Observational Aranesp Survey to Investigate the Q3W Schedule (OASIS): a prospective observational study of treatment of chemotherapy-induced anaemia with every 3 weeks darbepoetin alfa

INTRODUCTION

This prospective observational study examined the adherence to published European guidelines on erythropoiesis-stimulating agents (ESAs) and the pattern of use and effect of darbepoetin alfa (DA) 500 microg once every 3 weeks (Q3W) for the treatment of chemotherapy-induced anaemia (CIA).

MATERIALS AND METHODS

A total of 293 patients were included (263 solid tumour, 30 haematologic malignancy). Their mean age was 63 years, 51% were male, 57% had platinum-based chemotherapy. DA was started at a haemoglobin (Hb) level between 9 and 11 g/dL in 82% of patients.

RESULTS AND DISCUSSION

In an analysis correcting for transfusions, 55% of patients achieved > or =2 g/dL increase in Hb, and a Hb level of >11 g/dL was reached in 81%. Transfusion rate was 27%. Most patients (70%) were treated in a Q3W chemotherapy, and planned synchronisation of chemotherapy and Q3W DA could be maintained in 76%.

CONCLUSION

Adherence to European guidelines for DA treatment was good, and Q3W DA treatment was in synchronisation with Q3W chemotherapy in the majority of the patients, thereby reproducing the findings of a recent phase III study.

Vocal cord immobilisation in diffuse idiopathic skeletal hyperostosis (DISH)

Advanced forms of diffuse idiopathic skeletal hyperostosis or Forestier's disease can induce dysphagia and significant respiratory symptoms such as hoarseness, dyspnea, snoring and laryngeal stridor. Severe respiratory distress is very rare. Two identical cases of chronic respiratory distress due to bilateral vocal cord adduction-fixation in conjunction with skeletal pathology in the cervical area are presented. The clinical, diagnostic and therapeutic work-up and the prognostic outcome of the laryngeal pathology are discussed.

High-dose cytotoxic therapy with autologous bone marrow or peripheral blood progenitor cell transplantation in malignant lymphomas

The present paper is an attempt to assess the efficiency of high-dose cytotoxic therapy followed by autologous bone marrow or peripheral progenitor cell rescue with hematopoietic growth factor support given in a group of 27 patients (16 men, 11 women) at the Department of Hematology of the Mont Godinne University Clinics, mainly in the same interval 1990-1994. The reasons for introducing such a therapy in these patients (6 with Hodgkin's disease, 14 with intermediate or high grade, aggressive non Hodgkin lymphomas and 7 with low grade follicular non Hodgkin lymphomas) were relapse of disease after conventional therapy (11 cases), resistance to initial therapy (5 patients) or because of histologically proven transformation to a more aggressive form (one case); in 10 patients with extended, poor prognosis forms, the procedure was used as part of the first line therapy. The conditioning high dose chemotherapy was given according to various regimens, most of them containing Cyclophosphamide, BCNU and Etoposide, with or without total body irradiation. In 14 patients, bone marrow (BM) graft was used, while peripheral blood progenitor cells (PBPC) were infused in the remaining 13 patients. The number of infused granulocyte-macrophage colony forming units (CFU-GM) ranged between 7,650 and 3,900,000/kg, with a mean value of 461,000/kg. The median time intervals required to reach an absolute neutrophil count > 500/microliter, a platelet count > 50,000/microliter and a hematocrit > 30% were 13 days, 20 days and 23 days respectively. Growth factors (GM-CSF and G-CSF) and PBPC use shortened the time for neutrophil recovery as well as neutropenia-related complications. No procedure-related death was observed and complete remission was achieved in 22 cases (81.4%); after a mean follow-up of 32.6 months, 14 patients (55.5%) are alive and free of disease, while in 7 patients (31% of the complete responders) relapse occurred at an average time interval of 8.2 months since the procedure.

Physical and psychological symptoms experienced by Canadian women and their husbands during pregnancy and the postpartum

This study was designed to determine the type and frequency of physical and psychological symptoms reported by pregnant and postpartal women and their husbands, and to determine the relationship between spouses' strength of identification and similarities in their reports of symptoms. The sample included 20 couples who resided in south-eastern Ontario, Canada who completed a checklist of 20 physical and three psychological symptoms. Findings indicated that wives and husbands experienced a variety of physical and psychological symptoms during pregnancy and the postpartum. Although few symptoms were shared by spouses, the similarities in their reports were statistically significant. There was no evidence of a relationship between spouses' strength of identification and similarities in their symptom reports.

Pancreatic function after seromyotomy of the canine stomach

Anterior gastric seromyotomy combined with posterior truncal vagotomy has been proposed as an acid-reducing operation for patients with duodenal ulcer. Section of the posterior vagal trunk could, however, be held responsible for reduced pancreatic function, seen in patients after bilateral truncal vagotomy. In this study the pancreatic function after anterior gastric seromyotomy and posterior truncal vagotomy has been evaluated in a series of canine experiments by means of a direct hormone stimulation test. No reduction of the basal or stimulated exocrine pancreatic secretion was noted after this type of vagotomy.

Enzyme kinetics: a new procedure for data normalization

A procedure is proposed to normalize enzymatic reaction velocities measured in separate experiments. After calculation of the Km and maximum velocity in each individual set of data, the velocities measured in each experiment are reanalyzed by regression analysis with the constraint that they yield a Km identical to the geometric mean of the individual Km's calculated originally. The V derived from this second analysis can be taken, in each experiment, as the reference value relative to which all reaction velocities are normalized. All normalized velocities are eventually pooled together to establish the final regression line. This relatively simple and reliable procedure overcomes several difficulties otherwise encountered when the kinetics of an enzymatic reaction are judged from data collected in separate experiments.

Mathematical modelling of cyclic AMP-Ca2+ interactions in pancreatic islets

A mathematical model is proposed to account for the interactions between Ca2+ and cyclic AMP in the process of glucose-induced insulin release. This model allows simulation of experimental findings such as the glucose-induced accumulation of cyclic AMP in islet cells, the calcium dependency of the latter accumulation, the time course of 45Ca net uptake by the islets exposed to glucose and/or a phosphodiesterase inhibitor, the stimulation of insulin release by glucose, the suppression of such a release at low extracellular Ca2+ concentration and its amplification by phosphodiesterase inhibitors, the restoration of a significant secretory response to glucose in islets deprived of Ca2+ but exposed to a phosphodiesterase inhibitor, and the usual relationship between 45Ca net uptake and insulin release. All these data refer to studies performed over a 90-min incubation. The model is not suitable, however, to simulate the rapid response of the islet cells during the first few minutes that follow a change in the environment of the islets.