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Abstract: Objective: Hodgkin lymphoma can be treated by radiotherapy or chemotherapy alone or combined. Meningiomas account for 1-4.2% of all primary intracranial tumors in children, and chordoid meningioma is a very rare subtype. In this study, we investigated a case of an intraparenchymal chordoid meningioma that developed during the early stage in a patient with Hodgkin lymphoma who had been treated with radiotherapy. Case: A 10-year-old male patient was diagnosed with Hodgkin lymphoma and was treated with a combination of radiotherapy and chemotherapy. He presented at our emergency service 6 years later. He had a fever and was suffering from discomfort and insignificant left hemiparesis (4/5). Contrast-enhanced cranial magnetic resonance imaging (MRI) showed a mass in the right temporoparietal region. The intracranial lesion was surgically excised. The tumor was identified as a WHO grade 2 chordoid meningioma by the pathological examination. The Ki-67 proliferation index was found to be 20-25%. Conclusion: Surgeons must remember that radiation-associated meningiomas may occur in the early stage of the treatment as well as in the late stage. Young patients with grade 2 chordoid meningiomas must be followed-up in case of recurrence, and tumors with high Ki-67 indexes are highly expected to relapse. Keywords: Meningioma, Hodgkin lymphoma, radiation, secondary tumor, chordoid, intraparenchymal.Download Full Article |
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Abstract: In this study, we have calculated and reported the pharmacokinetics of irinotecan and its active metabolite, SN-38, in patients with increased plasma bilirubin levels. Four patients suffering from metastatic colorectal cancer (CRC) with high bilirubin levels (0.7 to 15 mg/dl) were selected for our study. These patients were being treated by CPT -11 (Irinotecan) in the hospital setup. To all four patients, CPT-11 was administered as a 60 min IV- infusion (180 mg/m2, total dose 339 ± 32 mg). Blood samples were collected at 0, 15, 30, 45, 60, 90,120, 180, 240, 300 and 360 minutes after the drug administration. The drug and its pharmacologically active metabolite, SN38 were quantified in these samples by an HPLC method. The blood level profiles were analyzed for their PK behavior by Kinetica® software system. SN 38 levels were found to be decreasing with increasing bilirubin values. The possible rationalizing for lower SN38 levels with elevated bilirubin levels might be some liver impairment which slows the metabolic conversion of irinotecan into SN-38. Keywords: Irinotecan (CPT-11), SN-38, Bilirubin, liver impairment, Pharmacokinetics, DLT. Download Full Article |
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Abstract: Objectives: We retrospectively compared the toxicity and efficacy of two neoadjuvant chemotherapy regimens (docetaxel+cisplatin+5-fluorouracil vs. cisplatin+5-fluorouracil) followed by chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma. Patients and Materials: We analysed 135 patients with stage III and IVA-B nasopharyngeal carcinoma. Forty-four patients were treated with docetaxel+cisplatin+5-fluorouracil and chemoradiotherapy (TPF group), and 91 were treated with cisplatin+5-fluorouracil and chemoradiotherapy (PF group). Chemoradiotherapy was administered with weekly cisplatin. Radical radiotherapy with total doses of 70–74Gy was administered using a conventional technique, over 7 weeks in 2.0Gy/fraction; boost doses of 6–10Gy were administered in 55.6% patients (n=75) with locally advanced cancer. Results: The median follow-up was 46.5 months (range, 9.8–62.8 months), and the follow-up rate was 95%. The TPF group had better 5-year estimated progression-free survival (77.0% vs. 73.5%; P = 0.510) and overall survival than the PF group (80.7% vs. 77.9%, P = 0.446); however, there was no statistically significant difference between the groups. Toxicities in the two groups were similar; grade 3/4 oral mucositis was more common in the TPF group (27.3%) than in the PF group (15.3%) during chemoradiotherapy. Conclusions: The neoadjuvant docetaxel+cisplatin+5-fluorouracil chemotherapy led to satisfactory long-term survival and slight improvement in progression-free survival and overall survival as compared with the classic cisplatin+5-fluorouracil regimen; toxicity was tolerable. However, prospective trials are needed to prove whether docetaxel+cisplatin+5-fluorouracil is a substitute for cisplatin+5-fluorouracil. Keywords: Nasopharyngeal carcinoma, induction-concurrent chemotherapy, docetaxel, cisplatin, 5-fluorouracil.Download Full Article |
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Abstract: According to the AML-BFM 2004 Interim, a treatment protocol used in Poland since 2005, presence of FLT3 internal tandem duplication (FLT3/ITD) qualifies a patient with acute myeloid leukemia (AML) to a high-risk group (HRG). The present study was aimed to identify the prevalence of FLT3/ITD in children with AML in Poland and to evaluate its prognostic significance in the HRG patients. Out of 291 children with de novo AML treated in 14 Polish centers between January 2006 and December 2012, samples from 174 patients were available for FLT3/ITD analysis. Among study patients 108 children (61.7%) were qualified to HRG.Genomic DNA samples from bone marrow were tested for identification of FLT3/ITD mutation by PCR amplification of exon 14 and 15 of FLT3 gene. Clinical features and treatment outcome in patients with and without FLT3/ITD were analyzed in the study. The FLT3/ITD was found in 14 (12.9%) of 108 HRG children. There were no significant differences between children with and without FLT3/ITD in age and FAB distribution. The white blood cells count in peripheral blood at diagnosis was significantly higher (p <0.01) in the children with FLT3/ITD. Over 5-year overall survival rate for FLT3/ITD positive children was worse (42.4%) comparing to FLT3/ITD negative children (58.9%), but the statistical difference was not significant. However, over 5-year survivals free from treatment failures were similar. The FLT3/ITD rate (12.9%) observed in the study corresponded to the published data. There was no significant impact of FLT3/ITD mutation on survival rates, although further studies are needed on this subject. Keywords: FLT3/ITD mutation, acute myeloid leukemia, children, treatment result, high risk group.Download Full Article |
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Abstract: On the basis of a leishmanicidal assay-guided isolation, chamuangone was purified from Garcinia cowa leaves together with four inactive compounds; 5-hydroxymethylfurfural; D-glyceropentaric acid,2-deoxy-3-C-(methoxycarbonyl)-1,4-lactone,5-ethyl ester; isoorientin-6"-O-rhamnoside; and dulcinoside. Chamuangone possessed a cytotoxic activity against Leishmania major with an IC50 value of 10.7 µM, and also exhibited strong inhibitory activity against lung adenocarcinoma (SBC3 and A549) and leukemia (K562, and K562/ADM) cells with IC50 values of 6.5, 7.5, 3.8, and 2.2 µM, respectively. The HPLC method utilised a TSK-gel ODS-80Tm column with the mixture of acetonitrile and 2% phosphoric acid in water (97:3, v/v) as the mobile phase at a flow rate of 1 mL/min, and UV detection at 245 nm. The parameters of linearity, precision, accuracy, specificity and sensitivity of the method were evaluated. The recoveries of the method were 100.4-101.6% and good linearity (r2 ³ 0.9999) was obtained. A high degree of specificity, sensitivity and precision were also achieved.. Keywords: 5-hydroxymethylfurfural, D-glyceropentaric acid, 2-deoxy-3-C-(methoxycarbonyl)-1, 4-lactone, 5-ethyl ester, isoorientin-6"-O-rhamnoside, dulcinoside, method validation.. Download Full Article |