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Knieper C, Ramsauer B, Hancke K, Woeckel A, Ismail L, Bühren A, Toth B. "Pregnant and Operating": Evaluation of a Germany-wide Survey Among Female Gynaecologists and Surgeons. Geburtshilfe Frauenheilkd 2014; 74:875-880. [PMID: 25278630 DOI: 10.1055/s-0034-1383065] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 08/21/2014] [Accepted: 08/21/2014] [Indexed: 10/24/2022] Open
Abstract
The current law on the protection of expectant and nursing mothers largely rules out surgical activities during pregnancy for female doctors who perform surgical roles in hospitals. The proportion of female junior staff in gynaecology amounts to 80 %, and, for many of these women, surgical further training is not possible following official notification of an existing pregnancy. In a Germany-wide survey of female gynaecologists and surgeons using a questionnaire, it was determined to what extent female doctors worked in surgery during pregnancy, whether it led to complications in the pregnancy, when the employer was notified about the pregnancy, and what desire for change there is with regard to the law on the protection of expectant and nursing mothers. The data from 164 female doctors, of which 136 are gynaecologists and 28 surgeons, was evaluated. On average, the pregnancy was announced during the 14th week of pregnancy (WOP), and the doctor was not allowed to perform surgical activities in the 21st WOP. Female doctors in higher professional roles tended to announce the pregnancy later and ended their surgical activities later. There was no link between the time of ceasing surgical activities and an increased occurrence of complaints or complications during the pregnancy. In total, only 53 % of respondents had an appraisal during pregnancy and 75 % wanted a change in the law on the protection of expectant and nursing mothers.
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Roesner S, Seydel A, Germeyer A, Thoene C, Seehaus D, Strowitzki T, Toth B. Prädiktive Marker: Evaluation von 25-OH Vitamin D, Osteopontin und Sclerostin als prädiktive Marker für die Schwangerschaftsrate im IVF-Programm. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Dietrich JE, Capp E, Weigert J, Strowitzki T, Toth B. Die Ploidie befruchteter Eizellen hat keinen Einfluss auf morphokinetische Eigenschaften von bis zu 8-zelligen Embryonen nach Polkörperdiagnostik und Time-Lapse Imaging. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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79
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Kuon RJ, Schaumann J, Goeggl T, Strowitzki T, Sadeghi M, Fluhr H, Daniel V, Toth B. Immunologische Profile bei Patientinnen mit idiopathischer habitueller Abortneigung. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1387960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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80
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Sabeth Pestka A, Knabl J, Toth B, Hüttenbrenner R, Kuhn C, Hofmann S, Wiest I, Jeschke U, Friese K. Regulation von RXRα, LXR und PPARγ in glandulären Epithelzellen der Dezidua in Aborten. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1387988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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81
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Weigert J, Dietrich J, Rösner S, Montag M, Toth B, Strowitzki T. Vergleich der Schwangerschaftsraten nach Embryotransfer am Tag 4 versus Tag 5. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1387985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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82
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Franz C, Nieuwland R, Montag M, Böing AN, Hajji N, Strowitzki T, Toth B. CD9-positive Mikropartikel in Follikelflüssigkeit – ein möglicher Einfluss auf das Reproduktionsgeschehen? Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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83
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Holschbach V, Toth B, Kuon RJ, Goeggl T, Franz C, Strowitzki T, Daniel V, Weber M, Markert U. Keine Korrelation uteriner und peripherer natürlicher Killerzellen bei Patientinnen mit habituellen Aborten und Implantationsversagen. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1387967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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84
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Wischmann T, Schilling K, Toth B, Rösner S, Strowitzki T, Wohlfarth K, Kentenich H. Sexuality, Self-Esteem and Partnership Quality in Infertile Women and Men. Geburtshilfe Frauenheilkd 2014; 74:759-763. [PMID: 25221344 DOI: 10.1055/s-0034-1368461] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 04/17/2014] [Accepted: 04/23/2014] [Indexed: 10/24/2022] Open
Abstract
Introduction: Infertile couples often report quality-of-life impairments, especially in terms of sexuality, self-esteem and partnership quality. So far, there have been no systematic studies of the sex lives and behaviour of infertile women and men before and after the emergence of their mutual desire for a child. Materials and Methods: From February 2010 to August 2010 all couples starting treatment either at Heidelberg University's Women's Hospital or at the Fertility Center Berlin were asked to fill out the Self-Esteem and Relationship Questionnaire (SEAR). A total of n = 158 women and n = 153 men participated in the study. Results: Decreasing tendencies were observable for both partners in the domains Sexual Relationship Satisfaction and Confidence and in the subscales Self-Esteem and Overall Relationship Satisfaction. There were especially clear indications of a loss of spontaneous sexuality during the experience of infertility. We were also able to establish that infertility has a negative impact on women's self-esteem. Discussion: The results of this study indicate that SEAR can be used as a feasible instrument for identifying infertile women and men whose infertility has a negative effect on their relationship quality and/or sex lives.
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85
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Fooks AR, Horton DL, Phipps LP, Mansfield KL, McCracken F, Jeffries CL, Johnson N, Wrigley S, Deuchande R, Toth B, Alzola R. Suspect West Nile encephalitis in a horse imported into the UK from Europe. VETERINARY RECORD CASE REPORTS 2014. [DOI: 10.1136/vetreccr-2014-000104] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Toth B, Slovis NM, Constable PD, Taylor SD. Plasma adrenomedullin concentrations in critically ill neonatal foals. J Vet Intern Med 2014; 28:1294-300. [PMID: 24773029 PMCID: PMC4857949 DOI: 10.1111/jvim.12358] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 02/05/2014] [Accepted: 03/12/2014] [Indexed: 11/17/2022] Open
Abstract
Background Bacterial sepsis remains a leading cause of morbidity and mortality in neonatal foals, but accurate diagnostic and prognostic markers are lacking. Adrenomedullin (AM) is a polypeptide with diverse biologic effects on the cardiovascular system that increases in septic humans and laboratory animals. Hypotheses Plasma AM concentration (p[AM]) is increased in septic neonatal foals compared to sick nonseptic and healthy control foals, and p[AM] is predictive of survival in septic neonatal foals. Animals Ninety critically ill (42 septic, 48 sick nonseptic) and 61 healthy foals <1 week of age. Methods A prospective observational clinical study was performed. Venous blood was collected from critically ill foals at admission and from healthy foals at 24 hours of age. Critically ill foals were categorized as septic or sick nonseptic based on blood culture results and sepsis score. Plasma [AM] was measured by using a commercially available ELISA for horses. Data were analyzed by using the Mann‐Whitney U‐test and P < .05 was considered significant. Results Plasma [AM] was not significantly different between septic and sick nonseptic foals (P = .71), but critically ill foals had significantly increased p[AM] compared to healthy controls (P < .0001). In critically ill foals, p[AM] was not predictive of survival (P = .051). A p[AM] cutoff concentration of 0.041 ng/mL provided a test sensitivity of 91% and specificity of 54% to predict illness. Conclusions and Clinical Relevance Plasma [AM] shows promise as a marker of health in neonatal foals, but p[AM] increases nonspecifically during perinatal illnesses and is not necessarily associated with sepsis.
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Goeckenjan M, Rösner S, Toth B, Strowitzki T, Germeyer A. Successful controlled ovarian stimulation despite elevated hCG levels after first-trimester abortion in the context of fertility preservation. Gynecol Endocrinol 2013; 29:960-2. [PMID: 23952105 DOI: 10.3109/09513590.2013.824961] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Fertility preservation prior to gonadotoxic chemotherapy by cryopreservation of the ovarian tissue and controlled ovarian stimulation can be effective immediately after induced abortion in the first trimenon. In a reproductive endocrinology and infertility unit of a tertiary care university-based medical centre (University Hospital of Heidelberg) a 37-year-old women with breast cancer was counseled for fertility preservation. Cryopreservation of ovarian tissue, followed by ovarian stimulation for planned intracytoplasmatic sperm injection (ICSI), transvaginal oocyte aspiration and cryopreservation of fertilized eggs was performed in spite of persistently elevated human chorionic gonadotropin (hCG)-levels after induced abortion. Twenty-four fertilized oocytes with a fertilization rate of 92% were cryopreserved. Ovarian stimulation and oocyte cryopreservation can be successfully performed with good results immediately after miscarriage, despite persistent high hCG-levels.
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Aleman M, Pickles K, Conley A, Standley S, Haggett E, Toth B, Madigan J. Abnormal Plasma Neuroactive Progestagen Derivatives in Ill, Neonatal Foals Presented to the Neonatal Intensive Care Unit. Equine Vet J 2013. [DOI: 10.1111/evj.12145_6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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90
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Schlossberger V, Schober L, Rehnitz J, Schaier M, Zeier M, Meuer S, Schmitt E, Toth B, Strowitzki T, Steinborn A. The success of assisted reproduction technologies in relation to composition of the total regulatory T cell (Treg) pool and different Treg subsets. Hum Reprod 2013; 28:3062-73. [DOI: 10.1093/humrep/det316] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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91
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Ruggiero S, Gralow J, Marx RE, Hoff AO, Schubert MM, Huryn JM, Toth B, Damato K, Valero V. Practical guidelines for the prevention, diagnosis, and treatment of osteonecrosis of the jaw in patients with cancer. J Oncol Pract 2013; 2:7-14. [PMID: 20871729 DOI: 10.1200/jop.2006.2.1.7] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE This article discusses osteonecrosis of the jaw (ONJ) and offers health care professionals practical guidelines and recommendations for the prevention, diagnosis, and management of ONJ in cancer patients receiving bisphosphonate treatment. METHODS A panel of experts representing oral and maxillofacial surgery, oral medicine, endocrinology, and medical oncology was convened to review the literature and clinical evidence, identify risk factors for ONJ, and develop clinical guidelines for the prevention, early diagnosis, and multidisciplinary treatment of ONJ in patients with cancer. The guidelines are based on experience and have not been evaluated within the context of controlled clinical trials. RESULTS ONJ is a clinical entity with many possible etiologies; historically identified risk factors include corticosteroids, chemotherapy, radiotherapy, trauma, infection, and cancer. With emerging concern for potential development of ONJ in patients receiving bisphosphonates, the panel recommends a dental examination before patients begin therapy with intravenous bisphosphonates. Dental treatments and procedures that require bone healing should be completed before initiating intravenous bisphosphonate therapy. Patients should be instructed on the importance of maintaining good oral hygiene and having regular dental assessments. For patients currently receiving bisphosphonates who require dental procedures, there is no evidence to suggest that interrupting bisphosphonate therapy will prevent or lower the risk of ONJ. Frequent clinical assessments and conservative dental management are suggested for these patients. For treatment of patients who develop ONJ, a conservative, nonsurgical approach is strongly recommended. CONCLUSION An increased awareness of the potential risk of ONJ in patients receiving bisphosphonate therapy is needed. Close coordination between the treating physician and oral surgeon and/or a dental specialist is strongly recommended in making treatment decisions.
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Pestka A, Fitzgerald J, Toth B, Markert U, Jeschke U. Nuclear Hormone Receptors and Female Reproduction. Curr Mol Med 2013; 13:1066-78. [DOI: 10.2174/1566524011313070002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 10/21/2012] [Accepted: 10/26/2012] [Indexed: 11/22/2022]
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Tejera A, Herrero J, Rubio I, Castello D, Pellicer A, Meseguer M, Iwata K, Yumoto K, Ueda M, Matoba Y, Kamada Y, Furuyama S, Mizoguchi C, Sargent HC, Kai Y, Tsuchie Y, Iba Y, Mio Y, Wirka KA, Suraj K, Conaghan J, Gvakharia M, Ivani K, Murugesan R, Chen AA, Shen S, Sundvall L, Ingerslev HJ, Knudsen UB, Kirkegaard K, Best L, Campbell A, Duffy S, Montgomery S, Fishel S, Montag M, Toth B, Weigert J, Strowitzki T, Kumtepe Y, Kahraman S, Cetinkaya M, Pirkevi C, Yelke H, Montag M. Session 57: Time lapse: the real revolution for ambryo assessment? Hum Reprod 2013. [DOI: 10.1093/humrep/det190] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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94
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Schenk M, Illing R, Rogenhofer N, Schleussner E, Seelinger G, Toth B. Kein Vorteil durch den Einsatz von niedermolekularem Heparin bei Patientinnen mit Abortus habitualis - Ergebnisse der ETHIG II Studie. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Rogenhofer N, Bohlmann M, Beuter-Winkler P, Würfel W, Thaler C, Toth B. Management und Schwangerschaftsoutcome des Antithrombin-Mangels. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Jayasena CN, Abbara A, Comninos AN, Ratnasabapathy R, Veldhuis JD, Nijher GMK, Ganiyu-Dada Z, Mehta A, Todd C, Ghatei MA, Bloom SR, Dhillo WS, Grynberg M, Frydman N, Frydman R, Peltoketo H, Bouchard P, Fanchin R, Freriks K, Verhaak CM, Sas TCJ, Menke LA, Otten BJ, Keizer-Schrama SMPFDM, Wit JM, Netea-Maier RT, Hermus ARMM, Kessels RPC, Timmers HJLM, Busnelli A, Benaglia L, Leonardi M, Faulisi S, Ragni G, Somigliana E, Roesner S, Toth B, Weigert J, Strowitzki T, Montag M. Session 69: Clinical endocrinology. Hum Reprod 2013. [DOI: 10.1093/humrep/det203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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97
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Franz C, Böing A, Hau C, Montag M, Strowitzki T, Nieuwland R, Toth B. Procoagulant tissue factor-exposing vesicles in human seminal fluid. J Reprod Immunol 2013; 98:45-51. [DOI: 10.1016/j.jri.2013.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 01/21/2013] [Accepted: 02/10/2013] [Indexed: 12/18/2022]
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Aleman M, Pickles KJ, Conley AJ, Stanley S, Haggett E, Toth B, Madigan JE. Abnormal plasma neuroactive progestagen derivatives in ill, neonatal foals presented to the neonatal intensive care unit. Equine Vet J 2013; 45:661-5. [PMID: 23600660 DOI: 10.1111/evj.12065] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Accepted: 01/18/2013] [Indexed: 11/28/2022]
Abstract
REASONS FOR PERFORMING THE STUDY Increased levels of pregnanes have been reported in foals with neonatal maladjustment syndrome (NMS). These steroids may cross the blood-brain barrier and have depressive effects in the central nervous system leading to behavioural abnormalities and altered states of consciousness in affected foals. OBJECTIVES The aim of this study was to determine the pregnane profile of foals with NMS and compare it with that of healthy controls and sick, non-NMS foals. STUDY DESIGN Prospective-clinical study. METHODS Thirty-two foals with a clinical diagnosis of NMS, 12 foals with other neonatal disorders and 10 healthy control foals were selected for the study. Heparinised blood samples were collected from each group of foals and pregnane and androgen concentrations determined using liquid chromatography mass spectrometry at 0, 24 and 48 h of age. RESULTS Healthy foals showed a significant decrease in pregnane concentrations over the first 48 h of life (P<0.01). Foals with NMS and sick, non-NMS foals had significantly increased progesterone, pregnenolone, androstenedione, dehydroepiandrosterone and epitestosterone concentrations compared with healthy foals (P<0.05). Progesterone and pregnenolone concentrations of sick, non-NMS foals decreased significantly over 48 h (P<0.05), whereas concentrations in NMS foals remained increased. CONCLUSIONS AND POTENTIAL RELEVANCE Pregnane concentrations of ill, neonatal foals remain increased following birth, reflecting a delayed, or interrupted, transition from intra- to extra-uterine life. Serial progesterone and pregnenolone measurement may be useful in aiding diagnosis of NMS.
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Schleussner E, Kamin G, Seeliger G, Rogenhofer N, Toth B. OC-09 Low-molecular-weight heparin in recurrent pregnancy loss – Results of the ETHIG II study. Thromb Res 2013. [DOI: 10.1016/s0049-3848(13)70035-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Westin JR, Thompson MA, Cataldo VD, Fayad LE, Fowler N, Fanale MA, Neelapu S, Samaniego F, Romaguera J, Shah J, McLaughlin P, Pro B, Kwak LW, Sanjorjo P, Murphy WA, Jimenez C, Toth B, Dong W, Hagemeister FB. Zoledronic acid for prevention of bone loss in patients receiving primary therapy for lymphomas: a prospective, randomized controlled phase III trial. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2012; 13:99-105. [PMID: 23276888 DOI: 10.1016/j.clml.2012.11.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 10/05/2012] [Accepted: 11/13/2012] [Indexed: 12/31/2022]
Abstract
UNLABELLED In patients with newly diagnosed lymphoma, low bone mineral density (BMD) is common at diagnosis and worsens with therapy. Our randomized phase III trial demonstrates that 2 doses of zoledronic acid (ZA) and supplementation with calcium and vitamin D effectively prevent further bone loss. BACKGROUND Patients with lymphoma are at risk of development of bone mineral density (BMD) loss from therapy with high-dose corticosteroids and alkylating agents. Zoledronic acid (ZA), a bisphosphonate, may prevent this complication of therapy. We evaluated the effect of ZA on the change in BMD and surrogate biomarkers in patients with lymphoma receiving initial chemotherapy. PATIENTS AND METHODS Our phase III trial randomized 74 patients with newly diagnosed lymphoma and a baseline BMD of ≥ -2.0 to receive oral calcium and vitamin D daily with or without ZA at enrollment and at 6 months after enrollment. BMD was evaluated at baseline and 1 year after enrollment. Secondary biomarker endpoints were collected at baseline and at 3, 6, 9, and 12 months after enrollment. RESULTS Forty-three percent of patients had baseline osteopenia. Fifty-three patients were evaluable for response: 24 received ZA and had stable BMD during the observation period, whereas 29 patients in the control group had decreased BMD (P < .05 at lumbar spine and bilateral femoral neck). Twenty-one randomized patients were not evaluable for response because of lymphoma progression or death, withdrawn consent/incomplete testing, or ineligibility. Bone biomarkers were higher in the control group at all intervals after treatment (P < .001). No fractures or intervention-related toxicities were observed during this trial. CONCLUSIONS Newly diagnosed patients with lymphoma are at risk of low BMD, which may worsen with therapy. Treatment with ZA effectively stabilizes BMD and prevents bone loss. Our data suggest that BMD testing and prophylaxis should be considered as an early intervention for a preventable problem.
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