Search

Summary: The factors possibly affecting the collection of peripheral blood stem cells (PBSC) were evaluated in 104 de novo acute leukemia patients (66 myeloid and 38 lymphoblastic leukemias) in first cytological complete remission (CR); all patients achieved CR after first-line induction chemotherapy. The acute myeloid leukemia patients (AML) were given consolidation-mobilization chemotherapy with cytarabine, and daunoblastin or mitoxantrone or idarubicin; the acute lymphoblastic leukemia patients (ALL) were given consolidation-mobilization chemotherapy with cytarabine and etoposide. In all patients, the collection of PBSC was performed during recovery after giving consolidation chemotherapy and granulocyte colony-stimulating factor (G-CSF). Two main groups were considered according to the CD34+ cells x 10(6)/kg b.w. collected, that is, poor mobilizers (PM), with a collection of <2 x 10(6)/kg and good mobilizers, with a collection of >2 x 10(6)/kg. Of 104 patients, 27 (25.9%) were PM; 20/27 had AML and 7/27 had ALL. At multivariate analysis, a lower CD34+ cells count premobilization chemotherapy (CD34 steady state), the presence of FUO (fever of unknown origin) or infection, and a lower number of CD34+ cells on the first day of collection correlated with poor mobilization. These results may enable early recognition of patients who may have poor mobilization, and aid selection of patients for different mobilization regimens., (Copyright 2004 Nature Publishing Group)

The present study describes supportive care (SC) in patients with advanced non-small-cell lung cancer (NSCLC), evaluating whether it is affected by concomitant chemotherapy, patient's performance status (PS) and age. Data of patients enrolled in three randomised trials of first-line chemotherapy, conducted between 1996 and 2001, were pooled. The analysis was limited to the first three cycles of treatment. Supportive care data were available for 1185 out of 1312 (90%) enrolled patients. Gastrointestinal drugs (45.7%), corticosteroids (33.4%) and analgesics (23.8%) were the most frequently observed categories. The mean number of drugs per patient was 2.43; 538 patients (45.4%) assumed three or more supportive drugs. Vinorelbine does not produce substantial variations in the SC pattern, while cisplatin-based treatment requires an overall higher number of supportive drugs, with higher use of antiemetics (41 vs 27%) and antianaemics (10 vs 4%). Patients with worse PS are more exposed to corticosteroids (42 vs 30%). Elderly patients require drugs against concomitant diseases significantly more than adults (20 vs 7%) and are less frequently exposed to antiemetics (12 vs 27%). In conclusion, polypharmacotherapy is a relevant issue in patients with advanced NSCLC. Chemotherapy does not remarkably affect the pattern of SC, except for some drugs against side effects. Elderly patients assume more drugs for concomitant diseases and receive less antiemetics than adults.

A questionnaire was sent to the 23 Dialysis Centers of the Piedmont and Aosta Valley Regions to probe present trend on the choice of peritoneal catheter, its setting, the tunnel conformation, the first use and its maintenance. The nephrologists attach great importance to a well fixed subcutaneous tract of the catheter: this goal is obtained with wide use of pre-molded catheters, often with long and curvilinear tunnel. Avoiding an early use of the catheter and the choice of small volumes in the first weeks will permit an efficient stability of the cuff and the reduction of the risk of leakage. The choice in maintenance and monitoring of the exit-site are various and it often has a protection covering; clinical controls are made on a monthly basis.

The purpose of this in vivo double-blind study was to determine and compare the antimicrobial effectiveness of four commercial over-the-counter mouthwashes and a water control. Two of the products tested contained alcohol (Listerine and Scope) and two products were alcohol-free (Rembrandt Mouth Refreshing Rincs and Clear Choice). The antimicrobial efficacy of the products was determined against aerobic, microaerophilic, and anaerobic bacteria in saliva. Thirty human subjects participated in the study. At each experimental session for a given subject, a pretest saliva sample was taken. This sample was divided and used to grow three bacteria cultures under the different incubation environments. After giving the pretest sample, the subject rinsed with one of the commercial mouthwashes or the water control for 30 seconds, then waited one hour at which time a posttest saliva sample was collected. Again, the sample was divided and used to culture the different type of bacteria. Following a 48-hour incubation period, the numbers of microbial colonies on each plate were counted and compared. The results indicated that all of the mouthwashes tested performed significantly better than the water control. Both of the non-alcohol-containing products showed efficacy in inhibiting aerobic, microaerophilic, and anaerobic bacteria. Rembrandt Mouth Refreshing Rinse and Listerine inhibited all three types of bacteria, and were not significantly different from each other in efficacy. The Rembrandt mouth wash inhibited all three types of bacteria more effectively than Clear Choice mouthwash, and inhibited two of the three types of bacteria more effectively than Scope mouthwash.

Two hundred and eighty-one patients received 927 doses of cis-platinum, generally on an outpatient basis, at 55 mg/m2 every 3-4 weeks. Mannitol and 2.2501 of hydration with saline and 5% dextrose plus NaCl and KCl were given in 3-4 hr. No case of acute renal failure ensued and when azotemia occurred (3.5% of patients) it was easily reversible and controlled. An abnormal level of one or more electrolytes was detected in 194 patients (69%) during chemotherapy. K+, Na+, Ca2+ and Mg2+ values usually decreased in serum after DDP administration, but their depletion seldom caused symptoms. Hypomagnesemia developed in 20% of patients, but was symptomatic in only 1%. cis-Platinum, at the doses utilized, is safely given to outpatients, with the hydration program employed. Serum electrolyte decrease during chemotherapy must be expected, and rapidly corrected when symptoms develop.

Sixty-one patients undergoing treatment with cis-platin-containing regimens were given prophylactically either metoclopramide or methylprednisolone, in order to reduce the gastrointestinal side effects. Vomiting occurred in 79% of the cycles (128/162), and had a distressing intensity in 39.5% of cycles (64/162). No significant differences were observed between metoclopramide and methylprednisolone with respect to number and duration of vomiting episodes and duration of nausea and anorexia. Two of 6 patients benefited from substitution of metoclopramide for methylprednisolone; only 1/11 benefited from the substitution of methylprednisolone for metoclopramide. Metoclopramide and methylprednisolone, at the dosage and schedule used, were well tolerated and moderately active in preventing nausea and vomiting induced by cis-platin; their use in combination could further improve these results.

Forty-two evaluable patients with advanced non-small cell lung cancer were treated with teniposide at doses ranging from 120 to 180 mg/m2 on Days 1, 3, and 5 every 3 weeks. Thirty-four patients had received no prior chemotherapy. Seven partial responses (16.6%) were obtained (21% in chemotherapy-unexposed patients). Marrow toxicity was the main side effect: life-threatening thrombocytopenia occurred in 9% of patients, and 54.5% experienced severe leukopenia. Teniposide, at the doses and schedule employed, has moderate activity in non-small cell lung cancer.