pirarubicin and Pleural-Effusion

The present study sought to reduce the incidence of treatment complications of low-risk neuroblastoma by using image-defined risk factors (IDRFs) to inform the timing of surgical resection.. Eligible patients included children (<18 years of age) with stage 1 or 2 disease, children (<365 days of age) with stage 3 disease, and infants with stage 4S disease. In IDRF-negative cases, treatment was completed with surgical resection alone. In IDRF-positive cases, the timing of surgery was determined based on the IDRFs after low-dose chemotherapy with 2-3 of the following four drugs: vincristine, cyclophosphamide, pirarubicin, and carboplatin. The outcome measures were overall survival, progression-free survival, and adverse events. This study was registered with the UMIN Clinical Trials Registry (number 000004355).. Of the 60 patients screened between 2010 and 2013, 58 eligible patients were enrolled; 32 were identified as IDRF negative at diagnosis while 26 were identified as IDRF positive and underwent induction chemotherapy. The 3-year overall and progression-free survival rates of the 58 patients were 100% and 82.8% (95% confidence interval: 70.3-90.3), respectively. Neutropenia was the most frequently reported grade 3 or 4 chemotherapy-related form of toxicity (41.7%). With regard to surgical complications, 2.5% of all patients developed pleural effusion and ascites as early complications, while only 2.5% developed renal atrophy as a long-term complication. No fatal toxicities were observed.. Using IDRFs to inform surgical decision making for the treatment of low-risk neuroblastoma improved prognosis and reduced the incidence of long-term complications.

Topics: Adolescent; Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Chemotherapy-Induced Febrile Neutropenia; Child; Child, Preschool; Clinical Decision-Making; Combined Modality Therapy; Cyclophosphamide; Doxorubicin; Female; Ganglioneuroblastoma; Humans; Infant; Infant, Newborn; Japan; Kaplan-Meier Estimate; Magnetic Resonance Imaging; Male; Neuroblastoma; Pleural Effusion; Postoperative Complications; Progression-Free Survival; Prospective Studies; Risk Factors; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Vascular Diseases; Vincristine

Enteropathy-associated T-cell lymphoma (EATL), an intestinal tumor of intraepithelial T lymphocytes, is a rare and highly aggressive disease. We herein describe a case of type II EATL with massive pyoid ascites in which a histological examination could not be performed despite emergency laparotomy that was successfully diagnosed using flow cytometry and the cell block technique to analyze the celomic fluid. This case suggests that EATL should be included in the differential diagnosis of pyoid ascites of unknown origin and that flow cytometry and the cell block technique of assessing celomic fluid are useful procedures for diagnosing EATL, especially in cases in which conducting a histological examination is impossible.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Ascites; Carcinoma, Renal Cell; Cyclophosphamide; Doxorubicin; Emergencies; Enteropathy-Associated T-Cell Lymphoma; Fatal Outcome; Female; Flow Cytometry; Humans; Intestinal Perforation; Kidney Neoplasms; Laparotomy; Multiple Organ Failure; Neoplasms, Second Primary; Nephrectomy; Omentum; Pleural Effusion; Prednisolone; Respiration, Artificial; Respiratory Insufficiency; Vincristine

THP-ADM is a new antitumor agent which belongs to the anthracycline family. This agent has shown a high therapeutic index compared with the mother compound, Adriamycin, in preclinical and clinical studies. This time, a pharmacokinetic study of THP-ADM was performed and the following characteristics of this agent were clarified. A short t 1/2 alpha was noted in comparison with that of Adriamycin in a 3-compartment open model. Leukocyte concentration with THP-ADM was much higher than that of plasma of red blood cells. Renal excretion over 48 hours was 9% and biliary excretion over the same period was 20%. High THP-ADM and low Adriamycin tissue concentrations were revealed in all tissues excluding the liver. In liver tissue, a high concentration of Adriamycin and a low concentration of THP-ADM was observed. A small amount of Adriamycin was noted in the plasma following THP-ADM administration. This was probably related to the small amount of existing Adriamycin in THP-ADM or conversion of THP-ADM to Adriamycin in the liver tissue, or both. Poor penetration of THP-ADM into the third space was noted.

Topics: Doxorubicin; Erythrocytes; Humans; Infusions, Intravenous; Kinetics; Lymph Nodes; Pancreatic Neoplasms; Pleural Effusion; Stomach Neoplasms