Pulmonary hypertension related to thalidomide therapy in refractory multiple myeloma.

Thalidomide is an effective treatment both in advanced multiplemyeloma (MM) and as first-line therapy in combination with dexamethasoneor other cytotoxic chemotherapy [1, 2]. Two cases [3, 4] of pulmonary hypertension in the absence ofthromboembolic events have been described in patients with MMduring thalidomide treatment [5]. A 63-year-old woman was diagnosed in     

High incidence of INR alteration in gastrointestinal cancer patients treated with mini-dose warfarin and 5-fluorouracil-based regimens.

Several studies have been performed to evaluate pharmacologicalprophylaxis with warfarin in cancer patients with central venouscatheters (CVCs), but the analysis of these studies does notallow firm conclusions to be drawn. Some studies have showedthat mini-doses of warfarin (1 mg/day) reduced catheter-relatedthrombosis [1, 2], whereas other studies did not support thispractice [3, 4]. However, in all these studies this prophylaxiswas considered     

Intra-arterial hepatic chemotherapy in heavily pretreated patients with epithelial ovarian cancer.

Ovarian cancer is the fifth leading cause of cancer-relateddeath among women, and is the most lethal of the gynaecologicmalignancies [1, 2]. The standard first-line treatment is cytoreductivesurgery and combination chemotherapy [3]. Relapsed ovarian canceris generally incurable and patients who relapse     

Cancer and aging: are there any differences in the information needs of elderly and younger patients? Results from an Italian observational study

The importance of providing information to cancer patients,and the problems that can arise, have been well documented inrecent decades [1–4]. Unfortunately, as the review ofChouliara et al. [5] shows, only a few studies have focusedon older cancer patients. Between June and December 2004, we     

Vascular endothelial growth factor (VEGF) expression is not associated with prognosis in patients with radically resected ampullary carcinoma.

Vascular endothelial growth factor (VEGF) is known to be a potentangiogenic mitogen that plays an important role in tumor angiogenesis[1]. The correlation between the expression of VEGF and eithermetastasis or a poor prognosis has been reported for severalcancers [2]. Kurahara and colleagues demonstrated that VEGFexpression in patients with pancreatic head cancer is significantlyassociated with lymphatic metastasis and prognosis [3].     

Pregnancy on imatinib: fatal outcome with meningocele.

We read with interest a recent letter by Prabhash et al. [1]showing a successful outcome of pregnancy in two patients onimatinib. There have also been a few other recent reports whereno adverse effects have been reported [2–4]. However,we     

Early subcutaneous wash-out in acute extravasations

Schrijvers [1] has published a review article on extravasationinjuries and their treatment. The paper gives guidelines ofprevention, and conservative and late operative treatment. However,the early treatment option of subcutaneous wash-out [2, 3] isneither mentioned nor referenced. Despite this the technique is very successful in our experience,possibly due to an     

Could the long-term persistence of low serum calcium levels and high serum parathyroid hormone levels during bisphosphonate treatment predispose metastatic breast cancer patients to undergo osteonecrosis of the jaw?

Osteonecrosis of the jaw (ONJ) is a serious event that uncommonlycomplicates the natural history of bone metastatic patientstreated with bisphosphonates [1]. The pathogenesis of this adverseevent is unknown and probably multifactorial [2, 3]. The mechanismsby which bisphosphonates may cause ONJ are unclear. It is commonlybelieved     

Warfarin-5-FU interactions

We read with great interest the two reports regarding the warfarin–FOLFOXinteraction [1, 2]. We agree with the comments made by Kuter[3] regarding the increased likelihood of an increased InternationalNormalized Ratio (INR) and possible bleeding when warfarin isused concomitantly with 5-fluorouracil     

Endometrial cancer: a frequent orphan disease.

Endometrial cancer is the most frequent invasive cancer of thefemale genital tract, with an estimated annual incidence ofalmost 38 000 in the ‘old’ European Union (before1 May 2004) and a similar figure in the United States. It issubstantially more frequent than ovarian cancer, but can becured more often by surgery and radiation therapy; this resultsin about 9000 deaths per year in the EU and 7000 in the UnitedStates [1,2]. Epidemiological risk factors for endometrial cancerare well known [3], but the optimal therapy of endometrial cancer     

Reply to "Early subcutaneous wash-out in acute extravasations", by R. Giunta (Ann Oncol 2004; 15: 1146), and to the reply by D. Schrijvers (Ann Oncol 2004; 15: 1147)

Dr Schrijvers's reply [1] to Dr Giunta's letter to the editor[2] suggests that an animal     

Topotecan versus paclitaxel in second-line therapy: a lost opportunity for quality-of-life evaluation?

ten Bokkel Huinink et al., on behalf of the International TopotecanGroup, have recently published a paper on the long-term outcomesof 226 patients with advanced epithelial ovarian cancer whofailed one prior platinum-based regimen and were enrolled ina multicentre randomised phase III study comparing topotecanversus paclitaxel as second-line therapy [1]. This study is an update of a study whose main results were previouslypublished in 1997 and 2001 [2, 3]. In the first paper, activity(response rate, duration of     

Assessing prognosis in patients with chronic lymphocytic leukemia a quarter of a century after Rai and Binet staging systems.

Chronic lymphocytic leukemia (CLL) has an extremely heterogeneousprognosis. Nowadays, the median survival of patients with thisform of leukemia is 8–10 years, compared with 5–6years in series reported in the 1970s. This is largely due tothe higher number of patients who are now being diagnosed inearly phase (up to 80%) and, hence, with better prognosis [1,2]. Individual survival, however, is highly variable.  Classically, clinical stages have been used to predictthe behavior of the disease [3, 4]. Although easy     

EGFR mutation in gefitinib-responsive small-cell lung cancer.

Activating mutations within the tyrosine kinase domain of theepidermal growth factor receptor (EGFR) underlie responsivenessto gefitinib in non-small-cell lung cancer (NSCLC) [1–3].To date, however, only a few EGFR mutations have been detectedin other solid tumors [4]. We now describe a patient with     

Can HER2 overexpression predict response to pegylated liposomal doxorubicin in metastatic breast cancer patients?

We conducted a phase II clinical trial to determine the clinicalefficacy and safety of pegylated liposomal doxorubicin in combinationwith gemcitabine as a first- or second-line treatment optionin patients with metastatic breast cancer [1]. Based on a previousphase II study [2], the recommended dose was pegylated liposomal     

Catheter-associated thrombosis: thromboprophylaxis for cancer patients who carry factor V Leiden?

Patients with cancer are at high risk of developing venous thromboembolism[1]. In the treatment of deep-vein thrombosis (DVT), there areno unequivocal indications for testing for the presence of thrombophilicabnormalities in either patients or their relatives [2]. However,it     

Reply to the "Letter to the Editor on 'Relevance of EGFR expression in colorectal cancer'" by C. Alliot (Ann Oncol 2005; 16: 1557)

Alliot and co-workers address relevant questions regarding ourrecent study which appeared in this journal [1]. In our study[1], we analysed epidermal growth factor receptor (EGFR) expressionand its relationship with the main     

Comment on 'Cancer genetic counselling' by P. Mandich et al. (Ann Oncol 2005; 16: 171).

With the advent of genetic tests, genetic counselling is attractingincreasing attention, as also shown by the recent letter byMandich et al. [1], which addressed some aspects of our oncologist-basedmultistep model of cancer genetic counselling [2]. Perhaps thefeatures of our model can be appreciated if we explain the rationale     

Severe interstitial pneumonitis following rituximab and bleomycin-containing combination chemotherapy

Rituximab is effective in B-cell lymphomas as a single agentor in combination with chemotherapy [1]. Its side-effects aregenerally mild but cases of severe pulmonary toxicity have recentlybeen reported [2].  We report two patients who developed severe interstitialpneumonitis after combination of rituximab with ACVBP (adriamycin,