Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0031117 (peripheral neuropathy)
 10,577 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seventeen patients with primary or metastatic malignancy in the liver were treated with 'two-route chemotherapy' (TRC). One course of this TRC consisted of hepatic artery infusion of cisplatin, 120 mg/m2, in combination with concurrent intravenous administration of sodium thiosulfate, its neutralizing agent, at a dose of 9.0 g/m2 by a rapid push, followed by 1.2 g/m2/h by continuous infusion for 6 h. Five of 11 (45%) hepatocellular carcinoma and two of six (33%) metastatic tumors achieved partial response. Although almost all patients experienced nausea or vomiting, severe side-effects, including nephrotoxicity, peripheral neuropathy or ototoxicity, were not encountered. Myelosuppression was observed in one patient after seven courses of this TRC. The results indicate that TRC may be relatively effective against hepatic malignancies in patients without severe toxicity.
Eur J Cancer Clin Oncol 1988 Oct
PMID:'Two-route chemotherapy' using intra-arterial cisplatin and intravenous sodium thiosulfate, its neutralizing agent, for hepatic malignancies. 266 Dec 36

We prospectively evaluated 50 cancer patients with new complaints of muscle cramps. Neurologic examination and laboratory evaluation identified disorders related to neural, muscular, or biochemical abnormalities in 41 (82%) patients. Abnormalities were confined mainly to the peripheral nervous system and included peripheral neuropathy in 22 patients, root and plexus pathology in 17 patients (six with leptomeningeal metastases), and polymyositis in two patients. Hypomagnesemia accounted for muscle cramps in only one patient. Identifiable causes of muscle cramps were related mostly either to metastatic or nonmetastatic complications of the underlying malignancy (14 patients) or to complications of its treatment (21 patients). Cramps, or rather complaints of cramps, were the presenting symptom of recognizable and previously unsuspected neurologic dysfunction in 64% (27 of 42) of the identified causes. Therefore, we conclude that muscle cramps in cancer patients may not be a benign complaint and that they usually mark the presence of an identifiable neurologic disorder. The use of simple clinical and laboratory measures is rewarding in the evaluation of these patients and leads to diagnosis in the majority of them.
Cancer 1989 Feb 01
PMID:Muscle cramps in cancer patients. 291 32

The toxicity of MOPP chemotherapy, including nausea, vomiting, hair loss, and neuropathy, can limit patient compliance. Alternative regimens employing oral alkylating agents and vinblastine have been designed to ameliorate these toxicities. The authors reviewed their experience in 24 patients with advanced-stage Hodgkin's disease who were treated with chlorambucil, vinblastine, procarbazine, and prednisone (ChlVPP). Complete responses were obtained in 92% (11/12) of previously untreated patients and in 92% (11/12) of patients who relapsed after radiation (10/10) or chemotherapy (one of two). Overall, relapse-free survival is 82% with a median duration of follow-up of 5.5 years. Toxicity was minimal with myelosuppression being the dose-limiting toxicity. Severe nausea and vomiting occurred in only two patients and was considered secondary to procarbazine. Mild nausea occurred in six other patients. Minimal alopecia was seen in three patients and only two patients developed a mild peripheral neuropathy. The authors conclude that ChlVPP appears as effective as MOPP chemotherapy for Hodgkin's disease in comparable presentations but is a less toxic regimen. Thus, it may be useful in situations where poor compliance and patient acceptance may compromise optimal dose and frequency of drug administration.
Cancer 1989 Mar 15
PMID:Chlorambucil, vinblastine, procarbazine, and prednisone. An effective but less toxic regimen than MOPP for advanced-stage Hodgkin's disease. 291 8

Twelve patients with refractory germ cell tumors were treated with etoposide (VP16) (100 g/m2/day X 5) and very high dose cisplatin (VHD-CDDP) (40 mg/m2/day X 5) every 28 days. All patients had progressed or relapsed after therapy with vinblastine (0.15 mg/kg/day X 2), CDDP (20 mg/m2/day X 5), and bleomycin (30 units/week). Thirty-three cycles of VP16 plus VHD-CDDP were administered. Five patients achieved complete response (two with chemotherapy only, two with chemotherapy + surgery, and one with chemotherapy + irradiation), five achieved partial response (two continue therapy), and two had disease progression. Only one patient achieved prolonged complete response (24+ months). Myelosuppression (median wbc count nadir, 1200/mm3; median platelet count nadir, 18,500/mm3), neurotoxicity (five patients with diminished hearing and six with substantial peripheral neuropathy), and hypomagnesemia (21 of 22 courses; magnesium, less than 1.5 mg/dl) were the dominant toxic effects. No important nephrotoxicity was seen (median maximum creatinine, 1.2 mg/dl; range, 0.8-2.2). VP16 plus VHD-CDDP is safe and tolerable and may provide a non-cross-resistant alternative to vinblastine, CDDP, and bleomycin.
Cancer Treat Rep 1985 Mar
PMID:Etoposide and very high dose cisplatin: salvage therapy for patients with advanced germ cell neoplasms. 298 93

Fifty-eight patients with advanced non-small cell lung cancer were randomly allocated to receive vindesine (3 mg/m2 every week) plus either cisplatin (80 mg/m2 every 3 weeks) or mitomycin (8 mg/m2 weekly X 3, then every 3 weeks). No patients achieved complete response. Among the 28 patients treated with vindesine plus cisplatin, there were 12 partial responders (42.9%); among the 30 patients treated with vindesine plus mitomycin, there were only three partial responders (10%) (P less than 0.005). The median duration of response was 11.5 weeks (range, 4-25) in the patients treated with vindesine plus cisplatin. The median survival times for patients treated with vindesine plus cisplatin and vindesine plus mitomycin were 10.1 and 10.2 months, respectively; there was no statistical difference in survival time between the two groups. Initial performance status was the strong predictor of patient survival. Toxic effects, including moderate myelosuppression, nephrotoxicity, peripheral neuropathy, and gastrointestinal symptoms, were generally manageable. The combination of vindesine and cisplatin appears to be effective against advanced non-small cell lung cancer.
Cancer Treat Rep 1985 Sep
PMID:Comparison of vindesine plus cisplatin or vindesine plus mitomycin in the treatment of advanced non-small cell lung cancer. 299 85

A patient with osteosclerotic myeloma and POEMS syndrome, unresponsive to pulse prednisone and melphalan therapy, was admitted to the hospital for a trial of plasma exchange therapy. The presentation included IgG lambda monoclonal gammopathy, peripheral neuropathy, hepatosplenomegaly, hyperpigmentation and thickening of the skin, edema, and tense ascites. Laboratory tests confirmed hypothyroidism, hypogonadism, and adrenal insufficiency. Six exchange procedures failed to affect the clinical course, and the patient died. Greater-than-one-plasma-volume exchanges (patient's measured plasma volume, 2,703 cc) were performed. When IgG and cholesterol removal were compared to the predicted removal, based on the volume of plasma removed, significantly less reduction in concentration than predicted was measured. IgG concentrations increased postapheresis and, at 2 weeks, three-fourths of the removed IgG had reaccumulated. A reduced efficiency of removal of both IgG and cholesterol can be explained by postulating increased vascular permeability with free exchange of soluble substances from one compartment to another. If an abnormal product is produced by the disease and is responsible for the clinical syndrome, a more intensive schedule of plasma exchange therapy may be needed to achieve a sustained depletion of the responsible soluble substance. Alternatively, neither increased vascular permeability or the clinical manifestations are responsive to removal of a soluble substance or are caused by a soluble substance produced by the malignancy.
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PMID:Therapeutic trial of plasma exchange in osteosclerotic myeloma associated with the POEMS syndrome. 299 55

Over the last decade, the increasing use of serum and urine protein electrophoretic screening of patients with idiopathic peripheral neuropathy has led to greater recognition of peripheral neuropathy syndromes that are associated with monoclonal proteins and plasma cell dycrasias. After careful evaluation, most of these patients have benign monoclonal gammopathy, followed in frequency by primary systemic amyloidosis and osteosclerotic myeloma, with occasional cases associated with osteolytic multiple myeloma, Waldenstrom's macroglobulinemia, gamma heavy chain disease, and other rare disorders. Several of these syndromes have distinctive presentations and are recognizable clinically, whereas others (especially multiple myeloma neuropathy) are diverse clinically and are not clearly distinguishable from other chronic neuropathies. The discovery of IgM-kappa monoclonal proteins directed at myelin antigens in some patients with benign monoclonal gammopathy and the delineation of the syndrome of neuropathy and multiorgan involvement in osteosclerotic myeloma are important developments which may shed light on the mechanism of the remote effects of malignancies on the nervous system.
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PMID:Peripheral neuropathies associated with monoclonal proteins: a clinical review. 299 4

Seven patients with cancer presented a sensory peripheral neuropathy induced by cisplatinum. This drug was used alone in 1 case and, in 6 other cases it was associated with drugs without any toxicity for the peripheral nervous system. Every patient had an electromyogram and motor and sensory nerve conduction studies. A sural nerve biopsy was performed in 5 cases for light and electron microscopic studies as well as for teasing and quantitative studies. Electromyograms and motor nerve conductions were normal. Sensory nerve conductions were slowed with very low amplitude sensory action potentials. Such results suggested axonal changes. Nerve biopsies showed typical axonopathic changes with secondary demyelination. Morphometric studies confirmed a loss of myelinated fibers affecting the large fibers in all cases, according to the slowed sensory nerve conductions. This study confirmed that the cisplatinum-induced neuropathy is a new form of toxic distal axonal neuropathy. The hypothesis of a primary demyelination of peripheral nerves, which has been proposed, could not be retained.
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PMID:[Neuropathy caused by cisplatin. Clinical, electrophysiological and morphological study]. 300 68

A high incidence of severe peripheral neuropathy occurred during the pilot study of a new regimen for the treatment of non-Hodgkin's lymphoma. The clinically observed incidence and severity of vincristine-induced peripheral neuropathy was considerably enhanced by the sequential use of vincristine and teniposide in this combination chemotherapy.
Cancer Treat Rep 1986 Apr
PMID:Vincristine neurotoxicity enhanced in combination chemotherapy including both teniposide and vincristine. 300 12

In two patients a peripheral neuropathy was the presenting symptom of a noncutaneous peripheral T-cell lymphoma. In the first patient, the neuropathy had a relapsing and remitting course, the symptoms improved under corticosteroid therapy. The second patient suffered from a relentless neuropathy. In both cases the lymphoma infiltrated the peroneal nerve with an angiocentric and perivascular pattern resembling that observed in central nervous system lymphomas. The characterization of T-cell subsets in the lymph node showed cells with the helper/inducer and suppressor/cytotoxic phenotype in the first case and a predominance of cells with the helper/inducer phenotype in the second case. In the nerve, lymphocytes beard the helper/inducer phenotype antigen. A typical paraneoplastic vasculitis of nerve showed clearly different immunologic features.
Cancer 1986 Dec 15
PMID:T-cell lymphoma revealed by a peripheral neuropathy. A report of two cases with an immunohistologic study on lymph node and nerve biopsies. 302 11


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