• 제목/요약/키워드: leukopenia

검색결과 155건 처리시간 0.037초

유도항암요법에 반응치 않는 환자와 재발한 두경부암환자에서 Cisplatin과 방사선 동시치료 (Concurrent Cisplatin and Radiotherapy in Refractory Patients to Induction Chemotherapy and Recurrent Head and Neck Cancer)

  • 김훈교;강진형;이경식;김동집;장홍석;윤세철;조승호;서병도
    • 대한두경부종양학회지
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    • 제8권1호
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    • pp.21-24
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    • 1992
  • In patients with locally advanced head and neck cancers who do not respond to induction chemotherapy and who have locoregional recurrence after local treatment subsequent radiotherapy alone does not have any additative effect. The theoretical rationale and promising clinical response of concurrent chemoradiotherapy in patients with the head and neck cancers have been recently conducted Ten patients(9 stage IV, q stage III) were treated with concurrent chemoradiotherapy(radiotherapy start from day 1 of chemotherapy; cisplatin $100mg/m^2$ intravenously every 3 weeks for $3{\sim}4$ cycles on day 1.22 and 43..). Four patients achieved complete response(CR) and overall response rate was 80% (8/10). The major toxicities we re leukopenia (90%), nausea/vomiting(80%), stomatitis(80%) and peripheral neuropathy(30%). Most of these side effects were mild to moderate and reversible.

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Retrospective analysis of treatment outcomes after postoperative chemoradiotherapy in advanced gastric cancer

  • Kim, Sup;Kim, Jun-Sang;Jeong, Hyun-Yong;Noh, Seung-Moo;Kim, Ki-Whan;Cho, Moon-June
    • Radiation Oncology Journal
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    • 제29권4호
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    • pp.252-259
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    • 2011
  • Purpose: To evaluate retrospectively the survival outcome, patterns of failure, and complications in patients treated with postoperative chemoradiotherapy (CRT) in advanced gastric cancer. Materials and Methods: Between January 2000 and December 2006, 80 patients with advanced gastric cancer who received postoperative concurrent CRT were included. Pathological staging was IB-II in 9%, IIIA in 38%, IIIB in 33%, and IV in 21%. Radiotherapy consisted of 45 Gy of radiation. Concurrent chemotherapy consisted of a continuous intravenous infusion of 5-fluorouracil and leucovorin on the first 4 days and last 3 days of radiotherapy. Results: The median follow-up period was 48 months (range, 3 to 83 months). The 5-year overall survival, disease-free survival, and locoregional recurrence-free survivals were 62%, 59%, and 80%, respectively. In the multivariate analysis, significant factors for disease-free survival were T stage (hazard ratio [HR], 0.278; P = 0.038), lymph node dissection extent (HR, 0.201; P = 0.002). and maintenance oral chemotherapy (HR, 2.964; P = 0.004). Locoregional recurrence and distant metastasis occurred in 5 (6%) and 18 (23%) patients, respectively. Mixed failure occurred in 10 (16%) patients. Grade 3 leukopenia and thrombocytopenia were observed in 4 (5%) and one (1%) patient, respectively. Grade 3 nausea and vomiting developed in 8 (10%) patients. Intestinal obstruction developed in one (1%). Conclusion: The survival outcome of the postoperative CRT in advanced gastric cancer was similar to those reported previously. Our postoperative CRT regimen seems to be a safe and effective method, reducing locoregional failure without severe treatment toxicity in advanced gastric cancer patients.

Whole Brain Radiotherapy Plus Chemotherapy in the Treatment of Brain Metastases from Lung Cancer: A Meta-analysis of 19 Randomized Controlled Trails

  • Liu, Wen-Jing;Zeng, Xian-Tao;Qin, Hai-Feng;Gao, Hong-Jun;Bi, Wei-Jing;Liu, Xiao-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권7호
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    • pp.3253-3258
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    • 2012
  • Objective: To evaluate the efficacy and safety of whole brain radiotherapy (WBRT) plus chemotherapy versus WBRT alone for treating brain metastases (BM) from lung cancer by performing a meta-analysis based on randomized controlled trials (RCTs). Methods: The PubMed, Embase, CENTRAL, ASCO, ESMO, CBM, CNKI, and VIP databases were searched for relevant RCTs performed between January 2000 and March 2012. After quality assessment and data extraction, the meta-analysis was performed using the RevMan 5.1 software, with funnel plot evaluation of publication bias. Results: 19 RCTs involving 1,343 patients were included. The meta-analyses demonstrated that compared to WBRT alone, WBRT plus chemotherapy was more effective with regard to the objective response rate (OR = 2.30, 95% CI = 1.79 - 2.98; P < 0.001); however, the incidences of gastrointestinal reactions (RR = 3.82, 95% CI = 2.33 - 6.28, P <0.001), bone marrow suppression (RR = 5.49, 95% CI = 3.65 - 8.25, P < 0.001), thrombocytopenia (RR = 5.83, 95% CI = 0.39 - 86.59; P = 0.20), leukopenia (RR = 3.13, 95% CI = 1.77 - 5.51; P < 0.001), and neutropenia (RR = 2.75, 95% CI = 1.61 - 4.68; P < 0.001) in patients treated with WBRT plus chemotherapy were higher than with WBRT alone. There was no obvious publication bias detected. Conclusion: WBRT plus chemotherapy can obviously improve total efficacy rate, butalso increases the incidence of adverse reactions compared to WBRT alone. From the limitations of this study, more large-scale, high-quality RCTs are suggested for further verification.

Clinical Study on Safety of Cantharidin Sodium and Shenmai Injection Combined with Chemotherapy in Treating Patients with Breast Cancer Postoperatively

  • Wang, Lin;Huang, Xin-En;Cao, Jie
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권14호
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    • pp.5597-5600
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    • 2014
  • Objectives: To assess side effects on Cantharidin sodium and Shenmai injection combined with chemotherapy in treating patients with breast cancer postoperatively. Method: Patients with breast cancer receiving postoperative chemotherapy were retrospectively collected, and divided into four groups: group A with cantharidin sodium injection combined with chemotherapy; group B with Shenmai injection combined with chemotherapy; group C with both cantharidin sodium and Shenmai injection combined with chemotherapy; while group D (control group) received chemotherapy alone. All patients were administered docetaxel at a dose of $75mg/m^2$ on day 1, epirubicin hydrochloride at a dose of $60mg/m^2$ on day 1, and cyclophosphamide at a dose of $500mg/m^2$ on day 1 for 3 cycles (repeated at 21 day intervals). After ${\geq}$ three courses of treatment, quality of life and side effects were evaluated. Results: There were a total of 78 patients in this study, and the incidence of leukopenia and gastrointestinal reactions in groups A and B were lower than those in the control group and lowest in group C (p<0.05). Conclusions: Thus cantharidin sodium and Shenmai injection combined with chemotherapy reduce side effects and deserve to be further investigated in randomized clinical control trials.

Concurrent Chemoradiation with Weekly Gemcitabine and Cisplatin for Locally Advanced Cervical Cancer

  • Hashemi, Farnaz Amouzegar;Akbari, Ehsan Hamed;Kalaghchi, Bita;Esmati, Ebrahim
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권9호
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    • pp.5385-5389
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    • 2013
  • Background: For more than 80 years, the standard treatment of locally advanced cervical cancer was radiotherapy. However, based on several phase III randomized clinical trials in the past decade, concurrent cisplatin-based chemoradiotherapy is the current standard for this disease. Gemcitabine has potent radiosensitizing properties in preclinical and clinical trials, so it can be utilized simultanously with radiation. Materials and Methods: Thirty women with untreated invasive squamous cell carcinoma of the cervix of stage IIB to stage IVA were enrolled in the study in the Radiation Oncology Department of Imam Khomeini Hospital in Tehran from September 2009 to September 2010. Sixty $mg/m^2$ gemcitabine followed by $35mg/m^2$ cisplatin were concurrently administered with radiotherapy to the whole pelvic region on day one of each treatment week for five weeks. One and three months after treatment, patients underwent a complete physical examination and MRI to determine the response to treatment. Results: The mean age of patients was $58.1{\pm}11.8$ (29-78) years. After 3 months of treatment, 73.3%had complete and 26.7% demonstrated partial response to treatment. Grade 3 anemia was seen in 10%, grade 3 thrombocytopenia in 3.3% and grade 3 leukopenia in 10% of the patients. Conclusions: According to the positive results of this study in stage IIB, further phase II and III clinical trials are suggested to evaluate the role of chemoradiation using Gemcitabine for advanced cervical cancers.

Recurrent macrophage activation syndrome since toddler age in an adolescent boy with HLA B27 positive juvenile ankylosing spondylitis

  • Park, Joon Hyeong;Seo, Yu Mi;Han, Seung Beom;Kim, Ki Hwan;Rhim, Jung Woo;Chung, Nack Gyun;Kim, Myung Shin;Kang, Jin Han;Jeong, Dae Chul
    • Clinical and Experimental Pediatrics
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    • 제59권10호
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    • pp.421-424
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    • 2016
  • Recurrent macrophage activation syndrome (MAS) is very rare. We present the case of an adolescent boy with human leukocyte antigen (HLA) B27-positive ankylosing spondylitis (AS), who experienced episodes of recurrent MAS since he was a toddler. A 16-year-old boy was admitted because of remittent fever with pancytopenia and splenomegaly after surgical intervention for an intractable perianal abscess. He had been diagnosed with hemophagocytic lymphohistiocytosis (HLH) 4 different times, which was well controlled with intravenous immunoglobulin and steroids since the age of 3. We were unable to identify the cause for the HLH. He remained symptom-free until the development of back pain and right ankle joint pain with swelling at 15 years of age. He was diagnosed with HLA B27-positive AS with bilateral active sacroiliitis. He showed symptom aggravation despite taking naproxen and methotrexate, and the symptoms improved with etanercept. On admission, his laboratory data showed leukopenia with high ferritin and triglyceride levels. Bone marrow biopsy examination showed histiocytic hyperplasia with hemophagocytosis. There was no evidence of infection. He received naproxen alone, and his symptoms and laboratory data improved without any other immunomodulatory medications. Genetic study revealed no primary HLH or inflammasome abnormalities. In this case, underlying autoimmune disease should have been considered as the cause of recurrent MAS in the young patient once primary HLH was excluded.

Cyclophosphamide투여 랫드의 혈구세포 변화 밀 호중구 탐식능에 있어서 계난백유래물질의 효과 (Effects of Chicken Egg White Derivatives on the Changes of Blood Cells and the Neutrophil Phagocytosis of Rats Administered with Cyclophosphamide)

  • 양만표;김기흥
    • 한국임상수의학회지
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    • 제15권2호
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    • pp.346-351
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    • 1998
  • As an antitumor agents cyclophosphamide (CPA) is frequently used in animal clinic. Important adverse effects of its administration are leukopenia, thrombocytopenia and anemia. We investigated the effects of chicken egg white derivatives (EWD and EF-203) on the changes of blood cells and the neutrophil phagocytosis of rats administered with CPA. Rats were administered CPA peritoneally at dose of 50 mgag once a day far 3 days plus either EWD or EF-203 orally at dose of 200 mg/kg once a day far 3 days. Thereafterl the changes of blood cells by automatic blood cell counter and the phagocytosis of neutrophils by flow cytometry were examined far 7 days. There was no change in RBC values regardless of administration of either EWD or EF-203 throughout experimental period. But rats receiving CPA plus either EWD or EF-203 showed a significant higher PCV values than those of CPA alone (p<0.01). The numbers of peripheral blood platelets and WBC and the differential count of neutrophils in the ra% receiving CPA plus either EWD or EF-203 were significantly higher (p<0.05 to 0.01) than those of CPA alone. Moreover, these rats showed significanly enhanced phagocytoses of neutrophils when compared to rats with CPA alone (p<0.01). These result suggested that chicken egg white derivatives including EWD and EF-2% have immunomodulatory effects in regard to the increase of platelets, WBC, differential count of neutrophils, PCV, and the enhancement of phagocytic activity of neutrophils in immunosuppressed rats by CPA. Thus, co-adminstration of chicken egg white derivatives will be able to reduce the side effects in the animals treated with antitumor agents.

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비고유숙주(非固有宿主)에 있어서 면역억제(免疫抑制)가 돼지회충(蛔蟲)의 감염(感染)에 미치는 영향(影響) II. 햄스터에서의 실험소견(實驗所見) (Effect of immunosuppression on Ascaris suum infection in undefinitive hosts II. Investigations in golden hamsters)

  • 이재구;김현철;박배근;이창현
    • 대한수의학회지
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    • 제34권1호
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    • pp.127-134
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    • 1994
  • As a series of studies to investigate the effect of immunosuppression on Ascaris suum infection in undefinitive hosts, a delicate relationship between host and parasite, in the present studies golden hamsters were alloted to experiment 1(normal undefinitive host group) and experiment 2(immunosuppressive group treated with prednisolone acetate) and inoculated with a single dose of 1,500 embryonated Ascaris suum eggs. The recovery rates, sizes and features of the larvae and immunological responses in the hamsters were chronologically monitored according to somatic migration. In both experiments, the larvae failed to develop into the adults, but the more and larger larvae were observed for a longer period from experiment 2 in comparison with experiment 1. The numbers of the mast cells in the small intestinal mucosa and mesenteric lymph nodes, of the goblet cells in the small intestinal mucosa and of T-cells in the mesenteric lymph nodes, spleens and cardiac blood from experiment 2 were fewer than those from the experiment 1. In general, increasing of these cells followed by expulsion of the worms in the both groups. Profound leukopenia due to lymphopenia was found through trial period in experiment 2. Considering the experimental results, development or expulsion mechanism of somatic migrant larvae may be related to lymphopenia and temporary increasing tendency of the mast cells, the goblet cells and T-cells. In addition, patent infection of A suum in the hamsters was not obviously observed in spite of immunosuppression by prednisolone acetate.

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Classification of acute clinical mastitis on the base of vital signs and complete blood count test in dairy cows

  • Hur, Tai-Young;Kang, Seog-Jin;Jung, Young-Hun;Lee, Hyun-June;Ki, Kwang-Seok;Choe, Chang-Yong;Suh, Guk-Hyun
    • 대한수의학회지
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    • 제53권1호
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    • pp.19-23
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    • 2013
  • This study was carried out to evaluate the diagnosis of acute clinical mastitis (ACM) which was based on the vital signs and complete blood count (CBC) tests in dairy cows. Twenty eight dairy cows diagnosed with ACM, were selected for the study between Jan 2003 and July 2006 in the National Institute of Animal Science. Based on their vital signs (rectal temperature, depression, rumen contraction and, dehydration status), ACM was divided into three different classes; mild, moderate and severe forms. In addition, ACM cows were subjected to CBC tests for further diagnosis of ACM. Of the 27 dairy cows diagnosed with ACM, 3 cows were determined to have a mild form, while moderate and sever forms were each observed in twelve cows. Among of them, 4 cows died, 5 cows were culled and 18 cows were recovered. In the mild form, all haematological parameters were comparable with normal values. However, leukopenia, due to neutropenia and lymphocytopenia, appeared characteristically in the moderate and severe forms. Using the observation of vital signs in conjunction with CBC tests, the diagnosis of ACM is more accurate, and is helpful in making decisions of whether treatment or culling of dairy cows infected with ACM is most appropriate.

아급성 괴사성 림프절염의 임상적 고찰 (Clinical Study of Subacute Necrotizing Lymphadenitis)

  • 추호석;정은재;우정수;황순재;이흥만
    • 대한두경부종양학회지
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    • 제19권2호
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    • pp.133-136
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    • 2003
  • Background and Objectives: Kikuchi's disease or subacute necrotizing lymphadenitis is a cause of persistently enlarged lymph nodes unresponsive to antibiotic therapy. It affects predominantly young women under the age of 30, and it is seen primarily in the Asian population. Although this disease usually follows a benign course, all describing a clinical entity that has been mistaken for malignant lymphoma, lupus, and an assortment of infectious diseases. The purpose of this study is to report clinical characteristics and treatment outcome in order to contribute to the precise diagnosis and treatment. Materials and Methods: We reviewed 27 cases, who were diagnosed as subacute necrotizing lymphadenitis on excisional biopsy during the past 5 years from January 1998 to December 2002. Results: It occurred more often in females (20 cases ; 74%) than males (7cases ; 26%), and it was seen more frequently in the second and third decades (21 cases ; 78%). Cervical lymphadenopathy were usually multiple (24 cases, 89%) and measured less than 2cm (20 cases, 74%). The posterior cervical and deep jugular chains are the most common location(34 cases ; 81%). Leukopenia(18 cases, 67%) and elevated ESR(20 cases, 75%) were commonly noted in laboratory data. Conclusions: It is easy that Kikuchi's disease is mistaken for malignant lymphoma. So we should consider fine needle aspiration or open biosy of lymph node for histologic diagnosis in patients who have localized cervical lymphadenopathy unresponsive to antibiotic therapy.