losartan-potassium and Testicular-Neoplasms

The use of erythropoietin (EPO) for the treatment of anemia associated with urological malignancies is not well defined. The rate of anemia is dependent on the type of cancer and on the different types of treatment. Only with a substantial risk for blood transfusion is substitution treatment by EPO justified. Additionally, the long-term risks of blood transfusions have to be balanced against the costs of EPO treatment.. Different experts have reviewed the literature on anemia and EPO regarding the four main tumor entities.. In prostate cancer, EPO treatment may be justified before radical prostatectomy and in patients with advanced, hormone-refractory disease. In bladder cancer, significant treatment-related anemia mainly occurs in patients who have to undergo radical cystectomy and in patients who will be treated with polychemotherapy for metastatic disease. Patients with renal cell carcinoma rarely suffer from anemia and thus are usually not candidates for EPO treatment. Testis cancer patients only have a substantial risk for blood transfusions if they belong to the intermediate or poor prognosis group according to IGCCCG or if they need salvage chemotherapy or salvage surgery. However, in testis cancer patients EPO treatment should generally be preferred to blood transfusions since cure rates are excellent and thus the potential risks of transfusion-related infections are significant.

Topics: Anemia; Carcinoma, Renal Cell; Erythropoietin; Germinoma; Humans; Male; Testicular Neoplasms; Urologic Neoplasms

Topics: Adolescent; Adrenocorticotropic Hormone; Adult; Brain Neoplasms; Carcinoma; Carcinoma, Bronchogenic; Carcinoma, Hepatocellular; Carcinoma, Squamous Cell; Cerebellar Neoplasms; Child; Child, Preschool; Choriocarcinoma; Cushing Syndrome; Diagnosis, Differential; Erythropoietin; Female; Gonadotropins; Hemangiosarcoma; Hormones, Ectopic; Humans; Hypercalcemia; Hypoglycemia; Infant; Infant, Newborn; Insulin; Insulin Secretion; Kidney Neoplasms; Liver Neoplasms; Lung Neoplasms; Male; Neoplasms; Parathyroid Hormone; Pheochromocytoma; Polycythemia; Pregnancy; Teratoma; Testicular Neoplasms; Thymus Neoplasms

Topics: Adult; Aged; Anemia; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Darbepoetin alfa; Drug Combinations; Erythropoietin; Etoposide; Humans; Male; Middle Aged; Palliative Care; Prognosis; Testicular Neoplasms; Treatment Outcome

At birth, undescended testes contain germ cells, but after 1 year of life, a reduced number of germ cells is generally found. Microlithiasis and carcinoma-in-situ-testis occur in cryptorchid boys. Multinucleated germ cells, including at least 3 nuclei in the cell, exist in impaired spermatogenesis and in the senescent testis.. We investigated whether multinucleated spermatogonia were present in undescended testes of cryptorchid boys, and if such a pattern is associated with special clinical features.. Multinucleated spermatogonia occurred in 13/168 (8%) of 163 consecutive cryptorchid boys, who underwent surgery for cryptorchidism with simultaneous testicular biopsy showing seminiferous tubules. The patients with multinucleated spermatogonia more often exhibited a normal germ cell number (Fisher's exact test, p<0.0005), and were younger at surgery (Mann Whitney, p<0.005) than the rest of the patients. Before surgery, 3 patients underwent treatment with Erythropoietin because of renal failure. An intra-abdominal testis underwent clipping and division of the spermatic vessels, and a biopsy at final surgery 7 months later, exhibited multinucleated spermatogonia. In 1 case the undescended testicular position, a fixed retraction, was acquired after surgery for an inguinal hernia. Multinucleated spermatogonia were found in cases of carcinoma-in situ-testis in 2 cryptorchid boys. No case of multinucleated germ cells appeared in our normal material.. Multinucleated spermatogonia are a further abnormality present in cryptorchidism. The cryptorchid boys with multinucleated spermatogonia in general exhibited rather many germ cells. This feature may be associated with an increased risk of testicular malignancy later in life, and we propose a careful follow up regime in these cases including ultrasound examination and a testicular biopsy in cases of symptoms or clinical findings.

Topics: Biopsy; Carcinoma in Situ; Cell Nucleus; Child; Child, Preschool; Cryptorchidism; Erythropoietin; Humans; Infant; Male; Precancerous Conditions; Renal Insufficiency; Risk Factors; Spermatogonia; Testicular Neoplasms

To determine the hematopoietic actions of recombinant human c-Mpl ligand (thrombopoietin [TPO]), we studied its effects on the proliferation and differentiation of highly purified CD34+ blood progenitors in plasma-containing and serum-free culture. TPO alone promoted the growth of small megakaryocyte colonies (CFU-Meg) in numbers two to three times greater than those produced by interleukin (IL)-3. The combination of TPO and stem cell factor (SCF) exerted a significant synergistic effect on CFU-Meg formation. In the presence of TPO and IL-3 or granulocyte/macrophage-colony stimulating factor (GM-CSF), a significant number of mixed colonies (CFU-Mix) were observed. The combination of TPO and Epo did not increase the number of CFU-Meg, but did support erythroid-burst (BFU-E) and CFU-Mix colony formation. Interestingly, the combination of TPO with cytokines known to have burst-promoting activity (BPA), including IL-3, GM-CSF, IL-9, and SCF, increased the number of BFU-E and CFU-Mix in the presence of Epo. The BPA of TPO was further investigated by delayed addition of Epo on day 6 after incubation with TPO from day 0. None of the BFU-E or CFU-Mix survived, indicating that TPO acted as a costimulant exclusively for Epo. Moreover, a neutralizing anti-human Mpl receptor polyclonal antibody completely abrogated the BPA of TPO, demonstrating that this effect was mediated through the Mpl receptor. Finally, experiments in single-cell clone sorting and serum-free culture clearly demonstrated that a combination of TPO and Epo directly supported BFU-E and CFU-Mix. These results suggest that TPO acts not only in megakaryocytopoiesis but also in the early stage of hematopoiesis.

Topics: Antigens, CD34; Dose-Response Relationship, Drug; Erythroid Precursor Cells; Erythropoiesis; Erythropoietin; Granulocyte-Macrophage Colony-Stimulating Factor; Hematopoiesis; Hematopoietic Cell Growth Factors; Humans; Interleukin-3; Male; Megakaryocytes; Neoplasm Proteins; Proto-Oncogene Proteins; Receptors, Cytokine; Receptors, Thrombopoietin; Testicular Neoplasms; Thrombopoietin

While investigating the cause of mild polycythemia in a young man, a testicular seminoma was discovered with unusual and tumor-dependent features: an absolute polycythemia with high plasma erythropoietin (EPO) levels, an overproduction of estradiol and testosterone, and a dramatic Leydig cell hyperplasia surrounding the tumor tissue. The authors attempted to gain insight into the relationship between this testicular tumor and the hormonal overproduction, i.e., of EPO, estradiol, and testosterone. Their results favored the conclusion that the high EPO levels and the polycythemia were an indirect effect secondary to the steroid overproduction rather than a direct EPO-producing activity. Moreover, the steroid overproduction by the testis could be caused by a paracrine mechanism through human chorionic gonadotropin activity on the Leydig cells.

Topics: Adult; Chorionic Gonadotropin; Dysgerminoma; Erythropoietin; Estradiol; Humans; Hyperplasia; Leydig Cells; Male; Polycythemia; Steroids; Testicular Neoplasms; Testosterone

The authors report the case of a 41-year old patient with polycythaemia and a mixed testicular tumour (seminoma with choriocarcinomatous contingent). The demonstration of a raised erythropoietin level in the tumor tissue with a high gradient in relation to the serum argues in favour of secondary paraneoplastic polycythaemia. With a follow-up of 5 years, the patient is still in complete remission from his two diseases. This case may represent the first case of testicular tumour responsible for secondary polycythaemia.

Topics: Adult; Choriocarcinoma; Dysgerminoma; Erythropoietin; Humans; Male; Neoplasms, Multiple Primary; Polycythemia; Testicular Neoplasms

Topics: Acid Phosphatase; Alkaline Phosphatase; alpha 1-Antitrypsin; alpha-Fetoproteins; Antibodies, Neoplasm; Antigens, Neoplasm; Carcinoembryonic Antigen; Chorionic Gonadotropin; Erythropoietin; Estrone; Female; Hormones, Ectopic; Humans; Inclusion Bodies, Viral; Isoenzymes; Kidney Neoplasms; L-Lactate Dehydrogenase; Male; Placental Lactogen; Polyamines; Prostatic Neoplasms; Receptors, Cell Surface; Sex Hormone-Binding Globulin; Testicular Neoplasms; Urinary Bladder Neoplasms; Urologic Neoplasms

Topics: Adrenocorticotropic Hormone; Bartter Syndrome; Calcitonin; Choriocarcinoma; Corticotropin-Releasing Hormone; Erythropoietin; Female; Gonadotropins; Humans; Hypercalcemia; Hypoglycemia; Male; Paraneoplastic Endocrine Syndromes; Paraneoplastic Syndromes; Pregnancy; Prolactin; Renin; Repressor Proteins; Teratoma; Testicular Neoplasms; Thyrotropin

Topics: Adenocarcinoma; Adolescent; Adult; Aged; Animals; Brain Neoplasms; Child; Child, Preschool; Dogs; Electric Stimulation; Erythropoiesis; Erythropoietin; Ethacrynic Acid; Haplorhini; Humans; Hydronephrosis; Hypertension; Hypothalamus; Infant; Iron Isotopes; Kidney Diseases; Kidney Neoplasms; Lung Neoplasms; Male; Mice; Middle Aged; Polycythemia Vera; Rats; Testicular Neoplasms; Testosterone; Urinary Calculi; Urologic Diseases; Wilms Tumor; Wounds and Injuries