RESUMEN
PURPOSE: The present study was undertaken to evaluate the effects of adjuvant anthracycline-based chemotherapy on thiobarbituric acid reactive substances (TBARS) and superoxide dismutase (SOD) levels in patients with breast cancer who had undergone surgery. METHODS: Body mass index (BMI), serum lipids (total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides), serum TBARS and SOD values were assessed in 30 patients with stage III breast cancer receiving adjuvant anthracycline- based chemotherapy. RESULTS: Anthracycline-based chemotherapy had no effect on BMI, blood pressure and lipid profile. A significant elevation was noted in TBARS (5.5±0.6 vs 5.9±0.9 µmol/L; p=0.038) and a significant reduction to baseline values in SOD levels (226.5±61.0 vs 203.1±48.3 U/mL; p=0.03) in patients following 6 cycles of adjuvant chemotherapy. CONCLUSION: The TBARS levels increased, whereas the SOD levels descreased after anthracycline-based chemotherapy. We suggest that oxidative stress is not always detrimental, as it can be beneficial in cancer treatment.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Antioxidantes/metabolismo , Biomarcadores de Tumor/metabolismo , Neoplasias de la Mama/metabolismo , Estrés Oxidativo , Adulto , Anciano , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/patología , Colesterol/sangre , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Ciclofosfamida/administración & dosificación , Docetaxel , Epirrubicina/administración & dosificación , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Pronóstico , Superóxido Dismutasa/metabolismo , Taxoides/administración & dosificación , Sustancias Reactivas al Ácido Tiobarbitúrico/metabolismo , Triglicéridos/sangreRESUMEN
PURPOSE: To investigate the depression and anxiety levels and the factors that affect patients receiving chemotherapy and their relatives with the Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) scoring system. METHODS: 330 patients and 330 relatives of these patients were enrolled in this study. The study forms including the questions regarding the patient demographic characteristics, BDI, and STAI were completed during face-to-face interviews by trained interviewers for the determination of the psychological status of the patients and their relatives. BDI and STAI were validated for Turkish population by studies made before. RESULTS: According to BDI scale, 96 (29.1%) patients had mild and 60 (18.2%) had severe depression. Seventy-one (21.5%) relatives had mild and 24 (7.3%) had severe depression. Anxiety evaluation was made by STAI scale and a statistical difference emerged between patients and relatives (patients: 44.93±8.8 vs relatives: 43.27±8.5, p=0.015). The depression and anxiety levels were higher in women, in people with low socio-economic level, in people having a time period between diagnosis and participation in the study longer than 6 months, and in people having relapsing disease. CONCLUSION: Since there are many emotional and psychological disorders in patients and their relatives, much attention should be paid in order to diagnose and treat their psychiatric disorders and enough information about their disease should be given.
Asunto(s)
Ansiedad/etiología , Depresión/etiología , Familia/psicología , Recurrencia Local de Neoplasia/complicaciones , Neoplasias/complicaciones , Calidad de Vida , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Ansiedad/diagnóstico , Ansiedad/psicología , Quimioradioterapia , Depresión/diagnóstico , Depresión/psicología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/psicología , Recurrencia Local de Neoplasia/terapia , Estadificación de Neoplasias , Neoplasias/psicología , Neoplasias/terapia , Pronóstico , Psicometría , Factores de Riesgo , Encuestas y Cuestionarios , Turquía , Adulto JovenRESUMEN
BACKGROUND: Imatinib mesylate [tyrosine kinase (TK) inhibitor] is a novel medication in the treatment of chronic myelogenous leukaemia (CML). TK is also essential in hypothalamo-pituitary-adrenal (HPA) axis. PURPOSE: The aim of this study was to evaluate HPA axis in patients treated with imatinib. Twenty-five patients were included in this study. METHODS: Glucagon stimulation test (GST) and low-dose (1 microg) adrenocorticotropin test (LDSST) were used to assess the HPA gland axis. RESULTS: Seventeen (68%) subjects had impaired peak response when a cortisol cut-off value is accepted as 500 nmol/L. Twelve (48%) out of 17 subjects also failed to show a response to LDSST. Therefore, 12 patients (48%) were defined as HPA deficient. Only two of these 25 patients had morning serum cortisol < 200 nmol/l (7.22 microg/dl), and failed the GST and/or LDSST, indicating that the majority had partial glucocorticoid deficiency. If the cut-off presume for LDSST is from 500 to 600 nmol/l, 16 patients (64%) would have failed both the GST and LDSST. CONCLUSION: Our results indicate an increased prevalence of subclinical glucocorticoid deficiency in patients receiving imatinib mesylate for CML. Therefore under stressed conditions, such as intercurrent illness state, overt and untreated partial glucocorticoid deficiency in CML patients become life threatening.
Asunto(s)
Enfermedades del Sistema Endocrino/inducido químicamente , Sistema Hipotálamo-Hipofisario/efectos de los fármacos , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Piperazinas/efectos adversos , Sistema Hipófiso-Suprarrenal/efectos de los fármacos , Inhibidores de Proteínas Quinasas/efectos adversos , Pirimidinas/efectos adversos , Hormona Adrenocorticotrópica , Adulto , Anciano , Antineoplásicos/efectos adversos , Benzamidas , Cosintropina , Enfermedades del Sistema Endocrino/metabolismo , Femenino , Glucagón , Glucocorticoides/deficiencia , Hormonas , Humanos , Hidrocortisona/metabolismo , Mesilato de Imatinib , Leucemia Mielógena Crónica BCR-ABL Positiva/metabolismo , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: The purpose of this study was to determine whether or not imatinib mesylate therapy induces growth hormone deficiency (GHD). SUBJECTS AND METHODS: Seventeen patients with chronic myloid leukemia (CML) were enrolled in the study. The glucagon stimulation test (GST), and standard deviation scores (SDSs) of insulin-like growth fac- tor 1 (IGF-I) and insulin-like growth factor binding protein (IGFBP-3) were used to determine GHD. The L-dopa test was performed on those with IGF-I SDSs above the -1.8 cut-off level. RESULTS: Of the 17 patients in the study, 12 (70%) had severe GHD (serum GH level <3 microg/l after GST). IGF-I SDSs and IGFBP-3 SDSs were below -1.8 in 12 patients (70%) and below -0.9 in 10 subjects (58%). Four of the 5 remaining subjects with IGF-I SDS >-1.8 showed insufficient GH response to L-dopa stimulation. Nine subjects (52%) had both severe GHD based on GST response and IGF-I SDS below -1.8. If an IGF-I SDS cut-off value l<-3 were used,5 out of 17 subjects (30%) would be classified as GH deficient. These same patients also showed severe GHD based on GST response. CONCLUSIONS: The data showed that a large number of patients on imatinib mesylate therapy had GH deficiency. A study involving a larger number of patients with a matched control group is needed to confirm the present observations.
Asunto(s)
Hormona de Crecimiento Humana/deficiencia , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Piperazinas/efectos adversos , Inhibidores de Proteínas Quinasas/efectos adversos , Pirimidinas/efectos adversos , Adulto , Benzamidas , Femenino , Glucagón , Humanos , Mesilato de Imatinib , Levodopa , Masculino , Persona de Mediana EdadRESUMEN
Non Hodgkin's lymphomas (NHL) of the thyroid are rare thyroid neoplasms. The majority of histopathologic types are extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type and, diffuse large B-cell lymphoma (DLBCL). Most of them arise in a background of Hashimoto's thyroiditis and patients mostly present with a rapidly enlarging thyroid mass and with pressure symptoms. Treatment depends on the histological subtype and stage of the disease and includes radiotherapy and chemotherapy. The prognosis usually is favorable with proper treatment. Herein, we discuss the clinical diagnosis and treatment of thyroid lymphoma.
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Linfoma de Células B/diagnóstico , Linfoma de Células B Grandes Difuso/diagnóstico , Neoplasias de la Tiroides/diagnóstico , Anciano , Femenino , Humanos , Linfoma de Células B/tratamiento farmacológico , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Persona de Mediana Edad , Pronóstico , Neoplasias de la Tiroides/tratamiento farmacológicoRESUMEN
We report herein an unusual case of metachronous triple cancers (rectum, prostate and Philadelphia(+) [Ph(+)] chronic myeloid leukemia [CML]). A metastatic rectal cancer was diagnosed in a 76-year-old male patient, who was treated with transanal tumor resection and chemotherapy. Thirty months from the initial rectal cancer diagnosis, prostate cancer was diagnosed and the patient was administered maximal androgen blockade and received palliative radiotherapy to the lumbar spine because of painful bone metastases. Thirty months after the diagnosis of rectal cancer and 12 months after the diagnosis of prostate cancer the patient developed Ph(+) CML and imatinib treatment was started. After one-year period in remission, CML evolved into accelerated phase and the patient died of intracranial hemorrhage.
Asunto(s)
Leucemia Mielógena Crónica BCR-ABL Positiva/patología , Neoplasias Primarias Múltiples/patología , Neoplasias de la Próstata/patología , Neoplasias del Recto/patología , Neoplasias Gástricas/patología , Anciano , Benzamidas , Crisis Blástica , Neoplasias Óseas/tratamiento farmacológico , Neoplasias Óseas/radioterapia , Neoplasias Óseas/secundario , Resultado Fatal , Humanos , Mesilato de Imatinib , Leucemia Mielógena Crónica BCR-ABL Positiva/complicaciones , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Masculino , Neoplasias Primarias Múltiples/complicaciones , Neoplasias Primarias Múltiples/tratamiento farmacológico , Cromosoma Filadelfia , Piperazinas/uso terapéutico , Neoplasias de la Próstata/complicaciones , Neoplasias de la Próstata/tratamiento farmacológico , Inhibidores de Proteínas Quinasas/uso terapéutico , Proteínas Tirosina Quinasas/antagonistas & inhibidores , Pirimidinas/uso terapéutico , Neoplasias del Recto/complicaciones , Neoplasias del Recto/tratamiento farmacológico , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/tratamiento farmacológicoRESUMEN
AA-type amyloidosis is a consequence of a long-standing systemic inflammation and is not associated with a monoclonal protein or clonal bone marrow plasma cells. Proinflammatory cytokines such as interleukin (IL)1, IL-6, and tumor necrosis factor (TNF) stimulate the synthesis of serum amyloid A during inflammation. Although the association of non-Hodgkin's lymphoma (NHL) with AL-type amyloidosis is well known and patients with Hodgkin's lymphoma with AA amyloidosis have been described, AA-type amyloidosis with NHL is extremely infrequent. We report a case of amyloidosis associated with NHL that subsided during R-CHOP chemotherapy.