Colchicine has been widely used as an anti-gout medication over the past decades.However,it is less commonly used due to its narrow therapeutic range,meaning that its lethal dose is close to its therapeutic dose.The l...Colchicine has been widely used as an anti-gout medication over the past decades.However,it is less commonly used due to its narrow therapeutic range,meaning that its lethal dose is close to its therapeutic dose.The lethal dose of colchicine is considered to be 0.8 mg/kg.As chronic colchicine poisoning has multiple manifestations,it poses a challenge in the clinician’s differential diagnosis.Historically,the drug was important in treating gout;however,clinical studies are currently underway regarding the use of colchicine in patients with coronavirus disease 2019 as well as its use in coronary artery disease,making this drug more important in clinical practice.CASE SUMMARY A 61-year-old male with a history of gout and chronic colchicine intake was admitted to our Emergency Department due to numbness and weakness of the lower limbs.The patient reported a history of colchicine intake for 23 years.After thorough examination,he was diagnosed with colchicine poisoning,manifesting as neuromyopathy,multiple gastric ulcers and myelosuppression.We advised him to stop taking colchicine and drinking alcohol.We also provided a prescription of lansoprazole and mecobalamin,and then asked him to return to the clinic for re-examination.The patient was followed up for 3-mo during which time his gout symptoms were controlled to the point where he was asymptomatic.CONCLUSION Colchicine overdose can mimic the clinical manifestations of several conditions.Physicians easily pay attention to the disease while ignoring the cause of the disease.Thus,the patient’s medication history should never be ignored.展开更多
Objective The influential factors of chemotherapy-induced myelosuppression in esophageal cancer in central China are unclear.This study aimed to investigate the effect of commonly used chemotherapy regimens on the inc...Objective The influential factors of chemotherapy-induced myelosuppression in esophageal cancer in central China are unclear.This study aimed to investigate the effect of commonly used chemotherapy regimens on the incidence of myelosuppression in clinical treatment of esophageal cancer.Methods In this retrospective study,624 patients with esophageal cancer who received six different chemotherapy regimens between 2013 and 2020 at our institute were included.Chemotherapy consisted of lobaplatin,5-fluorouracil(5-F),lobaplatin and 5-F,nedaplatin,nedaplatin and paclitaxel(PTX),cisplatin and PTX.Multivariable logistic regression analysis was used to explore the risk of myelosuppression among the six different chemotherapy regimens.Results Compared with lobaplatin group,the incidence of myelosuppression in patients treated with chemotherapy regimens of lobaplatin and 5-F,nedaplatin,nedaplatin and PTX and cisplatin and PTX were significantly ameliorated.The dose of lobaplatin was significantly reduced(P=0.007)when lobaplatin was combined with 5-F,and the combination could significantly reduce the risk of myelosuppression(P=0.022).Furthermore,chemotherapeutic regimens,the dose of platinum,hemoglobin and uric acid levels,age,sex,total bilirubin and immune-enhancing drugs were found to be strong predictors of developing myelosuppression.Conclusion Targeted preventive interventions that enhance immune function,reduce uric acid levels and choose combined medication during chemotherapy should be implemented for high-risk patients to reduce the occurrence of myelosuppression.In addition,the dose of lobaplatin should be adjusted when combined with other chemotherapy drugs to reduce the incidence of myelosuppression.展开更多
Objective:To evaluate the effect of acupuncture on myelosuppression after chemotherapy and summarize its acupoint selection strategy.Methods:After a systematic search,an acupoint database on myelosuppression after che...Objective:To evaluate the effect of acupuncture on myelosuppression after chemotherapy and summarize its acupoint selection strategy.Methods:After a systematic search,an acupoint database on myelosuppression after chemotherapy was constructed.A meta-analysis was conducted to assess the efficacy of acupuncture.On this basis,association analysis and cluster analysis were performed to explore the distribution of acupoints in SPSS Modeler18.0 and SPSS 22.0.Results:40 studies with 2988 patients were included.The white blood cell count,platelet count,red blood cell count,and hemoglobin were significantly higher in patients receiving acupuncture versus convention therapy exclusively.The two groups,however,did not differ in neutrophils count.Most acupoints,mainly distributed in the limbs and the back,were from the bladder meridian,the stomach meridian,and the spleen meridian.The lower sea and transport points were the most preferred specific points,in which ST36 and SP6 ranked highest in use.ST36-RN6,SP6-SP10,and ST36-SP10 turned out to be the most significant correlations in association rule mining.In cluster analysis,LI4-RN12,ST36-RN4-RN6 were grouped for their high similarity.Conclusion:For patients with myelosuppression after chemotherapy,acupuncture significantly inhibited the decline in blood cell components(white blood cell count,platelet count,red blood cell count,and hemoglobin)except for neutrophils.As the central combination of acupuncture prescriptions for this population,ST36-SP6-RN6-SP10-RN4 presented promising prospects and deserved more exploration for clinical use.展开更多
Paeonia lactiflora root(baishao in Chinese) is a commonly used herb in traditional Chinese medicines(TCM). Two isomers, paeoniflorin(PF) and albiflorin(AF), are isolated from P. lactiflora. The present study aimed to ...Paeonia lactiflora root(baishao in Chinese) is a commonly used herb in traditional Chinese medicines(TCM). Two isomers, paeoniflorin(PF) and albiflorin(AF), are isolated from P. lactiflora. The present study aimed to investigate the protective effects of PF and AF on myelosuppression induced by chemotherapy in mice and to explore the underlying mechanisms. The mouse myelosuppression model was established by intraperitoneal(i.p.) injection of cyclophosphamide(CP, 200 mg×kg^(–1)). The blood cell counts were performed. The thymus index and spleen index were also determined and bone morrow histological examination was performed. The levels of tumor necrosis factor-α(TNF-α) in serum and colony-stimulating factor(G-CSF) in plasma were measured by Enzyme-Linked Immunosorbent Assays(ELISA) and the serum levels of interleukin-3(IL-3), granulocyte-macrophagecolony- stimulatingfactor(GM-CSF), and interleukin-6(IL-6) were measured by radioimmunoassay(RIA). The levels of m RNA expression protein of IL-3, GM-CSF and G-CSF in spleen and bone marrow cells were determined respectively. PF and AF significantly increased the white blood cell(WBC) counts and reversed the atrophy of thymus. They also increased the serum levels of GM-CSF and IL-3 and the plasma level of G-CSF and reduced the level of TNF-α in serum.. PF enhanced the m RNA level of IL-3 and AF enhanced the m RNA levels of GM-CSF and G-CSF in the spleen. PF and AF both increased the protein levels of GM-CSF and G-CSF in bone marrow cells. In conclusion, our results demonstrated that PF and AF promoted the recovery of bone marrow hemopoietic function in the mouse myelosuppression model.展开更多
Objective: To study the efficacy and safety of Shuanghuang Shengbai Granule(双黄升白颗粒, SSG), a traditional Chinese herbal medicine, on myelosuppression of cancer patients caused by chemotherapy. Methods: A total of...Objective: To study the efficacy and safety of Shuanghuang Shengbai Granule(双黄升白颗粒, SSG), a traditional Chinese herbal medicine, on myelosuppression of cancer patients caused by chemotherapy. Methods: A total of 330 patients were randomly assigned to the treatment group(220 cases, analysed 209 cases) and the control group(110 cases, analysed 102 cases) with a 2:1 ratio by envelope method. The patients in the treatment group at the first day of chemotherapy started to take SSG for 14 days, while the patients in the control group took Leucogon Tablets. The changes of the blood routine, clinical symptoms and immune function in both groups were observed for safety and efficacy evaluation. Results: At the 7th day of chemotherapy, the white blood cells(WBCs) level in the treatment group was significantly higher than that in the control group(P<0.05). After treatment, the WBCs rate in the normal range accounted for 50.2% in the treatment group, the myelosuppression of WBCs and neutrophil were mainly grade Ⅰ, while 8.1% and 5.7% of patients emerged grade Ⅲ and grade Ⅳ myelosuppression, respectively. The incidence of myelosuppression of the treatment group was significantly lower than that of the control group(P<0.05). The total effective rate of Chinese medicine syndrome in the treatment group was significantly higher than that in the control group(84.2% vs. 72.5%, P<0.05). The immune cell levels in both groups were maintained in the normal range. Compared with that before treatment, the levels of CD3^+ and CD4^+ cells were significantly increased in the treatment group after treatment(P<0.05). The discrepancy of CD3^+ and CD4^+ cell activity before and after treatment in both groups were significantly different(P<0.05). No obvious adverse event occurred in both groups. Conclusion: SSG had a protection effect on bone marrow suppression, and alleviated the clinical symptoms together with clinical safety.展开更多
BACKGROUND Platelet transfusion is of great significance in the treatment of thrombocytopenia caused by myelosuppression during intensive chemotherapy in patients with acute leukemia.In recent years,with platelet tran...BACKGROUND Platelet transfusion is of great significance in the treatment of thrombocytopenia caused by myelosuppression during intensive chemotherapy in patients with acute leukemia.In recent years,with platelet transfusion increasing,ineffective platelet transfusion has become increasingly prominent.Generally speaking,platelet antibodies can be produced after repeated transfusion,thus rendering subsequent platelet transfusion ineffective.We report a case of first platelet transfusion refractoriness(PTR)in a patient with acute myelocytic leukemia(AML).Due to the rarity of such cases in clinical practice,there have been no relevant case reports so far.CASE SUMMARY A 51-year-old female patient attended the hospital due to throat pain and abnormal blood cells for 4 d.Her diagnosis was acute myelocytic leukemia[M2 type Fms related receptor tyrosine kinase 3,Isocitrate Dehydrogenase 1,Nucleophosmin 1,Neuroblastoma RAS viral oncogene homolog(+)high-risk group].She was treated with"IA"(IDA 10 mg day 1-3 and Ara-C 0.2 g day 1-5)chemotherapy.When her condition improved,the patient was discharged from the hospital,instructed to take medicine as prescribed by the doctor after discharge,and returned to the hospital for further chemotherapy on time.CONCLUSION We report a rare case of first platelet transfusion failure in a patient with AML during induction chemotherapy,which may be related to the production of platelet antibodies induced by antibiotics and excessive tumor load.This also suggests that we should consider the influence of antibiotics when the rare situation of first platelet transfusion failure occurs in patients with AML.When platelet antibodies are produced,immunoglobulins can be used to block antibodies,thereby reducing platelet destruction.For patients with PTR,both immune and non-immune factors need to be considered and combined in clinical practice along with individualized treatment to effectively solve the problem.展开更多
A male Japanese spitz(3 years)was brought at Himalayan Animal Rescue Trust(HART),Pokhara with a complaint of swollen gums and loss of appetite.A lobulated tumorous mass was seen at the gingival region on physical exam...A male Japanese spitz(3 years)was brought at Himalayan Animal Rescue Trust(HART),Pokhara with a complaint of swollen gums and loss of appetite.A lobulated tumorous mass was seen at the gingival region on physical examination.Diagnosis and treatment of condition detected in the dog was the major objective.Impression smear of tumor cell was prepared and was observed under oil immersion microscope(100x).Microscopic examination shows the presence of vacuolations within the cytoplasm and the condition was diagnosed to be CTVT.Chemotherapy was performed using the most effective cytostatic agents I.e.Vincristine sulphate(once a week,I/v).The chemotherapy was repeated for 3 doses till the tumor gets completely regressed.The condition was resolved after third session of chemotherapy.Myelosuppression and gastrointestinal effects like vomiting are the major complications of using vincristine.展开更多
Objective:To investigate the efficacy and prognosis of venetoclax combined with hypomethylating agents(HMAs)in the treatment of relapsed/refractory acute myeloid leukemia(AML).Methods:From June 2021 to February 2022,1...Objective:To investigate the efficacy and prognosis of venetoclax combined with hypomethylating agents(HMAs)in the treatment of relapsed/refractory acute myeloid leukemia(AML).Methods:From June 2021 to February 2022,14 patients with relapsed/refractory AML were treated with venetoclax combined with HMAs,among which nine patients were treated with venetoclax+azacytidine,while five patients were treated with venetoclax+decitabine.The efficacy of the treatments was observed,and the patients were followed up.Results:All patients received one to five courses of treatment,in which the median course of treatment was three;four cases achieved CR and another four achieved PR,with NR in six cases;there was no treatment-related death.There were seven deaths up to the end of the follow-up period,all of which were progressive deaths at the end of the disease,and the overall survival rate was 50.00%.All the patients experienced different degrees of nausea,vomiting,and myelosuppression(Grade Ⅱ–Ⅳ),nine patients had Grade 3–4 hematological adverse reactions,and seven patients had infection.Conclusion:Venetoclax combined with hypomethylating agents is effective in the treatment of relapsed/refractory AML,with good prognosis,and some patients may even achieve CR.Although bone marrow suppression is serious with this combination,it is well tolerated.展开更多
Background The side effects of chemotherapy-induced nausea and vomiting(CINV)and myelosuppression reduce the cancer patients’adherence to chemotherapy.Many Chinese patients choose Chinese medicine(CM)during chemother...Background The side effects of chemotherapy-induced nausea and vomiting(CINV)and myelosuppression reduce the cancer patients’adherence to chemotherapy.Many Chinese patients choose Chinese medicine(CM)during chemotherapy to reduce side effects;however,the evidence is lacking.The efficacy of a CM herbal treatment protocol,Jianpi Bushen Sequential Formula(健脾补肾续贯方,JBSF)will be evaluated on chemotherapy completion rate among patients with colon cancer.Methods A multi-center double-blind randomized controlled trial(RCT)will be conducted on 400 patients with colon cancer who will receive 8 cycles of adjuvant chemotherapy with oxaliplatin and capecitabine(CAPEOX).Patients will be randomized 1:1 to receive the JBSF or placebo formula.The primary outcome is the overall chemotherapy completion rate.The secondary outcomes include individual chemotherapy completion rate,4-cycle completion rate of chemotherapy,time to treatment failure,relative dose intensity and treatment toxicity.Follow-up visits will be scheduled before every and after last chemotherapy.Discussion This study will provide evidence on whether JBSF can improve the chemotherapy completion rate and reduce side effects among patients with colon cancer.(Trial registration:Clinical Trials.gov,No.NCT03716518)。展开更多
Objective:To evaluate the effect of Spirulina platensis polysaccharide (SPP) on hematopoietic recovery and related cytokines in mice with transplanted tumor after chemotherapy. Methods:Mouse model of transplanted soli...Objective:To evaluate the effect of Spirulina platensis polysaccharide (SPP) on hematopoietic recovery and related cytokines in mice with transplanted tumor after chemotherapy. Methods:Mouse model of transplanted solid tumor was established and treated with chemotherapy. Peripheral blood cells, bone marrow nucleated cells, and colony forming unit spleen (CFU S) were counted; the content of DNA in bone marrow was inspected by ultraviolet spectrophotometer; serum content of cytokines, interleukin (IL)1, IL 3, granulocyte macrophage colony stimulating factor (GM CSF) and tumor necrosis factor α (TNF α) were determined by double antibody sandwich ELISA.Results:Cyclophosphamide (CTX) could induce evident myelosuppression, manifested as decrease of peripheral blood cells, bone marrow nucleated cell and DNA, and the CFU S number. SPP could significantly ameliorate the myelosuppression induced by CTX without reducing anti tumor effect of CTX. In addition, it could also increase the contents of IL 1, IL 3, GM CSF, TNF α in serum. Conclusion:SPP can probably accelerate the hematopoietic recovery in mice after chemotherapy through promoting endogenous secretion of cytokines.展开更多
Objective:To explore the effect of carbon ion radiotherapy(CIRT)on the bone marrow adjacent to or within the treatment fields,and to observe the bone marrow toxicities after CIRT alone.Methods:Twenty-one patients with...Objective:To explore the effect of carbon ion radiotherapy(CIRT)on the bone marrow adjacent to or within the treatment fields,and to observe the bone marrow toxicities after CIRT alone.Methods:Twenty-one patients with malignant tumors of different body parts and treated with CIRT in Heavy Ion Center,Wuwei Cancer Hospital were analyzed retrospectively.The data of white blood cells,neutrophils,hemoglobin,platelets,lymphocytes and globulin before treatment,7,14 and 28 d during treatment,and 1 and 3 months after treatment were collected.Hematological toxicities were measured according to the Common Terminology Criteria for Adverse Events(CTCAE,Version 4.03)criteria.Dose-volume histogram parameters were obtained for all patients and analyzed for their correlation with myelosuppression.Univariate analysis was performed for patients’sex,age group,tumor site,radiation dose,and Karnofsky performance score(KPS)was used as an independent factor to find predictors factors for the risk of myelosuppression.Results:CIRT minimized the dose radiated to the bone marrow.Overall,volume receiving 3 GyE(V3)or more of the bone marrow were less than 0.5%,especially V5 less than 0.1%.No patients treated with carbon ion radiotherapy developed grade III or IV myelosuppression.Seven patients(33.3%)developed grade I myelosuppression and one patient(4.8%)developed grade II myelosuppression,and most of them showed reduced white blood cell counts.There were no significant differences in hemoglobin and globulin levels before and after CIRT.Univariate analysis did not find any statistically significant predictors for myelosuppression.Conclusions:CIRT is effective in preserving bone marrow function regardless of tumor site.Patients receiving CIRT alone have a low incidence of grade III myelosuppression and a mild effect on globulins.There was no significant correlation between occurrence of myelosuppression and the dose and site irradiated by CIRT.展开更多
文摘Colchicine has been widely used as an anti-gout medication over the past decades.However,it is less commonly used due to its narrow therapeutic range,meaning that its lethal dose is close to its therapeutic dose.The lethal dose of colchicine is considered to be 0.8 mg/kg.As chronic colchicine poisoning has multiple manifestations,it poses a challenge in the clinician’s differential diagnosis.Historically,the drug was important in treating gout;however,clinical studies are currently underway regarding the use of colchicine in patients with coronavirus disease 2019 as well as its use in coronary artery disease,making this drug more important in clinical practice.CASE SUMMARY A 61-year-old male with a history of gout and chronic colchicine intake was admitted to our Emergency Department due to numbness and weakness of the lower limbs.The patient reported a history of colchicine intake for 23 years.After thorough examination,he was diagnosed with colchicine poisoning,manifesting as neuromyopathy,multiple gastric ulcers and myelosuppression.We advised him to stop taking colchicine and drinking alcohol.We also provided a prescription of lansoprazole and mecobalamin,and then asked him to return to the clinic for re-examination.The patient was followed up for 3-mo during which time his gout symptoms were controlled to the point where he was asymptomatic.CONCLUSION Colchicine overdose can mimic the clinical manifestations of several conditions.Physicians easily pay attention to the disease while ignoring the cause of the disease.Thus,the patient’s medication history should never be ignored.
基金the National Key R&D Programmes(NKPs)of China(No.2017YFC0909900).
文摘Objective The influential factors of chemotherapy-induced myelosuppression in esophageal cancer in central China are unclear.This study aimed to investigate the effect of commonly used chemotherapy regimens on the incidence of myelosuppression in clinical treatment of esophageal cancer.Methods In this retrospective study,624 patients with esophageal cancer who received six different chemotherapy regimens between 2013 and 2020 at our institute were included.Chemotherapy consisted of lobaplatin,5-fluorouracil(5-F),lobaplatin and 5-F,nedaplatin,nedaplatin and paclitaxel(PTX),cisplatin and PTX.Multivariable logistic regression analysis was used to explore the risk of myelosuppression among the six different chemotherapy regimens.Results Compared with lobaplatin group,the incidence of myelosuppression in patients treated with chemotherapy regimens of lobaplatin and 5-F,nedaplatin,nedaplatin and PTX and cisplatin and PTX were significantly ameliorated.The dose of lobaplatin was significantly reduced(P=0.007)when lobaplatin was combined with 5-F,and the combination could significantly reduce the risk of myelosuppression(P=0.022).Furthermore,chemotherapeutic regimens,the dose of platinum,hemoglobin and uric acid levels,age,sex,total bilirubin and immune-enhancing drugs were found to be strong predictors of developing myelosuppression.Conclusion Targeted preventive interventions that enhance immune function,reduce uric acid levels and choose combined medication during chemotherapy should be implemented for high-risk patients to reduce the occurrence of myelosuppression.In addition,the dose of lobaplatin should be adjusted when combined with other chemotherapy drugs to reduce the incidence of myelosuppression.
基金supported by the Natural Science Foundation of China(Grant Nos.81703839,81874411).
文摘Objective:To evaluate the effect of acupuncture on myelosuppression after chemotherapy and summarize its acupoint selection strategy.Methods:After a systematic search,an acupoint database on myelosuppression after chemotherapy was constructed.A meta-analysis was conducted to assess the efficacy of acupuncture.On this basis,association analysis and cluster analysis were performed to explore the distribution of acupoints in SPSS Modeler18.0 and SPSS 22.0.Results:40 studies with 2988 patients were included.The white blood cell count,platelet count,red blood cell count,and hemoglobin were significantly higher in patients receiving acupuncture versus convention therapy exclusively.The two groups,however,did not differ in neutrophils count.Most acupoints,mainly distributed in the limbs and the back,were from the bladder meridian,the stomach meridian,and the spleen meridian.The lower sea and transport points were the most preferred specific points,in which ST36 and SP6 ranked highest in use.ST36-RN6,SP6-SP10,and ST36-SP10 turned out to be the most significant correlations in association rule mining.In cluster analysis,LI4-RN12,ST36-RN4-RN6 were grouped for their high similarity.Conclusion:For patients with myelosuppression after chemotherapy,acupuncture significantly inhibited the decline in blood cell components(white blood cell count,platelet count,red blood cell count,and hemoglobin)except for neutrophils.As the central combination of acupuncture prescriptions for this population,ST36-SP6-RN6-SP10-RN4 presented promising prospects and deserved more exploration for clinical use.
基金supported by the National Nature Science Foundation of China(Nos.81473370,81173569)
文摘Paeonia lactiflora root(baishao in Chinese) is a commonly used herb in traditional Chinese medicines(TCM). Two isomers, paeoniflorin(PF) and albiflorin(AF), are isolated from P. lactiflora. The present study aimed to investigate the protective effects of PF and AF on myelosuppression induced by chemotherapy in mice and to explore the underlying mechanisms. The mouse myelosuppression model was established by intraperitoneal(i.p.) injection of cyclophosphamide(CP, 200 mg×kg^(–1)). The blood cell counts were performed. The thymus index and spleen index were also determined and bone morrow histological examination was performed. The levels of tumor necrosis factor-α(TNF-α) in serum and colony-stimulating factor(G-CSF) in plasma were measured by Enzyme-Linked Immunosorbent Assays(ELISA) and the serum levels of interleukin-3(IL-3), granulocyte-macrophagecolony- stimulatingfactor(GM-CSF), and interleukin-6(IL-6) were measured by radioimmunoassay(RIA). The levels of m RNA expression protein of IL-3, GM-CSF and G-CSF in spleen and bone marrow cells were determined respectively. PF and AF significantly increased the white blood cell(WBC) counts and reversed the atrophy of thymus. They also increased the serum levels of GM-CSF and IL-3 and the plasma level of G-CSF and reduced the level of TNF-α in serum.. PF enhanced the m RNA level of IL-3 and AF enhanced the m RNA levels of GM-CSF and G-CSF in the spleen. PF and AF both increased the protein levels of GM-CSF and G-CSF in bone marrow cells. In conclusion, our results demonstrated that PF and AF promoted the recovery of bone marrow hemopoietic function in the mouse myelosuppression model.
基金Supported by National Natural Science Foundation of China(No.81202670)Project of Longhua Medical Team Shanghai,China(No.LYTD-18)
文摘Objective: To study the efficacy and safety of Shuanghuang Shengbai Granule(双黄升白颗粒, SSG), a traditional Chinese herbal medicine, on myelosuppression of cancer patients caused by chemotherapy. Methods: A total of 330 patients were randomly assigned to the treatment group(220 cases, analysed 209 cases) and the control group(110 cases, analysed 102 cases) with a 2:1 ratio by envelope method. The patients in the treatment group at the first day of chemotherapy started to take SSG for 14 days, while the patients in the control group took Leucogon Tablets. The changes of the blood routine, clinical symptoms and immune function in both groups were observed for safety and efficacy evaluation. Results: At the 7th day of chemotherapy, the white blood cells(WBCs) level in the treatment group was significantly higher than that in the control group(P<0.05). After treatment, the WBCs rate in the normal range accounted for 50.2% in the treatment group, the myelosuppression of WBCs and neutrophil were mainly grade Ⅰ, while 8.1% and 5.7% of patients emerged grade Ⅲ and grade Ⅳ myelosuppression, respectively. The incidence of myelosuppression of the treatment group was significantly lower than that of the control group(P<0.05). The total effective rate of Chinese medicine syndrome in the treatment group was significantly higher than that in the control group(84.2% vs. 72.5%, P<0.05). The immune cell levels in both groups were maintained in the normal range. Compared with that before treatment, the levels of CD3^+ and CD4^+ cells were significantly increased in the treatment group after treatment(P<0.05). The discrepancy of CD3^+ and CD4^+ cell activity before and after treatment in both groups were significantly different(P<0.05). No obvious adverse event occurred in both groups. Conclusion: SSG had a protection effect on bone marrow suppression, and alleviated the clinical symptoms together with clinical safety.
基金Supported by Innovation Platform and Talent Program of Hunan Province,No.2021SK4050.
文摘BACKGROUND Platelet transfusion is of great significance in the treatment of thrombocytopenia caused by myelosuppression during intensive chemotherapy in patients with acute leukemia.In recent years,with platelet transfusion increasing,ineffective platelet transfusion has become increasingly prominent.Generally speaking,platelet antibodies can be produced after repeated transfusion,thus rendering subsequent platelet transfusion ineffective.We report a case of first platelet transfusion refractoriness(PTR)in a patient with acute myelocytic leukemia(AML).Due to the rarity of such cases in clinical practice,there have been no relevant case reports so far.CASE SUMMARY A 51-year-old female patient attended the hospital due to throat pain and abnormal blood cells for 4 d.Her diagnosis was acute myelocytic leukemia[M2 type Fms related receptor tyrosine kinase 3,Isocitrate Dehydrogenase 1,Nucleophosmin 1,Neuroblastoma RAS viral oncogene homolog(+)high-risk group].She was treated with"IA"(IDA 10 mg day 1-3 and Ara-C 0.2 g day 1-5)chemotherapy.When her condition improved,the patient was discharged from the hospital,instructed to take medicine as prescribed by the doctor after discharge,and returned to the hospital for further chemotherapy on time.CONCLUSION We report a rare case of first platelet transfusion failure in a patient with AML during induction chemotherapy,which may be related to the production of platelet antibodies induced by antibiotics and excessive tumor load.This also suggests that we should consider the influence of antibiotics when the rare situation of first platelet transfusion failure occurs in patients with AML.When platelet antibodies are produced,immunoglobulins can be used to block antibodies,thereby reducing platelet destruction.For patients with PTR,both immune and non-immune factors need to be considered and combined in clinical practice along with individualized treatment to effectively solve the problem.
文摘A male Japanese spitz(3 years)was brought at Himalayan Animal Rescue Trust(HART),Pokhara with a complaint of swollen gums and loss of appetite.A lobulated tumorous mass was seen at the gingival region on physical examination.Diagnosis and treatment of condition detected in the dog was the major objective.Impression smear of tumor cell was prepared and was observed under oil immersion microscope(100x).Microscopic examination shows the presence of vacuolations within the cytoplasm and the condition was diagnosed to be CTVT.Chemotherapy was performed using the most effective cytostatic agents I.e.Vincristine sulphate(once a week,I/v).The chemotherapy was repeated for 3 doses till the tumor gets completely regressed.The condition was resolved after third session of chemotherapy.Myelosuppression and gastrointestinal effects like vomiting are the major complications of using vincristine.
文摘Objective:To investigate the efficacy and prognosis of venetoclax combined with hypomethylating agents(HMAs)in the treatment of relapsed/refractory acute myeloid leukemia(AML).Methods:From June 2021 to February 2022,14 patients with relapsed/refractory AML were treated with venetoclax combined with HMAs,among which nine patients were treated with venetoclax+azacytidine,while five patients were treated with venetoclax+decitabine.The efficacy of the treatments was observed,and the patients were followed up.Results:All patients received one to five courses of treatment,in which the median course of treatment was three;four cases achieved CR and another four achieved PR,with NR in six cases;there was no treatment-related death.There were seven deaths up to the end of the follow-up period,all of which were progressive deaths at the end of the disease,and the overall survival rate was 50.00%.All the patients experienced different degrees of nausea,vomiting,and myelosuppression(Grade Ⅱ–Ⅳ),nine patients had Grade 3–4 hematological adverse reactions,and seven patients had infection.Conclusion:Venetoclax combined with hypomethylating agents is effective in the treatment of relapsed/refractory AML,with good prognosis,and some patients may even achieve CR.Although bone marrow suppression is serious with this combination,it is well tolerated.
文摘Background The side effects of chemotherapy-induced nausea and vomiting(CINV)and myelosuppression reduce the cancer patients’adherence to chemotherapy.Many Chinese patients choose Chinese medicine(CM)during chemotherapy to reduce side effects;however,the evidence is lacking.The efficacy of a CM herbal treatment protocol,Jianpi Bushen Sequential Formula(健脾补肾续贯方,JBSF)will be evaluated on chemotherapy completion rate among patients with colon cancer.Methods A multi-center double-blind randomized controlled trial(RCT)will be conducted on 400 patients with colon cancer who will receive 8 cycles of adjuvant chemotherapy with oxaliplatin and capecitabine(CAPEOX).Patients will be randomized 1:1 to receive the JBSF or placebo formula.The primary outcome is the overall chemotherapy completion rate.The secondary outcomes include individual chemotherapy completion rate,4-cycle completion rate of chemotherapy,time to treatment failure,relative dose intensity and treatment toxicity.Follow-up visits will be scheduled before every and after last chemotherapy.Discussion This study will provide evidence on whether JBSF can improve the chemotherapy completion rate and reduce side effects among patients with colon cancer.(Trial registration:Clinical Trials.gov,No.NCT03716518)。
文摘Objective:To evaluate the effect of Spirulina platensis polysaccharide (SPP) on hematopoietic recovery and related cytokines in mice with transplanted tumor after chemotherapy. Methods:Mouse model of transplanted solid tumor was established and treated with chemotherapy. Peripheral blood cells, bone marrow nucleated cells, and colony forming unit spleen (CFU S) were counted; the content of DNA in bone marrow was inspected by ultraviolet spectrophotometer; serum content of cytokines, interleukin (IL)1, IL 3, granulocyte macrophage colony stimulating factor (GM CSF) and tumor necrosis factor α (TNF α) were determined by double antibody sandwich ELISA.Results:Cyclophosphamide (CTX) could induce evident myelosuppression, manifested as decrease of peripheral blood cells, bone marrow nucleated cell and DNA, and the CFU S number. SPP could significantly ameliorate the myelosuppression induced by CTX without reducing anti tumor effect of CTX. In addition, it could also increase the contents of IL 1, IL 3, GM CSF, TNF α in serum. Conclusion:SPP can probably accelerate the hematopoietic recovery in mice after chemotherapy through promoting endogenous secretion of cytokines.
基金Science and Technology Bureau of Gansu Province,China(No.2019-0203-SFC-0207).
文摘Objective:To explore the effect of carbon ion radiotherapy(CIRT)on the bone marrow adjacent to or within the treatment fields,and to observe the bone marrow toxicities after CIRT alone.Methods:Twenty-one patients with malignant tumors of different body parts and treated with CIRT in Heavy Ion Center,Wuwei Cancer Hospital were analyzed retrospectively.The data of white blood cells,neutrophils,hemoglobin,platelets,lymphocytes and globulin before treatment,7,14 and 28 d during treatment,and 1 and 3 months after treatment were collected.Hematological toxicities were measured according to the Common Terminology Criteria for Adverse Events(CTCAE,Version 4.03)criteria.Dose-volume histogram parameters were obtained for all patients and analyzed for their correlation with myelosuppression.Univariate analysis was performed for patients’sex,age group,tumor site,radiation dose,and Karnofsky performance score(KPS)was used as an independent factor to find predictors factors for the risk of myelosuppression.Results:CIRT minimized the dose radiated to the bone marrow.Overall,volume receiving 3 GyE(V3)or more of the bone marrow were less than 0.5%,especially V5 less than 0.1%.No patients treated with carbon ion radiotherapy developed grade III or IV myelosuppression.Seven patients(33.3%)developed grade I myelosuppression and one patient(4.8%)developed grade II myelosuppression,and most of them showed reduced white blood cell counts.There were no significant differences in hemoglobin and globulin levels before and after CIRT.Univariate analysis did not find any statistically significant predictors for myelosuppression.Conclusions:CIRT is effective in preserving bone marrow function regardless of tumor site.Patients receiving CIRT alone have a low incidence of grade III myelosuppression and a mild effect on globulins.There was no significant correlation between occurrence of myelosuppression and the dose and site irradiated by CIRT.
