Vincristine induced cranial polyneuropathy

We describe a 5-year-old girl showed recovery of vincristine induced cranial polyneuropathy with pyridoxine and pyridostigmine treatment. A 5-year-old girl was diagnosed preB cell Acute Lymphoblastic Leukemia (ALL). She received chemotherapy according to the previously described modified St. Jude total therapy studies XIII. Five days after the fourth dose of vincristine, she presented with bilateral ptosis. Neurological examination revealed bilateral ptosis, and complete external opthalmoplegia with normal pupillary and corneal reflexes. She received 3.8 mg cumulative dose of vincristin before development of ptosis. A neuroprotective and neuroregenerative treatment attempt with pyridoxine and pyridostigmine was initiated. The bilateral ptosis markedly improved after 7 days of pyridoxine and pyridostigmine treatment and completely resolved after two weeks. The both agents were given for 3 weeks and were well tolerated without any side effects. During the follow up period we did not observe residue or recurrence of the ptosis.     

Vincristine,an efficacious alternative for diffuse neonatal haemangiomatosis

Diffuse neonatal haemangiomatosis (DNH) is an uncommon condition characterized by multiple cutaneous and visceral haemangiomas frequently causing severe complications. Corticosteroids constitute the first therapeutic line; however, when they fail, other alternatives are available, provided possible side effects are closely monitored during and after treatment. We present a case of life‐threatening DNH, non‐responsive to corticosteroids, successfully treated with Vincristine with minor side effects. We conclude that Vincristine is a valid alternative in corticosteroid‐resistant DNH.     

Clinical and biochemical markers in CIPN: A reappraisal

The increased survival of cancer patients has raised growing public health concern on associated long-term consequences of antineoplastic treatment. Chemotherapy-induced peripheral neuropathy (CIPN) is a primarily sensory polyneuropathy, which may be accompanied by pain, autonomic disturbances, and motor deficit. About 70% of treated cancer patients might develop CIPN during or after the completion of chemotherapy, and in most of them such complication persists after six months from the treatment. The definition of the potential risk of development and resolution of CIPN according to a clinical and biochemical profile would be certainly fundamental to tailor chemotherapy regimen and dosage on individual susceptibility. In recent years, patient-reported and clinician-related tools along with quality of life instruments have been featured as primary outcomes in clinical setting and randomized trials. New studies on metabolomics markers are further pursuing accurate and easily accessible indicators of peripheral nerve damage. The aim of this review is to outline the strengths and pitfalls of current knowledge on CIPN, and to provide a framework for future potential developments of standardized protocols involving clinical and biochemical markers for CIPN assessment and monitoring.     

进口长春瑞滨与国产长春新碱治疗急性淋巴细胞白血病的疗效比较

目的比较“吡柔比星＋左旋门冬酰胺酶＋强的松＋硫酸长春新碱”与“吡柔比星＋左旋门冬酰胺酶＋强的松＋重酒石酸长春瑞滨注射液”分别诱导化疗ALL患者的疗效。方法40例ALL患者，分成观察组和对照组。对照组：“吡柔比星＋左旋门冬酰胺酶＋强的松＋重酒石酸长春瑞滨注射液”诱导化疗；观察组：“吡柔比星＋左旋门冬酰胺酶＋强的松＋硫酸长春新碱”诱导化疗。结果观察组和对照组的CR率、PR率与NR率，差异无统计学意义（P〉0．05），见表1。造血系统毒副作用、非血液学毒性反应及继发感染发生率等，差异均无统计学意义（P〉0．05），见表2。国产药长春新碱要比进口药长春瑞滨实惠。结论吡柔比星、左旋门冬酰胺酶和强的松加用国产药注射用硫酸长春新碱诱导化疗ALL患者不但疗效佳，而且也经济实惠，建议临床进一步推广。     

黄精多糖干预长春新碱抑制骨髓基质细胞增殖的研究

目的:探讨黄精多糖(PSP)促进小鼠骨髓基质细胞(BMSCs)生长及干预长春新碱(VCR)对小鼠BMSCs增殖的抑制。方法:①PSP 0.5、1.0、2.0、4.0g/L,以及VCR 2.5、5.0、10、15mg/L分别与骨髓单个核细胞(BMMCs)共同培养14d,应用MTT法测定BMSCs增殖。②PSP 0.5、1.0、2.0、4.0g/L与BMMCs预培养2h后再分别加入终浓度为5.0mg/L的VCR继续培养14d,应用MTT法测定BMSCs增殖。结果:BMSCs培养14d后,PSP 1.0、2.0、4.0g/L组的OD值(3.80、4.48、4.05)均高于正常对照组(3.70),其中PSP 2.0g/L组OD值与正常对照组比较差异均有统计学意义(P<0.05)。VCR 5.0、10.0、15.0mg/L 3组OD值(2.36、1.83、1.67)均显著低于正常对照组(3.70)(P<0.05)。BMSCs培养第14d PSP 2.0g/L+VCR 5.0mg/L组OD值(3.51)与VCR 5.0mg/L组OD值(2.62)比较差异有统计学意义(P<0.05)。结论:VCR明显抑制BMSCs生长;PSP可促进BMSCs生长,且干预VCR对BMSCs增殖的抑制。     

The role of chemotherapy in anaplastic astrocytoma patients

Objective

This retrospective study was performed to evaluate the role of chemotherapy in the management of patients with anaplastic astrocytoma (AA).

Methods

We compared the survival outcome among the 3 different treatment protocol groups in a single institution. A total of 86 patients (39 men and 47 women) with newly diagnosed AA after surgery were analyzed. Among them, 31 patients (36.0%) were treated with radiotherapy only (RT Group), 30 patients (34.9%) were treated with nimustine-cisplatin chemotherapy before RT (ACNU-CDDP group), and 25 patients (29.1%) were treated with procarbazine, lomustine and vincristine (PCV) chemotherapy after radiotherapy (PCV group).

Results

The median survival was 14.0, 30.0 and 72.0 months in RT, ACNU-CDDP, and PCV group, respectively and showed significant differences (RT vs. ACNU-CDDP; p=0.039, RT vs. PCV; 0.002, ACNU-CDDP vs. PCV; 0.045). PCV group showed less toxicity rate (5 patients; 20%) than ACNU-CDDP group (12 patients; 40%), while only 3 patients (9.6%) in RT group experienced grade 3 or 4 toxicities.

Conclusion

An application of chemotherapy before or after radiotherapy is beneficial in prolonging the survival of patients with AA. Adjuvant PCV chemotherapy after radiotherapy is recommendable.     

长春新碱诱导建立人结肠癌MDR动物模型及MDR1和MRP1基因表达

目的建立人结肠癌多药耐受性动物模型并初步探索其耐药机制。方法结合体内外诱导方法建立人结肠癌多药耐受性动物模型,利用VCR和CTX的肿瘤抑制实验评价其MDR特性;利用real-time PCR和Western blotting等方法分析其P-gp/MDR1和MRP1基因和蛋白的表达。结果肿瘤抑制实验结果显示,MDR和敏感型结肠癌模型的肿瘤生长速度差异不显著,MDR结肠癌动物模型对于VCR和CTX的耐药性均有较大程度的提高;表达分析结果显示,人结肠癌MDR动物模型的P-gp/MDR1表达水平有较大提高,而MRP1表达没有显著变化。结论人结肠癌多药耐受性动物模型具有较好的多药耐受性,其多药耐受性表型主要是由于P-gp/MDR1过量表达所导致。     

小分子干扰RNA片段逆转KBv200细胞多药耐药的实验研究

目的：研究小分子干扰RNA片段（siRNA）对舌癌多药耐药（MDR）细胞系KBv200细胞的MDR1基因表达及其功能的影响，探讨siRNA作为未来化疗增敏剂的可能性。方法：运用针对MDR1基因序列的siRNA（MDR1-siRNA）在脂质体的介导下转染KBv200细胞；用RT—PCR分析MDR1 mRNA的表达水平；流式细胞术检测P-糖蛋白（P-gP）的表达；荧光分光光度法检测细胞内多柔比星（Dox）的积蓄；MTT法检测KBv200细胞对长春新碱（VCR）和Dox的敏感性变化。结果：MDR1-siRNA作用24和48h能抑制MDR1基因的表达（P〈0．05），其mRNA水平和P-gP水平均明显下降，同时使KBv200细胞对VCR和Dox的敏感性显著增加（P〈0．01），并显著增加细胞内Dox的蓄积（P〈0．01）。结论：MDR1-siRNA能显著抑制KBv200细胞内MDR1基因介导的MDR。     

Determination of vinca alkaloids in human plasma by liquid chromatography/atmospheric pressure chemical ionization mass spectrometry

 A sensitive assay was developed for the quantitation of vinblastine, desacetylvinblastine and vincristine using liquid chromatography-atmospheric pressure chemical ionization mass spectrometry (LC-APCI-MS). Analyses were performed on an Ultrasphere C₁₈ microbore column using ammonium acetate as mobile phase. The calibration curves were linear across the range of 0.51–4.00 ng/ml (0.63–4.93 nM) for vinblastine, 0.74–3.93 ng/ml (0.96–5.11 nM) for desacetylvinblastine and 0.30–3.95 ng/ml (0.36–4.79 nM) for vincristine. Vinca alkaloid concentrations were measured with an accuracy and precision within 11%. This assay could be implemented to determine the plasma concentrations for pharmacokinetic studies of vinblastine, desacetylvinblastine and vincristine in conjunction with clinical trials. Received: 15 December 1995 / Accepted: 16 June 1996