Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0854467 (myelosuppression)
 5,932 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seventy-nine patients with metastatic breast cancer underwent examination of their bone marrow as part of their staging workup. Thirty-one (39%) showed no evidence of bone marrow involvement (BM-); 48 (61%) were found to have bone marrow metastases (BM+). Both groups of patients were treated with intensive chemotherapy with 5-FU, Adriamycin, cyclophosphamide, methotrexate, and nonspecific immunotherapy with BCG, methanol extraction residue, or Levamisole. The groups were comparable in age, race, menopausal status, and disease-free interval; however, the BM+ group had a higher proportion of patients with dominant osseous disease and a somewhat lower overall tumor burden. Ten of 21 patients in the BM+ group treated with 100% of the calculated dose of chemotherapy are still alive, compared with only three of 27 patients treated with lower doses. A similar dose response was observed in the BM- group. Myelosuppression was more common and more severe in the BM+ group. Hematologic support, i.e., packed erythrocytes and platelet transfusions, was required in 60% of BM+ patients, as opposed to 26% of BM-. Infectious complications were also higher in the BM+ group, in which five episodes of sepsis and two infectious deaths were observed. These results suggest that metastatic breast cancer patients with bone marrow invasion achieve excellent palliation with aggressive high-dose chemotherapy. Higher morbidity requiring aggressive supportive care suggests that these patients should be treated by physicians and centers experienced in their management.
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PMID:Combination chemotherapy for breast cancer metastatic to bone marrow. 723 95

Use of cancer chemotherapeutic drugs is associated with several adverse drug reactions (ADRs) ranging from mild nausea to fatal myelosuppression. Data regarding safety profile of cancer chemotherapy is lacking in Nepal. To study the pattern of ADRs caused by cancer chemotherapeutic drugs in Manipal Teaching Hospital (MTH), Pokhara, Nepal. Hospitalized patients treated with cancer chemotherapy drugs from 1st January to 30th June 2006, was studied retrospectively. Necessary information was collected from the patients' hospital records. Total 60 patients underwent chemotherapy among which 25 (41.67%) developed ADRs. More than half (60 %) were male and 40 % were of age group 61-70 years. The mean SD age was 57.8 +/- 11.54 years. More than half of the patients (56%) who developed ADRs were on adjuvant chemotherapy. Alkylating agents were responsible for the ADRs in nearly half of the patients (52%) followed by antimetabolites (20%). Cisplatin was the individual drug responsible for 44% of the ADRs. The onset of the ADR was within a day in 44% of the patients. Thirty six percent of patients developing ADRs stayed in the hospital for 1-4 days. Hematological system was affected primarily (40.47% of the patients), followed by the gastrointestinal tract (33.33%). Grade I neutropenia was the most common ADR affecting 28.6% of the patients, followed by emesis (21.4%). Increased dose of antiemetics was needed in 38.5% of the patients to manage the ADRs. Levamisole was the drug used primarily (30.43%) for managing ADRs. Male patients and age group 61-70 years were highly predisposed to ADRs. Cisplatin was the common drug responsible for ADRs. Levamisole was commonly used in managing the ADRs. Similar studies covering more patients form different regions are needed to validate our findings.
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PMID:Pattern of adverse drug reactions due to cancer chemotherapy in a tertiary care teaching hospital in Nepal. 1754 6