bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pitfalls in diagnosis of primary low-grade non-Hodgkin’s lymphomas of the spleen
Authors: Musteata V. 
Published: March 2020

17559 Background: Primary low-grade (LG) non-Hodgkin’s lymphomas (NHL) of the spleen are indolent B-cell malignancies usually involving the liver, bone marrow (BM) and the blood while disseminating. The aim of the study was to outline diagnostic problems in primary LG NHL of the spleen, and to improve recommendations regarding the differential diagnosis between these lymphoproliferative disorders and benign abdominal organ pathology (BAOP). Methods: A series of 105 patients (pts) (age range of 15–82 years) with LG splenic NHL was enrolled in our study. In all pts the diagnosis was confirmed morphologically, with immunophenotyping in selected cases. The following histological types of splenic NHL had been identified: follicular (47.6%), small lymphocytic (37.1%), marginal-zone (11.4%), and mantle cell (3.9%) lymphoma. BM involvement and leukemic conversion (LC) were revealed at diagnosis in 102 (99.0%) and 85 (83.3%) pts, respectively. Results: Leading to diagnosis symptoms resulted from splenomegaly and hematological abnormalities. Of 41 (39.0%) pts with splenic NHL, that one had been initially interpreted and treated as chronic hepatitis with hypersplenism (17/16.2%), liver cirrhosis with portal hypertension and hypersplenism (11/10.5%), gastric ulcer/chronic gastroduodenitis (4/3.8%), chronic pancreatitis (3/2.9%), collagenosis (3/2.9%), or nephritis (1/0.9%). In 12 pts with a preliminary diagnosis of chronic hepatitis, or liver cirrhosis with portal hypertension and hypersplenism splenectomy was performed at the surgical departments of district hospitals as a treatment modality of choice. In these cases the initial histological examination of spleen specimens had failed to reveal the lymphomatous involvement, that led to delay in diagnosis. In 17 (16.2%) pts with stage IV disease LG splenic NHL was confirmed occasionally during prophylaxis follow up, or examinations axed on diagnosis of internal diseases. Conclusions: Primary LG NHL of the spleen exhibit the latent onset and nonspecific clinical picture, that usually lead to delay in diagnosis due to resemblance with BAOP. Progressive splenomegaly, LC, consequent liver, abdominal and peripheral lymph node enlargement may indicate the lymphoproliferative malignancy and require BM aspiration/biopsy for diagnosis. No significant financial relationships to disclose.
Pirarubicin (THP) therapy for elderly aggressive non-Hodgkin’s lymphoma— T-COP vs reduced CHOP, and reduced T-COP in the patients with poor physical status
Authors: Mori M. , Oota M. , Taguchi H. , Ohno T. , Tanimoto M. , Miyata A. , Naoe T. , Murai Y. , Masuda M. 
Published: March 2020

17571 Background: We have previously reported that T-COP using pirarubicin (THP) is useful in treatment of NHL in elderly patients. In the present study on elderly aggressive NHL, the usefulness and safety were compared between THP and ADM using the optimum dose of THP (ML1). In patients with poor physical status, reduced dose T-COP was conducted (ML2). Methods: ML1 protocol: PS 0–3 and Alb ≥ 3.0 g/dl Patients in their 70s were assigned randomly to either T-COP (A group) or CHOP (B group) receiving THP (A) or ADM (B) 40 mg/m2,CPA 650 mg/m2, VCR 1 mg/m2dayl, P 40 mg/m2dayl -5. Patients in their 80s were assigned randomly to either T-COP (C) or CHOP (D) receiving THP (C) or ADM (D) 30, CPA 400, VCR 1, P 30. ML2 protocol: PS 4 or Alb < 3.0 g/dl. Patients in their 70s (E group) received THP 26, CPA 430, VCR 1, P 40. Patients in their 80s (F group) received THP 20, CPA 260, VCR 1, P 30. Each group underwent 3 courses every 3 weeks. CR (CR+CRu) patients underwent 6 courses or more. Results: Analyzed as competent cases were 173 out of 207 patients who were registered between Aug 99 and Dec 03. The CR rates were A: 83% (39/47), B: 74% (37/50), C: 67% (14/21), D: 74% (14/19), E: 58% (7/12), F: 33% 2/6, and 78% in T-COP (A + C) and 74% in CHOP (B + D). The 5-year survival rates were A: 50%, B: 35% (p < 0.05) and C: 26% D: 55% (p < 0.05.), demonstrating that T-COP in their 70s and CHOP in their 80s were significantly higher. The 5-year survival rate in ML1 was 41%. In multivariate analysis, factors influencing the survival (p < 0.01) in ML1 were age, the primary effect and treatment method. There were no significant differences in PS, CS, LDH and lesions outside nodes. Conclusions: Patients aged 70 years or older had the CR rate at 75.9% and a 5-year survival rate at 41%, demonstrating satisfactory outcomes. The results suggested that in 70s, THP 40 mg/m2 was more effective than ADM 40 mg/m2. In their 80s, ADM30 mg/m2 was more effective than THP30 mg/m2. ML2 was feasible in elderly patients with poor physical status. No significant financial relationships to disclose.
Feasibility of pegfilgrastim as haematopoietic support for dose-dense every-2-week adjuvant chemotherapy in breast cancer
Authors: Gomez P. , Vilar E. , Saura C. , Cortes J. , Ocaña A. , Bellet M. , Carrera J. , Baselga J. 
Published: March 2020

18606 Background: Dose-dense sequential chemotherapy has been safety supported with Filgrastim (F). Pegfilgrastim (PEGF) is a pegylated recombinant human granulocyte colony-stimulating factor (G-CSF) that has a long half-life, a fact that facilitates a less frequent dosing. Its safety and efficacy has been established in 21- and 28-days schedules. Methods: We have performed a retrospective analysis of medical records of 2 cohort of patients (n=38) treated at our institution between December 2003 and November 2005. All patients received Adriamicin 60 mg/m2 plus Ciclophosphamide 600 mg/m2 q2w for 4 cycles followed by Paclitaxel 175 mg/m2 q2w for 4 cycles. As G-CSF support, in Cohort A (n=29) PEGF was administered 6 mg on day 2 of each cycle and in Cohort B (n=9) F days 3 to 10 at 5 μg/kg. The primary end point was to explore the feasibility and safety in terms of febrile neutropenia (FN) events, number of treatment delays (TD), incidence of neutropenia grade 3 (NPG3) and 4 (NPG4) and mean absolute neutrophil count (ANC) on day 14 of cycle 1 to 7 for both groups. Indirect comparisons have been performed. Results: Patients characteristics in both cohorts were well balanced, except for age in cohort A compared with cohort B (44,89 versus 52,5, p = 0,02). FN events and TD were increased in cohort B compared with cohort A (22% versus 0%, p=0.051, both comparisons). No statistically significant difference in number of episodes of NPG3 and NPG4 was observed. Median ANC on day 14 for each treatment cycle was significantly greater for Cohort A than Cohort B, except for cycle 6. Conclusions: PEGF is very safe and efficacy in patients treated with dose-dense sequential adjuvant chemotherapy for breast cancer. It could be even more efficient than F in preventing febrile neutropenia events. [Table: see text]
Co-administration of ondansetron and casopitant mesylate, a novel NK-1 receptor antagonist, results in augmented anti-emetic activity in the ferret
Authors: Gagnon R. C. , King A. G. 
Published: March 2020

18608 Background: As monotherapies, ondansetron (a 5HT3 receptor antagonist) and casopitant mesylate ( GW679769 ) are effective anti-emetics in models of chemotherapy-induced nausea and vomiting in the ferret. To demonstrate the potential benefit of combination therapy, suboptimal doses of both ondansetron and casopitant mesylate were administered to ferrets receiving cisplatin. Methods: A 4x4 factorial design was utilized to test for therapeutically synergistic anti-emetic activity. Suboptimal doses (administered as monotherapy, which reduced vomiting and retching by >50% compared to control ferrets but did not result in complete protection) of each compound alone and in combination (0.3, 0.1, and 0.03 mg/kg) were administered 25 minutes prior to injection with cisplatin (10 mg/kg, IP). All emetic events/behaviors were recorded digitally via camera and DVR. Normal behaviors (eating, drinking, urination, defecation), emetic events (vomits, retches), and peri-emetic events (excessive mouth licking, burrowing, eye squinting, backward walking, and body scratching) were recorded temporally. All events were analyzed by finding the cumulative sum of events over time. Therapeutic synergy calculations were determined by analysis of variance. Results: Analysis of emetic events demonstrated the combination of ondansetron and casopitant mesylate resulted in significantly fewer events than either agent alone. Similar activity was demonstrated for vomits, retches, event latency, duration of emesis, water intake, food intake, and complete response. Conclusions: Co-administration of ondansetron and casopitant mesylate results in therapeutically synergistic anti-emetic and potential anti-nausea activity in this cisplatin-induced emesis model in ferrets. Pharmacokinetic analysis indicated no alteration of disposition of either agent. Therefore, we believe the synergy observed between ondansetron and casopitant mesylate is the result of their complementary mechanisms of pharmacologic action. Casopitant mesylate is currently in phase III trials for the prevention of PONV and CINV from moderately and highly emetogenic chemotherapy. It is also in clinical development for depression and anxiety. [Table: see text]
Reversal of anorexia with megestrol acetate (MA): Impact on quality of life (QoL) in non-metastasic lung cancer patients (pts) undergoing radiation therapy
Authors: Pardo J. , Mena A. , Monleon A. , Macias V. , Sole J. , Hernández M. , Macia M. 
Published: March 2020

18613 Background: Anorexia is a common and major problem in cancer patients. Its ethiology is multifactorial and has negative effects on pts QoL. Up to 30% of non-metastasic lung cancer pts receiving radiotherapy will develop anorexia during treatment. We conducted a randomized trial comparing the efficacy of two different doses of MA. The results of the first 130 pts included, presented at ASCO 2003, indicated that MA at doses of 600 mg/day is significantly more effective in the treatment of anorexia in these pts than low doses (320 mg/day) of MA. Here we present the results of the quality of life sub-study which purpose is to evaluate the effect of reversing anorexia in pts health related quality of life (HRQOL). Methods: From February 1999 to April 2003, 160 non-mestastatic lung cancer pts who developed anorexia during radiotherapy were randomized to receive either 320 mg/day or 600 mg/day of MA. All pts who developed anorexia filled up the EuroQuol (EQ-5D) quality of life questionnaire before treated with MA and the responders did it again when appetite was regained. The endpoint was improvement in pts HRQOL (defined as an increase > 5 mm in the EQVAS score between the second and first questionnaires). Results: The analysis of the EuroQuol (EQ-5D) questionnaires of the 131 pts who responded to treatment with MA shows that 106 pts (81%) had an improvement > 5 mm in the EQVAS score while 19 % did not. The difference is statistically significant (Binomial test: p < 0.0001). Regarding differences between the two series, 42 pts improved in the 320 mg arm versus 64 in the 600 mg arm which is not statistically significant (Fisher test: p = 0.501). Conclusions: Our results indicate that reversal of anorexia with MA has a clinically significant improvement in HRQOL in non-metastatic lung cancer pts undergoing radiation therapy. The absence of statistically significant differences between the two series may be due to the sample size. [Table: see text] No significant financial relationships to disclose.
Primary adrenocortical carcinoma: A retrospective review of The Cleveland Clinic Foundation experience between 1995 to 2002
Authors: Tirgan N. J. , Hamrahian A. H. 
Published: March 2020

18614 Background: Primary adrenocortical carcinoma (PAC) is a rare disease with a incidence of 1 per million. PAC’s are highly malignant tumors with guarded prognosis. Radical surgery is the treatment of choice. Methods: The pathology database and medical charts of these patients were retrospectively reviewed. Results: There were 14 females, 8 males, and 95% were caucasion. The mean age was 49.2 ± 11.8 years (females 51.6 years, males 45 years). The mean size of the tumor was 12.6 ± 5.1 cm (range of 3.6 to 25 cm). Thirteen patients (59.1%) presented with left and nine (40.9%) with right sided PAC. Seventy- two percent of the patients had abdominal, back, and/or flank pain. Forty five percent of patients had symptoms related to hypercortisolism and/or hyperandrogenism. Twelve patients (55%) had functional tumors (hypercortisolism 67%, hyperandrogenism 42%, and DHEA-S hypersecretion 42%) and ten were non-functional. Five percent of the tumors were classified as stage I, 33% were stage II, 38% were stage III, and 24% were stage IV. Twelve patients (55%) had distant metastases (liver 75%, lung 67%, retroperitoneum 33%, kidney 17%, contra-lateral adrenal gland 17%). All 22 patients had adrenalectomies (open 91%; laparoscopic 9%). The microscopic margin of resection were negative in 14 and positive in 6 patients. The information for 18 patients were evaluable for treatment. Eight patients received post-op therapy. Four patients received Mitotane (o,p’-DDD) alone (three died at 2, 29, and 213 months; and one is alive at 38 months after diagnosis). Three patients received both Mitotane and chemotherapy (two died at 3 and 43 months, one is alive at 140 months). One patient received only chemotherapy and died at 8 months. Ten patients received no post-op therapy. The estimated 5-year survival for the entire group was 48% (Kaplan-Meier survival estimate, 95% confidence interval). The estimated 5-year survival for stage III was 33%, and for stage IV was 30%. There were no deaths in patients with stage II group. The estimated 5-year survival for the treated group (8 patients) was 33% and 58% for the untreated group (10 patients). Conclusions: In PACs, surgery remains the main method of therapy. In our experience, Mitotane with or without chemotherapy did not improve survival. No significant financial relationships to disclose.
Healing by design: The influence of an artistic design on the well being of cancer patients—A 10 years follow up
Authors: Samonigg H. , Andritsch E. , Dietmaier G. , Bauernhofer T. , Andritsch H. , Zloklikovits S. , Kasparek A. K. , Stoeger H. , Schaberl-Moser R. , Ploner F. 
Published: March 2020

18615 Background: The style of the surrounding in which cancer patients, who experience physical as well as high psychological distress are treated, can help them to acquire a sense of security, to reduce their anxiety and depression. Inspired by this model the famous artist F. Hundertwasser created the redesign of the oncological ward with the aim to generate an atmosphere of security by utilizing bright, warm and vivid colours, light and plants. The aim of this study was to investigate in a prospective manner whether the artistic redesign have an influence on the welfare of cancer patients using standardized questionnaires pre and immediately post reconstruction and in a follow up 10 years later. Methods: A total of 261 patients were interviewed (93 before the redesign, 81 immediately and 87 ten years after redesign) to assess the influence of depression (Zerssen Depression Scale, PD-S) quality of life (Spitzer Index)and perceptions of the ward design (semi-structured interview) on wellbeing (Zerrsen Mood Scale, Bf-S). Results: A factor analysis of the semi-structured interview yielded four factors assessed with a MANOVA showing that patients interviewed after redesign reported more positive effects of the ward design (F2;227 = 484.274; p < 0.001). In addition, they were more content with treatment and medical care (F2;227 = 20.103; p < 0.001), more positive in their emotions and thoughts regarding illness (F2;227 = 8.600; p = 0.003) and placed greater importance on the fixtures (F2;227 = 6.067; p = 0.003) than the patients interviewed before the redesign. In a regression analysis depression, the “impact of ward design”, quality of life, gender, “emotions and thoughts regarding illness”, age and education predicted wellbeing with an “R” of 0.0469 (p < 0.05). Conclusions: The results provide important aspects for the discussion if the physical surroundings in which cancer patients are treated serve as a potentially positive factor in the “healing process”. No significant financial relationships to disclose.
Darbepoetin Alfa assessment in chemotherapy induced anemia
Authors: Samantas E. , Rigatos S. K. , Konstantinopoulou A. , Vourli G. , Siganaki M. , Pectasides D. , Pectasides M. , Papakostas E. , Karagianidis G. , Aravantinos G. 
Published: March 2020

18617 Background: Anemia is a very common complication of cancer and its treatment. Epoetins have been proven effective in correcting anemia in cancer patients resulting to the reduction of the need for blood transfusions and having a positive impact to the quality of life (QoL). Darbepoetin alfa, is a novel erythropoiesis stimulating protein (NESP) with longer half life. Methods: This is a prospective, single-centre, clinical trial. Patients with haemoglobin < 12 g/dl, suffering from cancer (solid tumor or lymphoma), for whom chemotherapy is scheduled for at least 12 weeks and have life expectancy >6 months and performance status ECOG 0–2,are treated with Darbepoetin alfa 150 mg per week subcutaneously for at least 12 weeks. Full blood count should be tested at least every 2 weeks and biochemistry every 4 weeks. QoL was assessed before and after treatment using the FACT-An (Functional Assessment of Cancer Therapy-Anemia) scale. Primary endpoint is the correction of anemia (Hb value above 12 g/dl). Frequency of the demographic and clinical characteristics were reported for the categorical variables, while mean and standard deviation were reported for continuous variables, such as age and Hb levels. Results: Fifty-six (56) patients entered the study, 66% of them female. Median age was 64 years. The more common cancers were colorectal (26.8%) ovarian (17.9%), breast (16.1%), lung (12.5%), and bladder (8.9%). Two thirds of the patients had not received previous chemotherapy. A statistically significant increase for Hb was found between week 0 and 12 [1.48; 95% CI 1.07–1.88; p < 0.001]. The increase was significant from 3rd week onwards. There was no evidence of significant difference in any of the QoL components or for significant change in mean fatigue sub-scale (fatigue, non-fatigue), between the two assessments. Conclusions: Darbepoetin alfa given at 150 mg per week subcutaneously to cancer patients under chemotherapy appears to correct anaemia, but has not positive impact on QoL, within the limits of the sample size of this study. No significant financial relationships to disclose.
Capecitabine and irinotecan in elderly patients with advanced or metastatic gastro-intestinal tumors
Authors: Kattan J. , Abou Yared J. , Farhat F. , Chahine G. , Nasr F. , Moukadem W. , Younes F. , Ghosn M. 
Published: March 2020

18619 Background: Capecitabine and Irinotecan exhibit single-agent activity in gastro-intestinal tumors. Their combination seems safe and effective. Adult patients with advanced or metastatic gastric or colorectal cancers were enrolled separately in 2 phase II trials dealing with the combination of both drugs. The aim of this study was to evaluate retrospectively the toxicities and the safety profile of this combination in elderly patients (≥ 65 years) as first line therapy for advanced or metastatic gastro-intestinal cancers. Methods: Patients with advanced or metastatic adenocarcinomas of the colon or the stomach aged 65 years or more were treated with the combination of: Irinotecan 80 mg/m2 IV d1,8,15, and Capecitabine 1250 mg/m2 orally d 1–14, Q 4w. Toxicities were graded according to the NCI common toxicities criteria version 3. Results: 24 naïve-chemotherapy patients were included. Median age was 68 years (extremes 65 to 88). Primary tumor was stomach, colon, and rectum in 13, 9, and 2 cases respectively. Frequent sites of metastases were liver (18), lymph nodes (8), peritoneum (7), and lung (5). They received 113 cycles with median number 4.7/patient, and extremes 1 to 14. Serious toxicities graded as IV were universally absent. Grade III anemia, diarrhea, and vomiting were encountered in 1, 1, and 2 patients respectively. Grade II anemia, leucopenia, diarrhea, alopecia, fatigue, and vomiting were recorded in 5, 2, 4, 2, 2, and 6 patients respectively. Hand-foot syndrome was observed as only grade I in 2 patients. There was no febrile neutropenia. In the other hand, objective response was encountered in 9 patients (37.5%), with median response duration of 6 months (extremes 1 to 15). After a median follow-up of 36 months, 19 patients died from progression of their disease with mean overall survival of 5.5 months (extremes 1 to 28). Conclusion: The combination of Irinotecan and Capecitabine according to our schedule revealed an excellent safety profile with easily manageable toxicities. This schedule is highly suitable for elderly patients. No significant financial relationships to disclose.
Lymphopenia and monocytopenia versus MASCC score system in patients with febrile neutropenia
Authors: Baykara M. , Demirkazik A. , Elhan A. , Yalcin B. , Buyukcelik A. , Dogan M. , Utkan G. , Tek I. , Doruk H. , Akan H. , Icli F. 
Published: March 2020

18622 Background: The purpose of this study was determine the clinical significance of lymphopenia and monocytopenia in terms of its duration and depth in patients with febrile neutropenia (FEN) and MASCC scores parametres. Methods: Sixty-six patients with FEN were prospectively analysed. Recurrent FEN episodes were excluded in this trial. Twenty-four patients had solid tumors, 42 patients had lymphoma-leukemia. Patients with MASCC-scores ≥21 evaluated as low-risk (LR) and the ones with their scores <21 were high-risk (HR). Results: Thirty-six patients had HR and the rest had LR. Lymphocyte count <700/mm3 and monocyte count <100/mm3 were found as 91.6% and 86.6% in HR and in LR groups, respectively.The rate of refractory fever(RF) in HR patients was clearly high.Patients with protracted neutropenia (PN) had higher rate of RF (p = 0.007). Patients with longer duration of neutropenia and monocytopenia tended to have RF (p = 0.052, p = 0.018). The rate of administered AFT was significantly high in HR patients (p = 0.005). AFT was administered to one third of HR patients, but no patient received AFT in LR-group (p < 0.001). In group with neutropenia duration (ND) <10 days, one patient received AFP (p < 0.001). AFT was given to most of the patients who had longer duration of lymphopenia or monocytopenia (respectively; p = 0.002, p = 0.001), and who had leukemia (p = 0.001). The most important parameters effecting the duration of antibiotic therapy (DAT) was found to be ND. DAT >14 days was found more than fourfold in patients PN (p = 0.007). Fifty-five percent out of patients with solid tumor or lymphoma were given <14 days antibiotic therapy. But, most of patients with leukemia had antibiotics >14 days (p = 0.002).The rate of antibiotic therapy >14 days was higher in patients with longer duration of lymphopenia and monocytopenia (respectively; p = 0.073, p = 0.062). The most important parameter that influences on antibiotic modification (AM) was severity of monocytopenia on the first day of FEN. The rate of AM was found in aproximately nine-fold in patients that had monocyte counts ≤100/ mm3 as compared to monocyte ≥100/ mm3 (p = 0.01). Conclusions: The depth of monocytopenia and durations of lymphopenia and monocytopenia were the important parameter influencing antibiotic modification in FEN. No significant financial relationships to disclose.