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Zhang CW, Wang YN, Ge XL. Lenalidomide use in multiple myeloma (Review). Mol Clin Oncol 2024; 20:7. [PMID: 38125742 PMCID: PMC10729307 DOI: 10.3892/mco.2023.2705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023] Open
Abstract
Lenalidomide is a second-generation new immunomodulatory medication used to treat multiple myeloma (MM). Its mechanism of action involves affecting the expression of vascular endothelial growth factor, interleukin-6, cytochrome c, caspase-8, as well as other factors including immunological modulation and the direct killing of cells, among others, rendering it a fundamental medication, useful for the treatment of MM. Combining lenalidomide with other medications such dexamethasone, bortezomib, ixazomib, carfilzomib and daratumumab can markedly alleviate MM. When autologous-hematopoietic stem cell transplantation (ASCT) cannot be utilized to treat newly diagnosed individuals with MM (NDMM), monotherapy maintenance following lenalidomide and dexamethasone may be employed. Following ASCT, single-agent maintenance with lenalidomide can be performed as an additional treatment. The combination of bortezomib and lenalidomide has been demonstrated to be associated with favorable response rates, tolerable toxicity, and therapeutic benefits although caution is warranted to prevent the onset of peripheral neuropathy with its use. A new-generation oral drug with an excellent safety profile, ixazomib, is more practical and therapeutically applicable in relapsed refractory MM. However, the frequent occurrence of cardiovascular events, hematocrit, and infections with it require flexible adjustment in its clinical application. Carfilzomib produces a rapid and profound response in patients with NDMM eligible for transplantation, but its cardiovascular side effects need to be closely monitored. The primary aim of the present review was to examine the pharmacological properties and pharmacokinetics of lenalidomide, as well as the efficacy and safety of lenalidomide-based treatments with reference to data from clinical trials and real-world studies.
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Affiliation(s)
- Chao-Wei Zhang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China
| | - Ya-Nan Wang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China
| | - Xue-Ling Ge
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China
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Han J, Owji S, Agarwal A, Kamat S, Luu Y, Mubasher A, Niedt G, Ray C, Cho HJ, Gulati N, Lamb A. Bortezomib-Induced Reticular Eruption in Patient with Multiple Myeloma. Dermatopathology (Basel) 2023; 10:226-230. [PMID: 37489455 PMCID: PMC10366922 DOI: 10.3390/dermatopathology10030031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/06/2023] [Accepted: 07/17/2023] [Indexed: 07/26/2023] Open
Abstract
Bortezomib is the first proteasome inhibitor to treat a variety of malignancies and is currently part of the standard of care regimen for the initial treatment of patients with newly diagnosed multiple myeloma. While bortezomib is generally well tolerated, it has been associated with various side effects, which have limited its use in some patients. Here, we describe a unique case with histological confirmation of a reticular eruption that appeared at the site of a subcutaneous administration of bortezomib in a 62-year-old male who was newly diagnosed with IgG kappa multiple myeloma. A skin biopsy was performed, which revealed superficial perivascular dermatitis predominantly composed of lymphocytes with rare eosinophils. The patient was successfully treated with betamethasone dipropionate 0.05% cream. When consulted, dermatologists should advise the oncology team of multiple myeloma patients treated with bortezomib to maintain a high threshold before discontinuing the drug when a patient experiences an atypical, reticular rash following subcutaneous administration. Additionally, potent topical corticosteroids, such as betamethasone dipropionate 0.05% cream, should be considered in managing the cutaneous reticular eruptions related to bortezomib administration, in order to maintain an optimal treatment regimen for patients with multiple myeloma.
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Affiliation(s)
- Joseph Han
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Shayan Owji
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Aneesh Agarwal
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Samir Kamat
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Yen Luu
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | - Adnan Mubasher
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - George Niedt
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Chloe Ray
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Hearn Jay Cho
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Angela Lamb
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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Rodríguez-Fuentes ME, Pérez-Sayáns M, Carreras-Presas CM, Marichalar-Mendia X, Bagán-Debón L, López-López R. Prevalence of acute oral mucosal damage secondary to the use of systemic antineoplastics: A systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 135:385-395. [PMID: 36585342 DOI: 10.1016/j.oooo.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of this study was to determine the prevalence of acute oral mucosal toxicities in non-irradiated patients treated with systemic antineoplastics agents. The secondary objective was to find out differences in its prevalence among the different types of systemic antineoplastics. STUDY DESIGN A systematic review and meta-analysis was performed. Articles from 2010 to July 2022 were retrieved and included if patients were adults undergoing oral assessment after administration of commercially available systemic antineoplastics. Data was extracted and pooled proportions were estimated using random-effect model method (Der Simonian and Lair). RESULTS Eighty-two articles were included in the study. The overall prevalence of acute oral mucosal damage across studies was 38.2% (95% CI: 33.1%-43.3%). The prevalence was 42.9% (95% CI: 32.8%-53%) in patients treated with chemotherapy alone, 38% (95% CI: 29.1%-47%) in patients treated with a combination of chemotherapy and targeted therapies, and 32.1% (95% CI: 26.8%-37.5%) in targeted therapies alone-treated patients. No statistically significant differences were found in the prevalence of oral mucosal toxicities between the different types of systemic antineoplastic treatments. CONCLUSIONS Oral mucosal toxicity is a major side effect in non-irradiated cancer patients undergoing systemic antineoplastics.
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Affiliation(s)
- Manuel Eros Rodríguez-Fuentes
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain.
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain.
| | | | - Xabier Marichalar-Mendia
- Department of Nursing I, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Leticia Bagán-Debón
- Department of Stomatology, Faculty of Medicine and Dentistry-INCLIVA, Valencia, Spain
| | - Rafael López-López
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Medical Oncology Unit, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
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Ali Sajadian S, Amani M, Saadati Ardestani N, Shirazian S. Experimental Analysis and Thermodynamic Modelling of Lenalidomide Solubility in Supercritical Carbon Dioxide. ARAB J CHEM 2022. [DOI: 10.1016/j.arabjc.2022.103821] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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Ri M, Iida S, Maruyama D, Sakabe A, Kamei R, Nakashima T, Tohkin M, Osaga S, Tobinai K, Fukuhara N, Miyazaki K, Tsukamoto N, Tsujimura H, Yoshimitsu M, Miyamoto K, Tsukasaki K, Nagai H. HLA genotyping in Japanese patients with multiple myeloma receiving bortezomib: An exploratory biomarker study of JCOG1105 (JCOG1105A1). Cancer Sci 2021; 112:5011-5019. [PMID: 34626515 PMCID: PMC8645746 DOI: 10.1111/cas.15158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/31/2021] [Accepted: 09/14/2021] [Indexed: 11/26/2022] Open
Abstract
Bortezomib (Btz) shows robust efficacy in patients with multiple myeloma (MM); however, some patients experience suboptimal responses and show specific toxicities. Therefore, we attempted to identify specific HLA alleles associated with Btz-related toxicities and response to treatment. Eighty-two transplant-ineligible patients with newly diagnosed MM enrolled in a phase II study (JCOG1105) comparing two less intensive melphalan, prednisolone, plus Btz (MPB) regimens were subjected to HLA typing. The frequency of each allele was compared between the groups, categorized based on toxicity grades and responses to MPB therapy. Among 82 patients, the numbers of patients with severe peripheral neuropathy (PN; grade 2 or higher), skin disorders (SD; grade 2 or higher), and pneumonitis were 16 (19.5%), 15 (18.3%), and 6 (7.3%), respectively. Complete response was achieved in 10 (12.2%) patients. Although no significant HLA allele was identified by multiple comparisons, several candidates were identified. HLA-B*40:06 was more prevalent in patients with severe PN than in those with less severe PN (odds ratio [OR] = 6.76). HLA-B*40:06 and HLA-DRB1*12:01 were more prevalent in patients with SD than in those with less severe SD (OR = 7.47 and OR = 5.55, respectively). HLA-DRB1*08:02 clustered in the group of patients with pneumonitis (OR = 11.34). Complete response was achieved in patients carrying HLA-DQB1*03:02, HLA-DQB1*05:01, and HLA-DRB1*01:01 class II alleles. HLA genotyping could help predict Btz-induced toxicity and treatment efficacy in patients with MM, although this needs further validation.
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Affiliation(s)
- Masaki Ri
- Department of Hematology and OncologyNagoya City University HospitalNagoyaJapan
| | - Shinsuke Iida
- Department of Hematology and OncologyNagoya City University HospitalNagoyaJapan
| | - Dai Maruyama
- Department of HematologyNational Cancer Center HospitalTokyoJapan
- Department of Hematology OncologyCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Aya Sakabe
- Department of Regulatory ScienceGraduate School of Pharmaceutical SciencesNagoya City UniversityNagoyaJapan
| | - Ryo Kamei
- Department of Regulatory ScienceGraduate School of Pharmaceutical SciencesNagoya City UniversityNagoyaJapan
| | - Takuto Nakashima
- Department of Regulatory ScienceGraduate School of Pharmaceutical SciencesNagoya City UniversityNagoyaJapan
| | - Masahiro Tohkin
- Department of Regulatory ScienceGraduate School of Pharmaceutical SciencesNagoya City UniversityNagoyaJapan
| | - Satoshi Osaga
- Clinical Research Management CenterNagoya City University HospitalNagoyaJapan
| | - Kensei Tobinai
- Department of HematologyNational Cancer Center HospitalTokyoJapan
| | - Noriko Fukuhara
- Department of Hematology and RheumatologyTohoku University HospitalSendaiJapan
| | - Kana Miyazaki
- Department of Hematology and OncologyMie University Graduate School of MedicineTsuJapan
| | | | | | - Makoto Yoshimitsu
- Department of Hematology and ImmunologyKagoshima University HospitalKagoshimaJapan
| | - Kenichi Miyamoto
- JCOG Data Center/Operating OfficeNational Cancer Center HospitalTokyoJapan
| | - Kunihiro Tsukasaki
- Department of HematologyInternational Medical CenterSaitama Medical UniversitySaitamaJapan
| | - Hirokazu Nagai
- Department of HematologyNational Hospital Organization Nagoya Medical CenterNagoyaJapan
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Choi GS, Lee HS, Kim HK. A case of bortezomib (Velcade)-induced Stevens-Johnson syndrome confirmed by patch test. Asia Pac Allergy 2021; 11:e17. [PMID: 34007827 PMCID: PMC8103010 DOI: 10.5415/apallergy.2021.11.e17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 04/19/2021] [Indexed: 12/27/2022] Open
Abstract
Bortezomib, a highly selective reversible inhibitor of the proteasome complex, is used to the current standard of care in the treatment of multiple myeloma. Although its most commonly reported side effects are gastrointestinal symptoms, peripheral neuropathy, neuropathic pain, and thrombocytopenia, cutaneous adverse reactions are also frequently seen. However, severe cutaneous adverse reactions (SCAR) such as Stevens-Johnson syndrome (SJS) occur very rarely. Here we report the first case of bortezomib-induced SJS with confirmed by patch test. In this case, we performed a patch test that proved bortezomib was the offensive drug in this patient, who had been treated with multiple drugs including antibiotics, allopurinol, and anticancer drugs. Although bortezomib-induced SCARs are generally very rare, we suggest that clinicians be aware of potential adverse reactions including SJS.
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Affiliation(s)
- Gil-Soon Choi
- Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Ho Sup Lee
- Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Hee-Kyoo Kim
- Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
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Du R, Wang X, Ma L, Larcher LM, Tang H, Zhou H, Chen C, Wang T. Adverse reactions of targeted therapy in cancer patients: a retrospective study of hospital medical data in China. BMC Cancer 2021; 21:206. [PMID: 33639888 PMCID: PMC7916285 DOI: 10.1186/s12885-021-07946-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/21/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The adverse reactions (ADRs) of targeted therapy were closely associated with treatment response, clinical outcome, quality of life (QoL) of patients with cancer. However, few studies presented the correlation between ADRs of targeted therapy and treatment effects among cancer patients. This study was to explore the characteristics of ADRs with targeted therapy and the prognosis of cancer patients based on the clinical data. METHODS A retrospective secondary data analysis was conducted within an ADR data set including 2703 patients with targeted therapy from three Henan medical centers of China between January 2018 and December 2019. The significance was evaluated with chi-square test between groups with or without ADRs. Univariate and multivariate logistic regression with backward stepwise method were applied to assess the difference of pathological characteristics in patients with cancer. Using the univariate Cox regression method, the actuarial probability of overall survival was performed to compare the clinical outcomes between these two groups. RESULTS A total of 485 patients were enrolled in this study. Of all patients, 61.0% (n = 296) occurred ADRs including skin damage, fatigue, mucosal damage, hypertension and gastrointestinal discomfort as the top 5 complications during the target therapy. And 62.1% of ADRs were mild to moderate, more than half of the ADRs occurred within one month, 68.6% ADRs lasted more than one month. Older patients (P = 0.022) and patients with lower education level (P = 0.036), more than 2 comorbidities (P = 0.021), longer medication time (P = 0.022), drug combination (P = 0.033) and intravenous administration (P = 0.019) were more likely to have ADRs. Those with ADRs were more likely to stop taking (P = 0.000), change (P = 0.000), adjust (P = 0.000), or not take the medicine on time (P = 0.000). The number of patients with recurrence (P = 0.000) and metastasis (P = 0.006) were statistically significant difference between ADRs and non-ADRs group. And the patients were significantly poor prognosis in ADRs groups compared with non-ADRs group. CONCLUSION The high incidence of ADRs would affect the treatment and prognosis of patients with cancer. We should pay more attention to these ADRs and develop effective management strategies.
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Affiliation(s)
- Ruofei Du
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001 China
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 China
- School of Medical Sciences, Zhengzhou University, Zhengzhou, 450001 China
| | - Xin Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001 China
| | - Lixia Ma
- School of Statistics, Henan University of Economics and Law, Zhengzhou, 450046 China
| | - Leon M. Larcher
- Centre for Comparative Genomics, Murdoch University, Perth, WA 6150 Australia
| | - Han Tang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001 China
| | - Huiyue Zhou
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001 China
| | - Changying Chen
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 China
| | - Tao Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001 China
- Centre for Comparative Genomics, Murdoch University, Perth, WA 6150 Australia
- Hebi People’s Hospital, Hebi, 458030 China
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Tuler S, Kaur J, Delaware S, Dasanu CA. Multidirectional pattern of hair growth with carflizomib use for multiple myeloma. J Oncol Pharm Pract 2020; 27:1291-1295. [PMID: 33050803 DOI: 10.1177/1078155220964544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Extensive use of novel therapies for multiple myeloma has been accompanied by intriguing toxic side effects affecting various organs and organ systems. Although skin effects with some of these medications have been well-documented, hair changes are fairly rare. CASE REPORT We report herein a unique case of a patient with myeloma who developed multidirectional pattern of scalp hair growth starting at 14 months into treatment with cafilzomib. This pattern of hair growth had not previously been described in the literature.Management and outcome: The patient had a near-complete response to caflizomib, and continues on this maintenance treatment regimen to the present day. There has not been any change in the unusual hair appearance and texture. DISCUSSION A score of 5 on the Naranjo nomogram makes the causality relationship between carfilzomib use and the multidirectional hair growth probable. The mechanism by which carfilzomib causes this hair change remains to be elucidated.
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Affiliation(s)
- Shahaf Tuler
- Department of Medicine, Eisenhower Health, Rancho Mirage, CA, USA
| | - Jaspreet Kaur
- Department of Medicine, Eisenhower Health, Rancho Mirage, CA, USA
| | - Suzette Delaware
- Lucy Curci Cancer Center, Eisenhower Health, Rancho Mirage, CA, USA
| | - Constantin A Dasanu
- Lucy Curci Cancer Center, Eisenhower Health, Rancho Mirage, CA, USA.,UC San Diego Health, San Diego, CA, USA
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Soni RK, Supekar BB, Mukhi JI, Singh RP. A Rare Case Report of Photosensitivity in Non-Hodgkin'S Lymphoma Treated with Lenalidomide. Indian J Dermatol 2020; 65:333-335. [PMID: 32831388 PMCID: PMC7423238 DOI: 10.4103/ijd.ijd_64_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Rajesh K Soni
- Department of Dermatology, Venereology and Leprosy, Government Medical College and Hospital, Nagpur, Maharashtra, India. E-mail:
| | - Bhagyashree B Supekar
- Department of Dermatology, Venereology and Leprosy, Government Medical College and Hospital, Nagpur, Maharashtra, India. E-mail:
| | - Jayesh I Mukhi
- Department of Dermatology, Venereology and Leprosy, Government Medical College and Hospital, Nagpur, Maharashtra, India. E-mail:
| | - Rajesh P Singh
- Department of Dermatology, Venereology and Leprosy, Government Medical College and Hospital, Nagpur, Maharashtra, India. E-mail:
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Masatkar V, Nagure A, Gupta LK. Unusual and Interesting Adverse Cutaneous Drug Reactions. Indian J Dermatol 2018; 63:107-116. [PMID: 29692451 PMCID: PMC5903039 DOI: 10.4103/ijd.ijd_584_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Any drug can cause any rash! Cutaneous adverse drug reactions (CADRs) are great mimickers and can be included in the differential diagnosis of any inflammatory dermatoses. Several drugs can cause rash of similar morphology and the same drug can cause rash of different morphology. While some common and specific drug reaction patterns are recognized easily by the clinicians, many a times unusual and interesting patterns can be induced by drug(s), thus leading to erroneous diagnosis and mistreatment. This review aims to familiarize clinicians with some rare, yet interesting patterns of CADR.
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Affiliation(s)
- Vaishali Masatkar
- Department of Dermatology, Ananta Institute of Medical Sciences and Research Centre, Rajsamand, India
| | - Ashok Nagure
- Department of Dermatology, Bidar Institute of Medical Sciences, Bidar, Karnataka, India
| | - Lalit Kumar Gupta
- Department of Dermatology, RNT Medical College, Udaipur, Rajasthan, India
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de la Puente P, Azab AK. Nanoparticle delivery systems, general approaches, and their implementation in multiple myeloma. Eur J Haematol 2017; 98:529-541. [PMID: 28208215 DOI: 10.1111/ejh.12870] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2017] [Indexed: 12/25/2022]
Abstract
Multiple myeloma (MM) is a hematological malignancy that remains incurable, with relapse rates >90%. The main limiting factor for the effective use of chemotherapies in MM is the serious side effects caused by these drugs. The emphasis in cancer treatment has shifted from cytotoxic, non-specific chemotherapies to molecularly targeted and rationally designed therapies showing greater efficacy and fewer side effects. Traditional chemotherapy has shown several disadvantages such as lack of targeting capabilities, systemic toxicity, and side effects; low therapeutic index, as well as most anticancer drugs, has poor water solubility. Nanoparticle delivery systems (NPs) are capable of targeting large doses of chemotherapies into the target area while sparing healthy tissues, overcoming the limitations of traditional chemotherapy. Here, we review the current state of the art in nanoparticle-based strategies designed to treat MM. Many nanoparticle delivery systems have been studied for myeloma using non-targeted NPs (liposomes, polymeric NPs, and inorganic NPs), triggered NPs, as well as targeted NPs (VLA-4, ABC drug transporters, bone microenvironment targeting). The results in preclinical and clinical studies are promising; however, there remains much to be learned in the emerging field of nanomedicine in myeloma.
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Affiliation(s)
- Pilar de la Puente
- Cancer Biology Division, Department of Radiation Oncology, Washington University in Saint Louis School of Medicine, St. Louis, MO, USA
| | - Abdel Kareem Azab
- Cancer Biology Division, Department of Radiation Oncology, Washington University in Saint Louis School of Medicine, St. Louis, MO, USA
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Cao Y, Qiu GQ, Wu HQ, Wang ZL, Lin Y, Wu W, Xie XB, Gu WY. Decitabine enhances bortezomib treatment in RPMI 8226 multiple myeloma cells. Mol Med Rep 2016; 14:3469-75. [PMID: 27571872 DOI: 10.3892/mmr.2016.5658] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 06/24/2016] [Indexed: 11/06/2022] Open
Abstract
The present study investigated the interactions between decitabine (DAC) and bortezomib (BTZ) in RPMI 8226 multiple myeloma (MM) cells. Cells were exposed to DAC alone and in combination with BTZ for 48 h. A Cell Counting Kit‑8 assay was performed to assess the rate of proliferation inhibition in the cells. Cell apoptosis was investigated by Annexin V-fluorescein isothiocyanate and propidium iodide staining. Flow cytometry was used to detect the different cell cycle stages. Western blotting was performed to analyze the protein expression levels of poly(ADP‑ribose) polymerase 1 (PARP‑1), caspase‑3, ‑9 and DNA (cytosine‑5‑)‑methyltransferase 1 (DNMT1). Reverse transcription‑quantitative polymerase chain reaction was used to assess DNMT1 gene expression. The combination of DAC and BTZ increased the proliferation inhibition, apoptotic rate and G0‑G1 arrest compared with use of a single therapeutic agent. In addition, the combination treatment enhanced PARP‑1 cleavage, caspase‑3 and caspase‑9 activation and downregulated the protein and mRNA expression levels of DNMT1. Therefore, the current study determined that the combination of BTZ and the epigenetic agent DAC may be a novel therapeutic strategy to improve the efficacy of BTZ in patients with MM.
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Affiliation(s)
- Yang Cao
- Department of Hematology, The First People's Hospital of Changzhou, Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu 213003, P.R. China
| | - Guo-Qiang Qiu
- Department of Hematology, The First People's Hospital of Changzhou, Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu 213003, P.R. China
| | - Hao-Qing Wu
- Department of Hematology, The First People's Hospital of Changzhou, Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu 213003, P.R. China
| | - Zhi-Lin Wang
- Department of Hematology, The First People's Hospital of Changzhou, Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu 213003, P.R. China
| | - Yan Lin
- Department of Hematology, The First People's Hospital of Changzhou, Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu 213003, P.R. China
| | - Wei Wu
- Department of Hematology, The First People's Hospital of Changzhou, Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu 213003, P.R. China
| | - Xiao-Bao Xie
- Department of Hematology, The First People's Hospital of Changzhou, Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu 213003, P.R. China
| | - Wei-Ying Gu
- Department of Hematology, The First People's Hospital of Changzhou, Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu 213003, P.R. China
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Barley K, He W, Agarwal S, Jagannath S, Chari A. Outcomes and management of lenalidomide-associated rash in patients with multiple myeloma. Leuk Lymphoma 2016; 57:2510-5. [DOI: 10.3109/10428194.2016.1151507] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Cheungpasitporn W, Leung N, Rajkumar SV, Cornell LD, Sethi S, Angioi A, Fervenza FC. Bortezomib-induced acute interstitial nephritis. Nephrol Dial Transplant 2015; 30:1225-9. [PMID: 26109684 DOI: 10.1093/ndt/gfv222] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Acute interstitial nephritis (AIN) is one of the important causes of acute kidney injury (AKI) resulting from inflammatory tubulointerstitial injury induced by medications, infections and systemic diseases. Bortezomib has been increasingly used especially in renal related indications such as multiple myeloma and monoclonal gammopathy of renal significance. Severe allergic reactions from bortezomib treatment including AIN have not been described in the literature. We report a 47-year-old white man who developed biopsy-proven allergic AIN after treatment with bortezomib for his C3 glomerulonephritis. The patient's kidney function improved after treatment with glucocorticoid therapy and discontinuation of bortezomib, but worsened with recurrent AKI episode after re-initiation of bortezomib. His renal function improved after glucocorticoid therapy and discontinuation of bortezomib. To our knowledge, this is the first report of a biopsy-proven AIN from bortezomib.
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Affiliation(s)
| | - Nelson Leung
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | - Lynn D Cornell
- Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA
| | - Sanjeev Sethi
- Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA
| | - Andrea Angioi
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
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Kuiper E, Kardaun S. Late onset perforating folliculitis induced by lenalidomide: a case report. Br J Dermatol 2015; 173:618-20. [DOI: 10.1111/bjd.13698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- E.M. Kuiper
- Department of Dermatology Reference Centre for Cutaneous Adverse Drug Reactions University Medical Center Groningen University of Groningen Groningen the Netherlands
| | - S.H. Kardaun
- Department of Dermatology Reference Centre for Cutaneous Adverse Drug Reactions University Medical Center Groningen University of Groningen Groningen the Netherlands
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Wohlrab J, Bangemann N, Kleine-Tebbe A, Thill M, Kümmel S, Grischke EM, Richter R, Seite S, Lüftner D. Barrier protective use of skin care to prevent chemotherapy-induced cutaneous symptoms and to maintain quality of life in patients with breast cancer. BREAST CANCER-TARGETS AND THERAPY 2014; 6:115-22. [PMID: 25114589 PMCID: PMC4126578 DOI: 10.2147/bctt.s61699] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Purpose Chemotherapy with anthracyclines, taxanes, or alkylating agents often causes cutaneous side effects. Nonspecific inhibition of the proliferative activity of keratinocytes has antidifferentiation effects that lead to defects in the barrier function and, thus, to dry, itchy, and irritable skin. These cutaneous symptoms reduce the quality of life of the patients considerably. Conditioning with topical application of niacinamide uses the cytoprotective and barrier stabilizing effect of vitamin B3. Patients and methods A multicenter randomized crossover study investigated the influence of the test preparation on the quality of life compared to standard care for 73 patients with breast cancer undergoing adjuvant or neoadjuvant cytostatic therapy. Primary target parameter was the Dermatology Life Quality Index with its respective subscales after 6 weeks of a twice-daily application of the respective preparations. Additionally, specific symptoms such as pruritus, dryness, and irritability have been assessed using visual analog scales. Results Regarding the total score of the Dermatology Life Quality Index, no relevant differences could be observed. However, the results for the “symptoms and feelings” subscale show a significant advantage in favor of the test preparation. Significant superiority of the test preparation could also be observed in the secondary target parameters, the visual analog scales (P<0.05). Conclusion The results show for the first time a significant superiority of prophylactic application of niacinamide for maintaining quality of life while undergoing cytostatic treatment.
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Affiliation(s)
- Johannes Wohlrab
- Martin Luther University Halle-Wittenberg, Department of Dermatology and Venereology, Halle (Saale), Germany
| | - Nikola Bangemann
- Interdisciplinary Breast Centre, University Hospital Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
| | | | - Marc Thill
- Breast Centre University of Lübeck, Department of Gynaecology and Obstetrics, Lübeck, Germany ; Department of Gynaecology and Obstetrics, Agaplesion Markus Hospital, Frankfurt am Main, Germany
| | - Sherko Kümmel
- Breast Centre and Clinic of Senology, Hospital Essen-Mitte, Essen, Germany
| | - Eva-Maria Grischke
- Breast Centre University of Tübingen, Department of Gynaecology, Tübingen, Germany
| | | | - Sophie Seite
- La Roche-Posay, Dermatological Laboratories, Asnières, France
| | - Diana Lüftner
- University Hospital Charité Berlin, Campus Benjamin Franklin, Department of Hematology, Oncology and Tumour Immunology, Berlin, Germany
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