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Bir Yücel K, Kilic ACK, Sütcüoglu O, Yazıcı O, Kilic K, Savaş G, Uner A, Günel N, Özet A, Özdemir N. Oxaliplatin‑induced changes in splenic volume and liver fibrosis indices: retrospective analyses of colon cancer patients receiving adjuvant chemotherapy. J Chemother 2024; 36:249-257. [PMID: 37578138 DOI: 10.1080/1120009x.2023.2246786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/10/2023] [Accepted: 06/12/2023] [Indexed: 08/15/2023]
Abstract
The aim of our study was to evaluate the association between increased splenic volume (SV) and liver fibrosis indices in colon cancer patients receiving oxaliplatin-based adjuvant chemotherapy. Patients who received adjuvant oxaliplatin-based regimens with the diagnosis of stage II and III colon cancer were evaluated. Splenic volume measurements, liver function tests, platelet count, and non-invasive liver fibrosis indices [NAFLD fibrosis score (NFS), AST to platelet ratio (APRI), and Fibrosis-4 (FIB-4)] were measured before and after treatment. A 30% increase in SV after chemotherapy compared to baseline was considered increased SV. The rate of increase in SV was 57.7% in the whole group. An increase in SV was shown at a higher rate in patients treated with capecitabine and oxaliplatin (CAPOX) than those treated with 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) (66.3% vs. 36.8%, p = 0.002). Furthermore, the CAPOX regimen (OR: 2.831, 95% CI: 1.125-7.121; p = 0.027), and higher post-treatment FIB-4 score (OR: 3.779; 95% CI:1.537- 9.294, p = 0.004) were determined as independent risk factors for the increased SV. Our study revealed that increased SV had a significant association with higher FIB-4 score in patients treated with oxaliplatin-based chemotherapy.
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Affiliation(s)
| | | | - Osman Sütcüoglu
- Department of Medical Oncology, Gazi University, Ankara, Turkey
| | - Ozan Yazıcı
- Department of Medical Oncology, Gazi University, Ankara, Turkey
| | - Koray Kilic
- Department of Radiology, Gazi University, Ankara, Turkey
| | - Gözde Savaş
- Department of Medical Oncology, Gazi University, Ankara, Turkey
| | - Aytug Uner
- Department of Medical Oncology, Gazi University, Ankara, Turkey
| | - Nazan Günel
- Department of Medical Oncology, Gazi University, Ankara, Turkey
| | - Ahmet Özet
- Department of Medical Oncology, Gazi University, Ankara, Turkey
| | - Nuriye Özdemir
- Department of Medical Oncology, Gazi University, Ankara, Turkey
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Kato N, Nakai T, Kodama S, Koyama S, Nakane S, Wada Y, Oda H, Katayama H, Mase H, Miyagawa Y, Miyazaki M, Yamada S, Yamada K. Risk Factors for Thrombocytopenia Induced by Capecitabine Plus Oxaliplatin Therapy in Patients With Colorectal Cancer. In Vivo 2024; 38:1243-1252. [PMID: 38688620 PMCID: PMC11059885 DOI: 10.21873/invivo.13561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND/AIM Capecitabine plus oxaliplatin (CapeOX) therapy is used as an adjuvant chemotherapy regimen for patients with colorectal cancer (CRC). Although oxaliplatin induces thrombocytopenia, the risk factors for thrombocytopenia in oxaliplatin-treated patients with CRC are not well established. We aimed to investigate the risk factors for thrombocytopenia in CapeOX-treated patients with CRC. In addition, we evaluated platelet counts and non-invasive liver fibrosis indices, specifically the aspartate aminotransferase-to-platelet ratio index (APRI) and the fibrosis-4 index (FIB-4), during CapeOX therapy in these patients. PATIENTS AND METHODS Between July 2017 and June 2020, we enrolled CapeOX-treated patients with high-risk stage II or stage III CRC at seven hospitals collaborating with the Division of Oncology, Aichi Prefectural Society of Hospital Pharmacists (Aichi prefecture, Japan). In this retrospective study, we investigated patients' backgrounds, laboratory data, concomitant medications, number of cycles of CapeOX and oxaliplatin, cumulative dose of oxaliplatin, and administration period. The cut-off values were calculated using receiver operating characteristic analysis of platelet counts and APRI and FIB-4 scores. RESULTS Fifty-five patients without thrombocytopenia and 44 patients with thrombocytopenia were enrolled. During CapeOX therapy, the thrombocytopenia group showed a significant decrease in platelet count and a significant increase in APRI and FIB-4 scores compared to the non-thrombocytopenia group. Baseline albumin level ≤3.5 g/dl and platelet count ≤238×103/μl were independently associated with ≥grade 2 thrombocytopenia in CapeOX-treated patients. CONCLUSION Baseline albumin level and platelet count may be useful for predicting thrombocytopenia in CapeOX-treated patients with high-risk stage II or stage III CRC.
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Affiliation(s)
- Nanami Kato
- Department of Hospital Pharmacy, Nagoya University Hospital, Nagoya, Japan
| | - Tsuyoshi Nakai
- Department of Pharmacotherapeutics and Informatics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Sachiyo Kodama
- Department of Pharmacy, Konan Kosei Hospital, Konan, Japan
| | - Sachiko Koyama
- Department of Pharmacy, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan
| | - Shigeki Nakane
- Department of Pharmacy, Japan Community Health care Organization Chukyo Hospital, Nagoya, Japan
| | - Yasuhiro Wada
- Department of Pharmacy, Nishichita General Hospital, Tokai, Japan
| | - Hiroshi Oda
- Department of Pharmacy, Tokoname Municipal Hospital, Tokoname, Japan
| | - Hiromi Katayama
- Department of Pharmacy, Hekinan Municipal Hospital, Hekinan, Japan
| | - Hiroki Mase
- Department of Pharmacy, NHO Sakakibara National Hospital, Mie, Japan
| | - Yasuhiro Miyagawa
- Department of Hospital Pharmacy, Nagoya University Hospital, Nagoya, Japan
| | - Masayuki Miyazaki
- Department of Hospital Pharmacy, Nagoya University Hospital, Nagoya, Japan
| | - Shigeki Yamada
- Department of Pharmacotherapeutics and Informatics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kiyofumi Yamada
- Department of Hospital Pharmacy, Nagoya University Hospital, Nagoya, Japan;
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Dai Y, Cheng Y, Zhou Z, Li Z, Luo Y, Qiu H. A contrast-enhanced CT-based whole-spleen radiomics signature for early prediction of oxaliplatin-related thrombocytopenia in patients with gastrointestinal malignancies: a retrospective study. PeerJ 2023; 11:e16230. [PMID: 37849829 PMCID: PMC10578303 DOI: 10.7717/peerj.16230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/12/2023] [Indexed: 10/19/2023] Open
Abstract
Background Thrombocytopenia is a common adverse event of oxaliplatin-based chemotherapy. Grade 2 or higher oxaliplatin-related thrombocytopenia may result in dose reduction, discontinuation or delay initiation of chemotherapy and may adversely affect the therapeutic efficacy and even overall survival of patients. Early recognition of patients at risk of developing grade 2 or higher thrombocytopenia is critical. However, to date there is no well-established method to early identify patients at high risk. The aims of this study were to develop and validate a contrast-enhanced CT-based whole-spleen radiomics signature for early prediction of grade 2 or higher thrombocytopenia in patients with gastrointestinal malignancies treated with oxaliplatin-based chemotherapy and to explore the incremental value of combining the radiomics signature and conventional clinical factors for risk prediction. Methods A total of 119 patients with gastrointestinal malignancies receiving oxaliplatin-based chemotherapy from March 2017 to December 2020 were retrospectively included and randomly divided into a training cohort (n = 85) and a validation cohort (n = 34). Grade 2 or higher thrombocytopenia occurred in 26.1% of patients (22 and nine patients in the training and validation cohort, respectively) with a median time interval of 101 days from the start of chemotherapy. The whole-spleen radiomics features were extracted on the portal venous phase of the first follow-up CT images. The least absolute shrinkage and selection operator (LASSO) algorithm was applied to select radiomics features and to build the radiomics signature for the prediction of grade 2 or higher thrombocytopenia. A clinical model that included clinical factors only and a clinical-radiomics model that incorporated clinical factors and radiomics signature were constructed. The performances of both models were evaluated and compared in the training, validation and the whole cohorts. Results The radiomics signature yielded favorable performance in predicting grade 2 or higher thrombocytopenia, with the area under the curve (AUC), sensitivity and specificity being 0.865, 81.8% and 84.1% in the training cohort and 0.747, 77.8% and 80.0% in the validation cohort. The AUCs of the clinical-radiomics model in the training and validation cohorts reached 0.913 (95% CI [0.720-0.935]) and 0.867 (95% CI [0.727-1.000]), greater than the AUCs of the clinical model. Integrated discrimination improvement (IDI) index showed that incorporating radiomic signature into conventional clinical factors significantly improved the predictive accuracy by 17.0% (95% CI [4.9%-29.1%], p = 0.006) in the whole cohort. Conclusions Contrast-enhanced CT-based whole-spleen radiomics signature might serve as an early predictor for grade 2 or higher thrombocytopenia during oxaliplatin-based chemotherapy in patients with gastrointestinal malignancies and provide incremental value over conventional clinical factors.
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Affiliation(s)
- Yuhong Dai
- Department of Oncology, Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yiqi Cheng
- Department of Radiology, Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ziling Zhou
- Department of Radiology, Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhen Li
- Department of Radiology, Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Luo
- Department of Radiology, Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Qiu
- Department of Oncology, Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Sun S, Lupton K, Batch K, Nguyen H, Gazit L, Gangai N, Cho J, Nicholas K, Zulkernine F, Sevilimedu V, Simpson A, Do RKG. Natural Language Processing of Large-Scale Structured Radiology Reports to Identify Oncologic Patients With or Without Splenomegaly Over a 10-Year Period. JCO Clin Cancer Inform 2022; 6:e2100104. [PMID: 34990210 PMCID: PMC9848545 DOI: 10.1200/cci.21.00104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To assess the accuracy of a natural language processing (NLP) model in extracting splenomegaly described in patients with cancer in structured computed tomography radiology reports. METHODS In this retrospective study between July 2009 and April 2019, 3,87,359 consecutive structured radiology reports for computed tomography scans of the chest, abdomen, and pelvis from 91,665 patients spanning 30 types of cancer were included. A randomized sample of 2,022 reports from patients with colorectal cancer, hepatobiliary cancer (HB), leukemia, Hodgkin lymphoma (HL), and non-HL patients was manually annotated as positive or negative for splenomegaly. NLP model training/testing was performed on 1,617/405 reports, and a new validation set of 400 reports from all cancer subtypes was used to test NLP model accuracy, precision, and recall. Overall survival was compared between the patient groups (with and without splenomegaly) using Kaplan-Meier curves. RESULTS The final cohort included 3,87,359 reports from 91,665 patients (mean age 60.8 years; 51.2% women). In the testing set, the model achieved accuracy of 92.1%, precision of 92.2%, and recall of 92.1% for splenomegaly. In the validation set, accuracy, precision, and recall were 93.8%, 92.9%, and 86.7%, respectively. In the entire cohort, splenomegaly was most frequent in patients with leukemia (32.5%), HB (17.4%), non-HL (9.1%), colorectal cancer (8.5%), and HL (5.6%). A splenomegaly label was associated with an increased risk of mortality in the entire cohort (hazard ratio 2.10; 95% CI, 1.98 to 2.22; P < .001). CONCLUSION Automated splenomegaly labeling by NLP of radiology report demonstrates good accuracy, precision, and recall. Splenomegaly is most frequently reported in patients with leukemia, followed by patients with HB.
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Affiliation(s)
- Simon Sun
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Kaelan Lupton
- School of Computing, Queen's University, Kingston, Ontario, Canada
| | - Karen Batch
- School of Computing, Queen's University, Kingston, Ontario, Canada
| | - Huy Nguyen
- Strategy and Innovation, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Lior Gazit
- Strategy and Innovation, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Natalie Gangai
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jessica Cho
- Strategy and Innovation, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Kevin Nicholas
- Strategy and Innovation, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Varadan Sevilimedu
- Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Amber Simpson
- School of Computing, Queen's University, Kingston, Ontario, Canada
| | - Richard K. G. Do
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY,Richard K. G. Do, MD, PhD, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065; e-mail:
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Zhu C, Ren X, Liu D, Zhang C. Oxaliplatin-induced hepatic sinusoidal obstruction syndrome. Toxicology 2021; 460:152882. [PMID: 34352347 DOI: 10.1016/j.tox.2021.152882] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/08/2021] [Accepted: 07/30/2021] [Indexed: 02/06/2023]
Abstract
Oxaliplatin (OXA) is a third-generation platinum anticancer drug that is mainly used for the treatment of metastatic colorectal cancer (CRC). Of note, hepatic sinusoidal obstruction syndrome (HSOS) induced by OXA has become a key concern for patients with CRC receiving chemotherapy with OXA in recent years. Splenomegaly, thrombocytopenia, abnormal liver function, and portal hypertension are some of the main clinical characteristics seen in patients with OXA-induced HSOS. Previous studies have suggested that oxidative stress, inflammatory damage, liver fibrosis, and platelet aggregation and adhesion may be involved in the pathogenesis of OXA-induced HSOS. Currently, there are no specific drugs for prevention and treatment of OXA-induced HSOS. In this review, we summarized the epidemiology, pathological characteristics, clinical predictive indicators, related mechanisms, possible prevention and treatment of OXA-related HSOS.
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Affiliation(s)
- Chen Zhu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiuhua Ren
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Dong Liu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Chengliang Zhang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Lees JG, White D, Keating BA, Barkl-Luke ME, Makker PGS, Goldstein D, Moalem-Taylor G. Oxaliplatin-induced haematological toxicity and splenomegaly in mice. PLoS One 2020; 15:e0238164. [PMID: 32877416 PMCID: PMC7467301 DOI: 10.1371/journal.pone.0238164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 08/11/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Haematological toxicities occur in patients receiving oxaliplatin. Mild anaemia (grade 1-2) is a common side effect and approximately 90% of recipients develop measurable spleen enlargement. Although generally asymptomatic, oxaliplatin-induced splenomegaly is independently associated with complications following liver resection for colorectal liver metastasis and separately with poorer patient outcomes. Here, we investigated oxaliplatin-induced haematological toxicities and splenomegaly in mice treated with escalating dosages comparable to those prescribed to colorectal cancer patients. METHODS Blood was analysed, and smears assessed using Wright-Giemsa staining. Paw coloration was quantified as a marker of anaemia. Spleen weight and morphology were assessed for abnormalities relating to splenomegaly and a flow cytometry and multiplex cytokine array assessment was performed on splenocytes. The liver was assessed for sinusoidal obstructive syndrome. RESULTS Blood analysis showed dose dependent decreases in white and red blood cell counts, and significant changes in haematological indices. Front and hind paws exhibited dose dependent and dramatic discoloration indicative of anaemia. Spleen weight was significantly increased indicating splenomegaly, and red pulp tissue exhibited substantial dysplasia. Cytokines and chemokines within the spleen were significantly affected with temporal upregulation of IL-6, IL-1α and G-CSF and downregulation of IL-1β, IL-12p40, MIP-1β, IL-2 and RANTES. Flow cytometric analysis demonstrated alterations in splenocyte populations, including a significant reduction in CD45+ cells. Histological staining of the liver showed no evidence of sinusoidal obstructive syndrome but there were signs suggestive of extramedullary haematopoiesis. CONCLUSION Chronic oxaliplatin treatment dose dependently induced haematological toxicity and splenomegaly characterised by numerous physiological and morphological changes, which occurred independently of sinusoidal obstructive syndrome.
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Affiliation(s)
- Justin G. Lees
- School of Medical Sciences, The University of New South Wales, Sydney, New South Wales, Australia
- * E-mail: (GM-T); (JGL)
| | - Daniel White
- School of Medical Sciences, The University of New South Wales, Sydney, New South Wales, Australia
| | - Brooke A. Keating
- School of Medical Sciences, The University of New South Wales, Sydney, New South Wales, Australia
| | - Mallory E. Barkl-Luke
- School of Medical Sciences, The University of New South Wales, Sydney, New South Wales, Australia
| | - Preet G. S. Makker
- School of Medical Sciences, The University of New South Wales, Sydney, New South Wales, Australia
| | - David Goldstein
- Prince of Wales Clinical School, The University of New South Wales, Sydney, New South Wales, Australia
| | - Gila Moalem-Taylor
- School of Medical Sciences, The University of New South Wales, Sydney, New South Wales, Australia
- * E-mail: (GM-T); (JGL)
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Ohta R, Yamada T, Hara K, Iwai T, Tanakaya K, Ishibashi K, Yoshimatsu K, Kosugi C, Tsubaki M, Nakajima H, Oya M, Yoshida H, Koda K, Ishida H. Oxaliplatin-induced increase in splenic volume: experiences from multicenter study in Japan. Int J Clin Oncol 2020; 25:2075-2082. [PMID: 32785799 DOI: 10.1007/s10147-020-01763-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/02/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Chemotherapy with oxaliplatin is known to induce sinusoidal obstruction syndrome (SOS). In a previous single-center study, we reported that oxaliplatin-induced increase in splenic volume (SV) is strongly indicative of SOS, and that this increase in SV persisted for > 1 year after completing chemotherapy. The aim of this study was to confirm the oxaliplatin-induced SV change in a multicenter study in patients with stage III colon cancer in Japan. METHODS We enrolled 59 patients who underwent curative resection for stage III colon cancer in the FACOS study in a phase II multi-center clinical study. Participants received mFOLFOX6 or CAPOX as adjuvant chemotherapy. SV change was assessed three times by computed tomographic volumetry: before surgery, on completion of adjuvant chemotherapy, and 1 year after completing adjuvant chemotherapy. RESULTS SV on completing and 1 year after chemotherapy was significantly higher than that before surgery (P < 0.001). Oxaliplatin-induced SOS persisted for > 1 year after the completion of adjuvant chemotherapy in half of the patients. There was no difference in 3-year disease-free survival with respect to the presence or absence of increased SV. An increase in SV was observed in 72% of patients treated with mFOLFOX6 and 94% of patients treated with CAPOX (P = 0.13). CONCLUSION This study can be verified the findings observed in our previous single-center study, oxaliplatin-based adjuvant chemotherapy was associated with an increase in SV. Furthermore, this increase can persist for > 1 year. The continuous presence of SOS may have a negative impact on prognosis in patients that develop recurrent disease.
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Affiliation(s)
- Ryo Ohta
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Takeshi Yamada
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan.
| | - Keisuke Hara
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Takuma Iwai
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Kohji Tanakaya
- Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan
| | - Keiichiro Ishibashi
- Department of Surgery Saitama Medical center, Saitama Medical University, Saitama, Japan
| | - Kazuhiko Yoshimatsu
- Department of Surgery, Tokyo Women's Medical University, Medical Center East, Tokyo, Japan
| | - Chihiro Kosugi
- Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan
| | | | - Hideo Nakajima
- Department of Oncology, Ageo Central General Hospital, Ageo, Japan
| | - Masatoshi Oya
- Department of Surgery Saitama Medical center, Dokkyo University School of Medicine, Mibu, Japan
| | - Hiroshi Yoshida
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Keiji Koda
- Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan
| | - Hideyuki Ishida
- Department of Surgery Saitama Medical center, Saitama Medical University, Saitama, Japan
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Jedlińska-Pijanowska D, Kasztelewicz B, Czech-Kowalska J, Jaworski M, Charusta-Sienkiewicz K, Dobrzańska A. Association between single nucleotide polymorphisms (SNPs) of IL1, IL12, IL28 and TLR4 and symptoms of congenital cytomegalovirus infection. PLoS One 2020; 15:e0233096. [PMID: 32421725 PMCID: PMC7233583 DOI: 10.1371/journal.pone.0233096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 04/28/2020] [Indexed: 12/12/2022] Open
Abstract
Congenital cytomegalovirus (cCMV) infection is the most common intrauterine infection. A non-specific immune response is the first line of host defense mechanism against human cytomegalovirus (HCMV). There is limited data on associations between Single Nucleotide Polymorphisms (SNPs) in genes involving innate immunity and the risk and clinical manifestation of cCMV infection. The aim of the study was to investigate association between selected SNPs in genes encoding cytokines and cytokine receptors, and predisposition to cCMV infection including symptomatic course of disease and symptoms. A panel of eight SNPs: IL1B rs16944, IL12B rs3212227, IL28B rs12979860, CCL2 rs1024611, DC-SIGN rs735240, TLR2 rs5743708, TLR4 rs4986791, TLR9 rs352140 was analyzed in 233 infants (92 cCMV-infected and 141 healthy controls). Associations between genotyped SNPs and predisposition to cCMV infection and symptoms were analyzed. The association analysis was performed using SNPStats software. No statistically significant association was found between any genotyped SNPs and predisposition to cCMV infection and symptomatic course of disease. In relation to particular symptoms, polymorphism of IL12B rs3212227 was linked to decreased risk of prematurity (OR = 0.37;95%CI,0.14-0.98;p = 0.025), while polymorphism of IL1B rs16944 was linked to reduced risk of splenomegaly (OR = 0.36;95%CI,0.14-0.98; p = 0.034) in infants with cCMV infection. An increased risk of thrombocytopenia was associated with IL28B rs12979860 polymorphism (OR = 2.55;95%CI,1.03-6.32;p = 0.042), while hepatitis was associated with SNP of TLR4rs4986791 (OR = 7.80;95%CI,1.49-40,81; p = 0.024). This is the first study to demonstrate four new associations between SNPs in selected genes (IL1B, IL12B, IL28B, TLR4) and particular symptoms in cCMV disease. Further studies on the role of SNPs in the pathogenesis of cCMV infection and incorporation of selected SNPs in the clinical practice might be considered in the future.
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Affiliation(s)
| | - Beata Kasztelewicz
- Department of Clinical Microbiology and Immunology, The Children’s Memorial Health Institute, Warsaw, Poland
| | | | - Maciej Jaworski
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, Warsaw, Poland
| | | | - Anna Dobrzańska
- Neonatal Intensive Care Unit, The Children’s Memorial Health Institute, Warsaw, Poland
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Abstract
Introduction Oxaliplatin-based chemotherapy is the standard treatment in stage III colon cancer. Oxaliplatin may cause sinusoidal damage and sinusoidal obstruction syndrome (SOS) in the liver. Clinical reflections of SOS are splenomegaly and thrombocytopenia. This study aimed to investigate the frequency of splenomegaly development in patients receiving oxaliplatin-based chemotherapy and thrombocytopenia incidence rates related to this condition. Materials and methods Files of 50 patients having received fluorouracil and oxaliplatin (mFOLFOX6) regimen for stage 3 colon cancer between 2015 and 2017 were retrospectively reviewed. Spleen volumes (SV) of the patients were calculated using pre-and post-chemotherapy tomographic examinations. A 50% increase in the SV after chemotherapy (SV ≥1.5 change) was accepted as chemotherapy-associated splenomegaly. The patients were divided into two groups as having or not having splenomegaly after chemotherapy. Complete blood count was evaluated prior to each treatment cycle, and on the third month of treatment, termination was used for thrombocyte values. Results Splenomegaly was determined in 50% of the patients. Cumulative oxaliplatin dosage was found higher in those who developed splenomegaly (p = 0.003). Chemotherapy dose reduction was higher in patients who did not develop splenomegaly (p = 0.015). Thrombocytopenia was confirmed higher in patients who developed splenomegaly compared to those who did not (p = 0.047). Lower thrombocyte counts were found in the complete blood count of the patients having developed splenomegaly which was performed during and 3 months after chemotherapy when compared to those that did not develop splenomegaly (p-values, respectively, as 0.005, 0.038). Upon multivariate logistic regression analysis, cumulative oxaliplatin dose was the single independent factor related to splenomegaly (OR: 7.55 (1.90-31.61); p = 0.004). Conclusion Thrombocytopenia was confirmed to be higher in colon cancer patients receiving adjuvant mFOLFOX6 and developing splenomegaly during the post-treatment period. Moreover, splenomegaly was shown to be associated with the cumulative oxaliplatin doses received. Thrombocytopenia seen in patients receiving oxaliplatin for colon cancer should be a warning in terms of splenomegaly and SOS development.
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Affiliation(s)
- Tulay Eren
- Oncology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, TUR
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Rejinold NS, Cherukula K, Ha JH, Park I, Kim Y. Olive Oil‐Based Ultrafine Theranostic Photo Nanoemulsions: A Versatile Tumor Maneuvering Nanoplatform for Precise Controlled Drug Release in Tumor and Complete Tumor Eradication Mediated by Photo‐Chemotherapy. ADVANCED THERAPEUTICS 2019. [DOI: 10.1002/adtp.201800154] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- N. Sanoj Rejinold
- Department of Chemical and Biomolecular EngineeringKorea Advanced Institute of Science and Technology Daejeon 305‐701 Republic of Korea
| | - Kondareddy Cherukula
- Department of Biomedical Science and BK21 PLUS Centre for Creative Biomedical ScientistsChonnam National University Medical School 160 Baekseo‐ro Gwangju 61469 Republic of Korea
| | - Jong Hoon Ha
- Department of Chemical and Biomolecular EngineeringKorea Advanced Institute of Science and Technology Daejeon 305‐701 Republic of Korea
| | - In‐Kyu Park
- Department of Biomedical Science and BK21 PLUS Centre for Creative Biomedical ScientistsChonnam National University Medical School 160 Baekseo‐ro Gwangju 61469 Republic of Korea
| | - Yeu‐Chun Kim
- Department of Chemical and Biomolecular EngineeringKorea Advanced Institute of Science and Technology Daejeon 305‐701 Republic of Korea
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Kang J, Park JS, Ahn SG, Lim JH, Baik SH, Yoon DS, Lee KY, Jeong J. Protective effect of Korean red ginseng on oxaliplatin-mediated splenomegaly in colon cancer. Ann Surg Treat Res 2018; 95:161-167. [PMID: 30182023 PMCID: PMC6121163 DOI: 10.4174/astr.2018.95.3.161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 12/27/2017] [Accepted: 01/23/2018] [Indexed: 01/05/2023] Open
Abstract
Purpose This study investigated how adding Korean red ginseng extract (KRG) to folinic acid, fluorouracil and oxaliplatin (FOLFOX) chemotherapy affected the rate of splenomegaly in colon cancer. Methods This retrospective study analyzed 42 patients who were randomly assigned to receive a FOLFOX regimen with or without KRG. Spleen volume change was assessed by computed tomography scans measured before surgery (presurgery volume) and 3 weeks after cessation of the 12th cycle of FOLFOX (postchemotherapy volume). Results All patients showed increased spleen volume. No difference was observed in median presurgery and postchemotherapy volume between the KRG and control groups. However, a ratio defined as postchemotherapy volume divided by presurgery volume was significantly lower in the KRG group than the control group (median, 1.38 [range, 1.0–2.8] in KRG group vs. median, 1.89 [range, 1.1–3.0] in control group, P = 0.028). When splenomegaly was defined as a >61% increase in spleen volume, the rate of splenomegaly was significantly lower in the KRG group than the control group (28.6% vs. 61.9%, P = 0.03). KRG consumption was inversely associated with developing splenomegaly in multivariate analysis. Conclusion Adding KRG during FOLFOX chemotherapy for colon cancer might protect against oxaliplatin-induced splenomegaly. The protective effect of Korean red ginseng should be investigated with further research.
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Affiliation(s)
- Jeonghyun Kang
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Joon Seong Park
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Gwe Ahn
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Hong Lim
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Hyuk Baik
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Sup Yoon
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kang Young Lee
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Joon Jeong
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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12
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Gloger O, Tönnies K, Bülow R, Völzke H. Automatized spleen segmentation in non-contrast-enhanced MR volume data using subject-specific shape priors. Phys Med Biol 2017; 62:5861-5883. [PMID: 28570262 DOI: 10.1088/1361-6560/aa766e] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
To develop the first fully automated 3D spleen segmentation framework derived from T1-weighted magnetic resonance (MR) imaging data and to verify its performance for spleen delineation and volumetry. This approach considers the issue of low contrast between spleen and adjacent tissue in non-contrast-enhanced MR images. Native T1-weighted MR volume data was performed on a 1.5 T MR system in an epidemiological study. We analyzed random subsamples of MR examinations without pathologies to develop and verify the spleen segmentation framework. The framework is modularized to include different kinds of prior knowledge into the segmentation pipeline. Classification by support vector machines differentiates between five different shape types in computed foreground probability maps and recognizes characteristic spleen regions in axial slices of MR volume data. A spleen-shape space generated by training produces subject-specific prior shape knowledge that is then incorporated into a final 3D level set segmentation method. Individually adapted shape-driven forces as well as image-driven forces resulting from refined foreground probability maps steer the level set successfully to the segment the spleen. The framework achieves promising segmentation results with mean Dice coefficients of nearly 0.91 and low volumetric mean errors of 6.3%. The presented spleen segmentation approach can delineate spleen tissue in native MR volume data. Several kinds of prior shape knowledge including subject-specific 3D prior shape knowledge can be used to guide segmentation processes achieving promising results.
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Affiliation(s)
- Oliver Gloger
- Institute for Community Medicine, University of Greifswald, Walther-Rathenau-Str. 48, 17475 Greifswald, Germany
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Xu C, Tang X, Qu Y, Keyoumu S, Zhou N, Tang Y. UGT1A1 gene polymorphism is associated with toxicity and clinical efficacy of irinotecan-based chemotherapy in patients with advanced colorectal cancer. Cancer Chemother Pharmacol 2016; 78:119-30. [PMID: 27220761 DOI: 10.1007/s00280-016-3057-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 05/04/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To investigate the relationship between uridine diphosphate glucoronosyltransferase 1A1 (UGT1A1)*28/*6 and toxicity and clinical efficacy of irinotecan-based chemotherapy in patients with advanced colorectal cancer (CRC) in Xinjiang Uygur and Han population. METHODS A total of 183 patients (Uygur, 114; Han, 69) with advanced CRC who received the irinotecan-based chemotherapy were enrolled in this retrospective analysis. Polymerase chain reaction amplification and direct sequencing method were used for UGT1A1*28 and UGT1A1*6 polymorphism detection. The patients were followed up to analyze the relationship between different genotypes with adverse reactions and the clinical outcome of irinotecan-based chemotherapy. RESULTS Significant differences were found in genotype frequencies of UGT1A1*28 and UGT1A1*28/*6 between Uygur and Han (P = 0.02 and P = 0.002). Uygur and Han patients carrying wild UGT1A1*28 and *6 genotypes appeared to have significantly lower diarrhea incidence (I/II and III/IV) than those carrying mutant genotypes (all P < 0.05). In Uygur patients, UGT1A1*28 genotypes were related with objective response rate and disease control rate (P < 0.05). Compared with *1 allele *1/*1, *1 allele *1/*28*1/*28 mutant of UGT1A1*28 was associated with shorter OS in both Uygur and Han ethnicities (all P < 0.05). Compared with double allele variants (DW), single allele variants (SV), and double allele variants (DV) of UGT1A1*28/*6 were associated with shorter overall survival (OS) in Uygur and Han (all P < 0.05). Cox regression analysis revealed factors significantly influencing OS, including UGT1A1*28, UGT1A1*6, combined genotypes and chemotherapy line in Ugyur, and only combined genotypes in Han (all P < 0.05). CONCLUSION UGT1A1 gene polymorphism predicts irinotecan-related adverse reactions in advanced CRC patients of Xinjiang Uygur and Han nationality; UGT1A1 gene polymorphism is correlated with efficacy and prognosis in Uygur nationality, but only related to prognosis in Han nationality in irinotecan-based chemotherapy.
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Affiliation(s)
- Chunlei Xu
- Department of Digestive Internal Medicine, The Affiliated Tumor Hospital of Xinjiang Medical University, No. 789, Suzhou East Road, Ürümqi, 830000, Xinjiang, People's Republic of China
| | - Xushan Tang
- Department of Digestive Internal Medicine, The Affiliated Tumor Hospital of Xinjiang Medical University, No. 789, Suzhou East Road, Ürümqi, 830000, Xinjiang, People's Republic of China
| | - Yanli Qu
- Department of Digestive Internal Medicine, The Affiliated Tumor Hospital of Xinjiang Medical University, No. 789, Suzhou East Road, Ürümqi, 830000, Xinjiang, People's Republic of China
| | - Saifuding Keyoumu
- Department of Digestive Internal Medicine, The Affiliated Tumor Hospital of Xinjiang Medical University, No. 789, Suzhou East Road, Ürümqi, 830000, Xinjiang, People's Republic of China
| | - Ning Zhou
- Department of Digestive Internal Medicine, The Affiliated Tumor Hospital of Xinjiang Medical University, No. 789, Suzhou East Road, Ürümqi, 830000, Xinjiang, People's Republic of China
| | - Yong Tang
- Department of Digestive Internal Medicine, The Affiliated Tumor Hospital of Xinjiang Medical University, No. 789, Suzhou East Road, Ürümqi, 830000, Xinjiang, People's Republic of China.
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