doi: 10.1111/ene.13838. 41. …

Patient-reported outcome claims in European and United States orphan drug approvals.

Purpose: We aimed to evaluate the rate of usage and the kind of patient-reported outcome (PRO) claims in orphan drug approvals from the European Medicines Agency (EMA) dated between 1/1/2012 and 31/12/2016 and to compare them to those from the US Food and Drug Administration (FDA). Methods: Orphan drug approval documentation was obtained from the EMA website. PRO-related language was extracted from the Summaries of Product Characteristics (SmPCs). Data were compared to a previously published analysis of the FDA approvals from the same time period. Results: Out of 60 approvals that met the incl

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… olaparib and placebo in patient-reported symptoms or HRQoL as measured by improvement and worsening rates in the FACT/NCCN Ovarian Symptom Index (FOSI), Trial Outcome Index (TOI) and Functional Analysis of Cancer Therapy–Ovarian total score (FACT-O total) obinutuzumab | 23/07/2014 | In combination with chlorambucil …

Axial Multicentric Osteosarcoma in an English Cocker Spaniel.

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… Carboplatin was discontinued and the dog was treated with chlorambucil 7 metronomic schedule, (4 mg/m 2 PO, q24 h). Three months later the dog had pelvic limb weakness and increased pain when going upstairs which was controlled by adding gabapentin (5–10 mg/kg PO, Q8 h) to the analgesic regimen. …

15th Report on Carcinogens.

BACKGROUND: The Report on Carcinogens (RoC) is a congressionally mandated, science-based public health document that the National Toxicology … C: Cadmium and Cadmium Compounds; Captafol; Carbon Tetrachloride; Ceramic Fibers (Respirable Size); Chlorambucil; Chloramphenicol; Chlorendic Acid; Chlorinated Paraffins (C12, 60% Chlorine); Chlorodibromoacetic Acid (see Haloacetic Acids Found as Water Disinfection By-products [Selected]); 1-(2-Chloroethyl)-3-cyclohexyl-1-nitrosourea (see Nitrosourea Chemother …

Pilot Study on the Cost of Some Oncohematology Diseases in Bulgaria.

The goal of the current study is to perform a pilot study of the cost of some oncohematology diseases in Bulgaria. This is a pilot broader burden of disease research. The official report of the National health insurance fund provided information about the total expenditures paid for medicines, ambulatory services, and hospitalizations in 2015 and 2016. To evaluate the costs from a patient perspective, an internet inquiry was organized with the support of the patient organization. The inquiry contained questions regarding the patients' demography, type of oncohematology disease, year of diagnos

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… Economic evaluation of obinutuzumab in combination with chlorambucil in first-line treatment of patients with CLL in Spain. ClinicoEconom Outcomes Res. (2016) 21:475–84. 10.2147/CEOR.S114524 16. Ponzetti C, Canciani M, Farina M, Era S, Walzer S. …

Hematology

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… Chemotherapy (cyclophosphamide, chlorambucil). Biological agents (rituximab, INF α ). … acute leukemias in adulthood, mean age 65 mortality —1.5% of all cancers RISK FACTORS family history —family history (3×), Down’s, Klinefelter, Fanconi syndrome, Bloom’s, ataxia telangiectasia, neurofibromatosis environmental —previous chemotherapy (alkylating agents [melphalan, cyclophosphamide, chlorambucil …

Value of influenza vaccines in cancer patients during the coronavirus (COVID-19) pandemic: a cross-sectional study.

BackgroundAccording to the recommendation of the Centers for Disease Control and Prevention (CDC), getting influenza vaccines during the coronavirus (COVID-19) pandemics is especially important for people with certain underlying medical conditions, like cancer. Due to the similarities between the symptoms of influenza and COVID-19, receiving the flu vaccine in suspicious cases can be helpful because it will make it easier to request a medical test and diagnosis. In this study, the value of influenza vaccination in the cancer population was investigated.MethodsIn a cross-sectional study, all ca

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… vaccine during the COVID-19 pandemic Melph melphalan; PRD prednison; Gem gemcitabine; Cis cisplatin; Capaci capecitabine; Nav Navelbine; TEC taxotere-epirubicin-cyclophosphamide; PVC procarbazine-lomustine-vincristine; Carb carboplatin; Av Avastin (bevacizumab); Tax paclitaxel; Doxo doxorubicin; Chlo chlorambucil …

How to calculate the dose of chemotherapy.

Body surface area-dosing does not account for the complex processes of cytotoxic drug elimination. This leads to an unpredictable variation in effect. Overdosing is easily recognised but it is possible that unrecognised underdosing is more common and may occur in 30% or more of patients receiving standard regimen. Those patients who are inadvertently underdosed are at risk of a significantly reduced anticancer effect. Using published data, it can be calculated that there is an almost 20% relative reduction in survival for women receiving adjuvant chemotherapy for breast cancer as a result of u

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… J Cancer 80 11 1763 1766 10468293 10.1038/sj.bjc.6690594 PMC2363113 RankinEMMillLKayeSBAtkinsonRCassidyLCordinerJCruickshankDDavisJDuncanIDFullertonWHabeshawTKennedyJKennedyRKitchenerHMacLeanAPaulJReedNSarkerTSoukopMSwappGHSymondsRP 1992 A randomised study comparing standard dose carboplatin with chlorambucil …

Case Report: Suspected Solitary Osseous Plasmacytoma in a Cat: Use of Magnetic Resonance Imaging to Diagnose and Confirm Resolution of Disease Following Chemotherapy.

A 9-year-old female spayed Domestic Shorthair cat presented for pain, reluctance to jump, and hyporexia of 14 days duration. Neurologic examination was consistent with C6-T2 myelopathy. Magnetic resonance imaging (MRI) revealed a solitary, contrast-enhancing lesion within the T2 vertebral body. Solitary osseous plasmacytoma was diagnosed based on neurologic examination, advanced imaging, and clinicopathologic findings. Melphalan and prednisolone therapy were initiated. Complete resolution of clinical signs and the vertebral lesion were documented at a 2-year follow up examination with neurolog

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… Several chemotherapies: cyclophosphamide, chlorambucil, and lomustine were trialed but unsuccessful at halting disease progression. Three years following initial diagnosis, the patient remained neurologically normal, but owners requested elective euthanasia due to progression of cutaneous masses. …

Chemotherapy-induced pulmonary complications in cancer: Significance of clinicoradiological correlation.

Chemotherapy while revolutionizing cancer management by improving survival and quality of life; is also associated with several adverse effects. Lung is the most common organ affected in chemotherapy-related complications, due to either drug toxicity or more commonly due to infections caused by immunosuppression and less commonly due to immune-mediated injury. Radiology, when used in combination with clinical and lab data, can help reach the specific diagnosis or narrow down the differentials. The common radiological patterns of drug toxicity include pulmonary interstitial and airway infiltrat

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… infiltrates | bleomycin, methotrexate, taxanes, platins, rituximab, gemcitabine, bortezomib, everolimus, temsorilimus, and gefitinib Diffuse alveolar damage | bleomycin, busulfan, carmustine, melphalan, mitomycin, cyclophosphamide Nonspecific interstitial pneumonia | methotrexate, bleomycin, carmustine, or chlorambucil …

Patient-reported outcomes in cancer survivorship: insights from two decades of population-based PROFILES registry research.

PurposeWhen the field of cancer survivorship research was in its infancy, the PROFILES registry was set up in 2004 to monitor patient-reported outcomes (PROs) in survivors and a normative population. This scoping review aims to summarize lessons learned from developing a population-based PRO registry, focusing on study methodologies, data collection shifts, data utilization, multidisciplinary collaboration, societal impact, and data sharing.MethodsA systematic computerized literature search through PubMed was performed to collect all publications using data from the PROFILES registry between J

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… Haematologica. 2013;98(3):479–86. 22929981 10.3324/haematol.2012.064907 PMC3659932 29. van den Broek EC Impact of active surveillance, chlorambucil, and other therapy on health-related quality of life in patients with CLL/SLL in the Netherlands Ann Hematol 2015 94 1 45 56 10.1007/s00277-014-2161-6 25038918 … Impact of active surveillance, chlorambucil, and other therapy on health-related quality of life in patients with CLL/SLL in the Netherlands. …

Expanding role of lenalidomide in hematologic malignancies.

Lenalidomide is an immunomodulatory agent that has been approved by the US Food and Drug Administration for treatment of multiple myeloma, deletion 5q myelodysplastic syndrome, and mantle cell lymphoma. In addition, it has clinical activity in lymphoproliferative disorders and acute myeloid leukemia. The mode of action includes immunomodulatory, anti-inflammatory, antiangiogenic, and antiproliferative mechanisms. The antitumor effect is a result of direct interference of key pathways in tumor cells and indirect modulation of the tumor microenvironment. There has been no recent collective revie

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… A large randomized study of lenalidomide versus chlorambucil called the ORIGIN trial was stopped early due to increased deaths in the lenalidomide arm compared to the chlorambucil arm. …

Epigenetic therapy in myeloproliferative neoplasms: evidence and perspectives.

The classic Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs), which include polycythaemia vera, essential thrombocythaemia and primary myelofibrosis, originate from a stem cell-derived clonal myeloproliferation that manifests itself with variable haematopoietic cell lineage involvement; they are characterized by a high degree of similarities and the chance to transform each to the other and to evolve into acute leukaemia. Their molecular pathogenesis has been associated with recurrent acquired mutations in janus kinase 2 (JAK2) and myeloproliferative leukemia virus oncogene

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… On the other hand, the risk of leukaemia was significantly increased in patients who received other chemotherapeutics in combination or in sequence with HU [ 22 , 30 ], or who were treated with radiophosphorus [ 22 ] or chlorambucil [ 31 ]. … Pungolino E Life expectancy and prognostic factors for survival in patients with polycythemia vera and essential thrombocythemia Am J Med 2004 117 755 61 15541325 10.1016/j.amjmed.2004.06.032 31 Berk PD Goldberg JD Silverstein MN Increased incidence of acute leukemia in polycythemia vera associated with chlorambucil …

Novel Strategies for Tumor Treatment: Harnessing ROS-Inducing Active Ingredients from Traditional Chinese Medicine Through Multifunctional Nanoformulations.

Reactive oxygen species (ROS) encompass a diverse group of chemically reactive molecules or ions distinguished by their substantial oxidative potential. Empirical studies have shown that the targeted administration of high toxic concentrations of ROS can effectively induce tumor cell death in various types. Numerous bioactive ingredients derived from traditional Chinese medicine (TCM), recognized for their ROS-inducing properties, have demonstrated significant anti-tumor activity. Nonetheless, their clinical application has been hindered by challenges such as low solubility, limited bioavailab

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… developed by Ren et al, facilitating the application of these nanoparticles in FI/MRI dual-modal imaging as well as targeted therapy in mice with pancreatic tumor xenografts. 146 Additionally, other researchers synthesized ROS/pH dual-sensitive polymer micelles for the simultaneous delivery of emodin and chlorambucil … This approach enhances oxidative stress levels by inducing ROS production and GSH depletion, while also reducing chlorambucil exocytosis. …

PARP Inhibitors and Haematological Malignancies-Friend or Foe?

Since their introduction several years ago, poly (ADP-ribose) polymerase (PARP) inhibitors (PARPi) have become the standard of care for breast and gynaecological cancers with BRCA gene mutations. Given that PARPi act by exploiting defective DNA repair mechanisms within tumour cells, they should be ideally suited to combatting haematological malignancies where these pathways are notoriously defective, even though BRCA mutations are rare. To date, despite promising results in vitro, few clinical trials in humans for haematological malignancies have been performed, and additional investigation is

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… Combining PJ34 and vorinostat decreased proliferation in HL60 cells | - | ++ | [ 42 ] HL60 | PJ34 | Doxorubicin, etoposide, cytarabine, or chlorambucil | PJ34 alone decreased cell survival. … By contrast, combination of PJ34 and the NOTCH inhibitor (N-[N[(3,5-difluorophenacetyl)-l-alanyl]- S -phenylglycine t -butyl ester) (DAPT), or PJ34 and doxorubicin, etoposide, cytarabine, or chlorambucil, did not enhance the cytotoxicity of either drug in Jurkat cells in vitro [ 43 , 49 ]. …

Treatment outcomes and safety of reduced‑dose venetoclax plus antifungal agents to treat acute myeloid leukemia: A single hospital experience in Taiwan.

Venetoclax, an orally administered B-cell lymphoma 2 inhibitor, requires dose adjustments when coadministered with cytochrome P450 inhibitors in patients with acute myeloid leukemia (AML). The present study retrospectively analyzed data on progression-free survival (PFS), overall survival (OS) and drug-related adverse events in patients with AML who received adjusted low-dose venetoclax with antifungal agents, compared with those receiving conventional chemotherapy regimens (I3A7, LDAC, and I2A5), at a single hospital. In total, 45 patients with AML who were treated between January 2015 and De

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… Robak T De la Serna J Venetoclax-rituximab in relapsed or refractory chronic lymphocytic leukemia N Engl J Med 378 1107 1120 2018 10.1056/NEJMoa1713976 29562156 12 Al-Sawaf O Zhang C Tandon M Sinha A Fink AM Robrecht S Samoylova O Liberati AM Pinilla-Ibarz J Opat S Venetoclax plus obinutuzumab versus chlorambucil …

Analysis of 2023 World Health Organization cancer Essential Medicines List and concordance with resource-stratified guidelines.

BackgroundThe World Health Organization (WHO) Essential Medicines List (EML) and resource-stratified guidelines both prioritize high-value medicines. We compared the 2023 EML cancer medicines list with global cancer statistics, examined the proportion of EML therapies recommended by resource-stratified guidelines, and identified gaps that merit evaluation by the WHO EML Committee.MethodsWe compared the 2023 EML medicines for adult cancers with cancer incidence and mortality data from GLOBOCAN 2022. We cross-referenced the EML with 2 resource-stratified guidelines (National Comprehensive Cancer

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… Methotrexate | | | | Realgar indigo naturalis formulation | | | | All-trans retinoid acid | | | | Chronic myeloid leukemia ( n = 4) | Hydroxycarbamide | | | | Dasatinib | | | | Imatinib | | | | Nilotinib | | | | Chronic lymphocytic leukemia ( n = 7) | Bendamustine | | | | Chlorambucil …

Will the reformed Cancer Drugs Fund address the most common types of uncertainty? An analysis of NICE cancer drug appraisals.

BackgroundOne of the functions of the reformed Cancer Drugs Fund in England is as a managed access fund, providing conditional funding for cancer drugs where there is uncertainty in the economic case, and where that uncertainty can be addressed by data collection during two years' use in the NHS. Our study characterises likely sources of such uncertainty, through a review of recent NICE Technology Appraisals.MethodsDiscussions of uncertainty in NICE Appraisal Committees were extracted from published Single Technology Appraisals of cancer drugs, 2014-2016, and categorised inductively. The locat

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… NICE Obinutuzumab in combination with chlorambucil for untreated chronic lymphocytic leukaemia (TA343) 2015 35. NICE Paclitaxel as albumin-bound nanoparticles in combination with gemcitabine for previously untreated metastatic pancreatic cancer (TA360) 2015 36. NICE. …

Outcome of therapy-related myeloid neoplasms treated with azacitidine.

BackgroundTherapy-related myeloid neoplasms (t-MN), including myelodysplastic syndromes and acute myeloid leukemia (t-MDS and t-AML) are associated to clinical and biologic unfavorable prognostic features, including high levels of DNA methylation.MethodsWe retrospectively evaluated 50 t-MN patients (34 MDS and 16 AML) selected among all patients receiving azacitidine (AZA) at 10 Italian Hematology Centers. Patients had developed a t-MN at a median of 6.5 years (range 1.7- 29) after treatment of the primary tumor (hematological neoplasm, 27 patients; solid tumor, 23 patients).ResultsThe overall

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… The exposure to cytotoxic agents however could hasten or induce this transformation as also suggested by an increased risk of AML in patients who were treated with radioactive phosphorus or chlorambucil in the Polycytemia Vera Study Group trial [ 25 ]. …

Multicenter phase 2 study of romidepsin plus lenalidomide for previously untreated peripheral T-cell lymphoma.

Peripheral T-cell lymphomas (PTCLs) are associated with poor prognosis when treated with cytotoxic chemotherapy. We report the findings of a phase 2 study evaluating a chemotherapy-free combination of romidepsin plus lenalidomide as initial treatment for patients with PTCL who were aged >60 years or noncandidates for chemotherapy. Treatment was initiated with romidepsin 10 mg/m2 IV on days 1, 8, and 15 and lenalidomide 25 mg taken orally from days 1 to 21 of 28-day cycle for up to 1 year. The primary objective was overall response rate (ORR). Secondary objectives included safety and survival.

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… Obinutuzumab plus chlorambucil in patients with CLL and coexisting conditions. N Engl J Med. 2014;370(12):1101–1110. doi: 10.1056/NEJMoa1313984. 18. Cosenza M, Civallero M, Fiorcari S, et al. …