• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.5057-5061
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• 2012

Purpose: Chemotherapy-induced anemia (CIA) is one of the most important causes of anemia in cancer patients. This study was conducted to describe the prevalence and characteristics of CIA in solid cancer patients in the Chinese population, and to explore the relationship of white blood cell (WBC) or platelet decrease with CIA. Methods: Data on age, gender, tumor diagnosis, anti-cancer treatment and blood cell analyses were available from 220 untreated non-anemic cancer patients who received at least 2 cycles of chemotherapy, and the data were analyzed to assess their relationship with CIA or its severity. Results: 139 patients (63.2%) presented anemia, most being Grade 1 or 2. Esophageal and lung cancers were associated with a high prevalence. G3/4 leucopenia and decrease of platelets were identified as independent risk factors for the occurrence of CIA. Moreover, G3/4 leucopenia, decrease of platelet and G3/4 thrombocytopenia were found to be also associated with the severity of CIA. Cisplatin-containing regimens were a main potential factor in causing CIA, although significant association was only found on univariate analysis. Conclusion: Anemia or decrease in hematoglobin are common in Chinese cancer patients receiving chemotherapy. Cisplatin-containing regimens might be an important factor influencing the occurrence of CIA. Our analysis firstly described some risk factors, such as decrease of platelets or WBCs, severity of leucopenia or thrombocytopenia, associated with the occurrence and severity of CIA.

• Journal of Korean Traditional Oncology
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• v.20 no.1
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• pp.31-44
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• 2015

Background : The purpose of this study is to investigate the efficacy and safety of the circadian delivery schedule of fluorouracil or capecitabine based chemotherapy for advanced colorectal cancer. Patients and methods : A meta-analysis was performed using individual data from eight international randomized clinical trials, especially phase II or III trials, comparing 5-fluorouracil, or capeticabine in chronomodulated or conventional schedule. The data from 8 studies was composed of 692 patients receiving chronomodulated chemotheray and 684 patients receiving conventional chemotherapy. The main end point was response rate. Results : Response rate was insignificantly different from each group (RR 1.14, 95%CI 0.74-1.74, p=0.55). Overall survival and progresseion-free survival were not significant either. Chemotherapy induced anemia, diarrhea, and nausea/vomiting were worse in the chronotherapy group, with statistic significance respectively. On the other hand, chemotherapy induced thrombocytopenia, stomatitis, peripheral neuropathy, and dermatotoxicity were better but they were not statistically significant results. Conclusions : Patients lived longer but not significantly on chronomodulated chemotherapy rather than on conventional chemotherapy. Patients on chronomodulated chemotherapy experienced adverse events more. The chronomodulated chemotherapy schedule needs adjustment of its delivery schedule and further research is required.

• Biomolecules & Therapeutics
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• v.6 no.3
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• pp.312-316
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• 1998

Efficacy and in vivo bioassay of recombinant human erythropoietin (rho-EPO), was investigated. Efficacy studies were conducted in normal, and cisplatin-induced anemic rats. Normal and anemic animals were treated intravenously with rhu-EPO for 5 days, and the changes in the number of red blood cells (RBC), hemoglobin concentration (Hb), hematocrit value (Hct) and percentage reticulocyte value (Ret, reticulocyte/RBC) were examined. In normal rats, rho-EPO significantly increased RBC, Hb, Hct and Ret at the doses of 50∼ 1,250 lU/kg/day in a dose-dependent fashion. Cisplatin-induced anemic rats showed significant increase of RBC, Hb, Hct and Ret after administration of rho-EPO (50-200 lU/kg/day) in a dose-dependent manner. These changes of hematological parameters disappeared gradually after cessation of the treatment. The in vivo bioassay results in polycythemic mice showed that rho-EPO had 90% of bioactivity compared to NIBSC standard rhu-EPO. These results suggest that rho-EPO might be useful for the therapy of anemia originated from renal failure and chemotherapy-induced anemia.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.1
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• pp.31-36
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• 2006

The aim of this study was to elucidate the mechanism of anemia associated with Dangguibohyel-tang (DBT) in rats. Using cyclophosphamide-induced (30mg/kg BW) anemic rats, changes in weight gain, the levels of red blood cell (RBC), hematocrit (Hct), platelet and hemoglobin (Hgb), serum vitamin B12, ALT(GPT) levels and erythropoietin (EPO) gene expression were monitored, and compared with DBT (1,000mg/kg BW, 14d)-treated and EPO (1,000IU/kg BW, 14d, s.c.)-treated rats. Food efficiency ratio (FER) were 31.6%, in normal group, 28.1% in cyclophosphamide-induced control group, 31.7% in DBT-treated group and 25.1%, in EPO-treated group after 14 days. The levels of red blood cell (RBC), hematocrit (Hct), platelet and hemoglobin (Hgb) of DBT-treated group were significantly higher than those of control. And DBT extract administered group showed dominant effects on the recovery of Hgb level. Serum vitamin B12 and ALT(GPT) levels were significantly increased at DBT-treated groups. EPO gene expression was decreased 91,9% in control group, 79.6% in DBT-treated group and 53.9% in EPO-treated group, respectively. These results suggest that administration of DBT could prevent human patient from chemotherapy derived anemia by improving hematological value and EPO status.

• Journal of Nutrition and Health
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• v.36 no.10
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• pp.1013-1021
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• 2003

Anemia, the condition of the diminished concentration of hemoglobin per erythrocyte is common in patients with cancer and is a frequent complication of myelosuppressive chemotherapy. Cham-Dang-Gui (Angelicae Gigantis Radix) has been used in traditional Korean medicine to treat hematologic deficiencies. In this study, Cyclophosphamide (CYP), an alkylating agent that has a broad spectrum of anti-cancer activities, was intraperitoneally injected into the experimental animals to suppress the bone marrow thereafter, causing anemia. The hemopoietic effects of Cham-Dang-Gui were examined using anemic rat model. Rats were divided into five groups: CON (control group), ANS (CYP-injected + normal diet), AND (CYP-injected + normal diet + Cham-Dang-Gui), ALS (CYP-injected + low iron diet), and ALD (CYP-injected + low iron diet + Cham- Dang-Gui) groups. CYP (30 mg/kg) was intraperitoneally injected to rats for 3 days to induce anemic condition. Saline or Cham-Dang-Gui was administrated orally during the entire experimental period. CYP injection decreased body weight gain and food consumption in comparison with CON group. Oral administration of Cham-Dang-Gui extract with normal iron diet significantly prevented the lower body weight gain. The blood level of hemoglobin, iron status (serum iron, transferrin, ferritin and TIBC) and blood level of vitamin B-12 in Cham-Dang-Gui treated groups were significantly higher than those of Cham-Dang-Gui untreated groups regardless of amount of iron in the diet. Taken together, it could be concluded that the Cham-Dang-Gui extract could improve anemic condition induced by CYP injection by improving hematological value, iron status and vitamin B12 status in rats.

• Korean Journal of Clinical Pharmacy
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• v.19 no.2
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• pp.146-152
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• 2009

Purpose : 본 연구의 목적은 항암치료로 인한 빈혈환자의 치료에서 epoetin alpha (rHuEPO) 피하주사 시, 주일회 요법과 주삼회요법의 헤모글로빈(hemoglobin, Hb) 상승 효과를 비교하는 것이다. Methods : 본 연구는 1999년 3월부터 2005년 3월까지 국립암센터에서 항암치료로 인한 빈혈로 epoetin alpha를 투여 받은 환자를 대상으로 의무기록의 자료를 후향적으로 수집하여 분석하였다. 연구에 포함된 환자는 rHuEPO 10,000 IU 주삼회투여군(n = 127)과 20,000 IU 주일회투여군(n = 81)으로 구분되었으며, 이들은 필요에 따라 경구용 철분보조제를 섭취하였다. Epoetin alpha 치료 시작 후 최대 8주까지 2주 간격으로 Hb 수치변화를 분석하였다. Results : 치료 시작 시점의 rHuEPO 10,000 IU 주삼회투여군과 20,000 IU 주일회투여군의 평균 Hb수치는 유사하였 다 (9.4 g/dL vs. 9.7 g/dL). Epoetin alpha 치료 후 8주까지 두 그룹간의 헤모글로빈 수치의 상승 정도에는 유의한 차이가 없었다 ($1.57{\pm}1.39$ g/dL vs. $1.68{\pm}1.35$ g/dL, p=0.59). 또한 경구용 철분보조제 투여여부, cisplatin 포함 항암제 투여여부 및 성별에 따른 군의 분류에 있어서도 rHuEPO 10,000 IU 주삼회투여군과 20,000 IU 주일회투여군의 평균 Hb 상승수치는 유의한 차이를 보이지 않았다. Conclusion : 한국인에서 항암치료로 인한 빈혈의 치료 시에 rHuEPO 20,000 IU 주일회투여 용법은 10,000 IU 주 삼회투여 용법과 유사한 Hb 상승효과를 가진다.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9291-9293
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• 2014

Background: Patients with refractory or relapsed multiple myeloma are considered to have a very poor prognosis, and new regimens are needed to improve the outcome. Gemcitabine, a nucleoside antimetabolite, is an analog of deoxycytidine which mainly inhibits DNA synthesis through interfering with DNA chain elongation and depleting deoxynucleotide stores, resulting in gemcitabine-induced cell death. Here we performed a systemic analysis to evaluate gemcitabine based chemotherapy as salvage treatment for patients with refractory and relapsed multiple myeloma. Methods: Clinical studies evaluating the impact of gemcitabine based regimens on response and safety for patients with refractory and relapsed multiple myeloma were identified by using a predefined search strategy. Pooled response rate (RR) of treatment were calculated. Results: In gemcitabine based regimens, 3 clinical studies which including 57 patients with refractory and relapsed multiple myeloma were considered eligible for inclusion. Systemic analysis suggested that, in all patients, pooled RR was 15.7% (9/57) in gemcitabine based regimens. Major adverse effects were hematologic toxicity, including grade 3 or 4 anemia, leucopenia and thrombocytopenia i. No treatment related death occurred with gemcitabine based treatment. Conclusion: This systemic analysis suggests that gemcitabine based regimens are associated with mild activity with good tolerability in treating patients with refractory or relapsed multiple myeloma.

• Tuberculosis and Respiratory Diseases
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• v.66 no.2
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• pp.104-109
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• 2009

Background: Anemia is quite common in lung cancer patients and known to decrease the quality of life. Darbepoetin alfa is an erythropoiesis-stimulating protein approved for administration to cancer patients. This study examined the efficacy and safety of darbepoetin alfa in lung cancer patients with a hemoglobin concentration <10 g/dl during chemotherapy. Methods: Lung cancer patients (n=178) received darbepoetin alfa at doses of 1.91 ${\mu}g/kg$ per week until the hemoglobin concentration increased to >10 g/dl. The efficacy and safety were measured by comparing the hemoglobin concentration and assessing the adverse events. Results: After chemotherapy, the hemoglobin concentration decreased to 9.03${\pm}$0.64 g/dl. With the darbepoetin alfa treatment, the hemoglobin concentration increased to 10.09${\pm}$1.17 g/dl after 4 weeks reaching a peak hemoglobin concentration of 10.45${\pm}$1.18 g/dl. The changes in hemoglobin after 4 and 8 weeks with treatment were 1.08${\pm}$1.24 g/dl and 1.38${\pm}$1.59 g/dl (p<0.01). At least a 1 g/dl or more increase in hemoglobin was observed in 62.4% of patients. There were no serious adverse effects except for some mild reactions. Conclusion: Darbepoetin alfa administered to lung cancer patients appears to be an effective, well-tolerated treatment for chemotherapy induced anemia.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7159-7162
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• 2014

Background: Patients with recurrent or refractory osteosarcoma are considered to have a very poor prognosis, and new regimens are needed to improve the prognosis in this setting. Gemcitabine, a nucleoside antimetabolite, is an analog of deoxycytidine which mainly inhibits DNA synthesis through interfering with DNA chain elongation and depleting deoxynucleotide stores, resulting in gemcitabine-induced cell death. Here we performed a systemic analysis to evaluate gemcitabine based chemotherapy as salvage treatment for patients with recurrent or refractory osteosarcoma. Methods: Clinical studies evaluating the impact of gemcitabine based regimens on response and safety for patients with osteosarcoma were identified by using a predefined search strategy. Pooled response rates (RRs) of treatment were calculated. Results: In gemcitabine based regimens, 4 clinical studies which included 66 patients with recurrent or refractory osteosarcoma were considered eligible for inclusion. Systemic analysis suggested that, in all patients, pooled RR was 12.1% (8/66) in gemcitabine based regimens. Major adverse effects were hematologic toxicity, including grade 3 or 4 anemia, leucopenia and thrombocytopenia in gemcitabine based treatment. No treatment related death occurred in gemcitabine based treatment. Conclusion: This systemic analysis suggests that gemcitabine based regimens are associated with mild activity with good tolerability in treating patients with recurrent or refractory osteosarcoma.

• Childhood Kidney Diseases
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• v.6 no.2
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• pp.237-242
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• 2002

Hemolytic Uremic Syndrome (HUS) is the most common cause of acute renal failure in children and is comprised of the combination of hemolytic anemia, thrombocytopenia, and acute renal failure. Atypical HUS, rare in childhood, has worse prognosis than that of typical HUS and is associated with chemotherapy drug, other bacterial (especially Streptococcus pneumoniae) or viral infections, and so on. We report a case of HUS caused by pneumococcal infection in 4-year-old boy. While he was admitted with pneumonia and pleural effusion, pneumococcal infection could be revealed. Although HUS progressed rapidly, he immediately received 3-time hemodialysis and recovered completely after two weeks.