Impact of front line relative dose intensity for methotrexate and comorbidities in immunocompetent elderly patients with primary central nervous system lymphoma

Primary central nervous system lymphomas (PCNSL) are non-Hodgkin lymphomas strictly localized to the CNS, occurring mainly in elderly patients with comorbidities. Current treatment in fit patients relies on high-dose methotrexate and high-dose cytarabine. The aim of this study was to evaluate the efficacy and feasibility of this treatment in elderly patients and to assess potential prognostic factors associated with survival. We conducted a retrospective study in two centers between January 2008 and September 2015 including 35 elderly immunocompetent patients who received first-line treatment with high-dose methotrexate. With a median follow-up of 19.8 months (range: 1.7–73.4 months), median overall survival (OS) was 39.5 months (95% confidence interval (95% CI): 18.3–60.7) and median progression-free survival (PFS) was 25.8 months (95% CI: 5.2–46.4). In univariate analysis, administration of high-dose cytarabine and achieving a relative dose intensity for methotrexate >?75% were associated with increased OS (p?=?0.006 and p?=?0.003, respectively) and PFS (p?=?0.003 and p?=?0.04, respectively) whereas comorbidities, defined by a CIRS-G score ≥?8, were associated with decreased OS and PFS (p?=?0.02 and p?=?0.04, respectively). A high MSKCC score was associated with decreased OS (p?=?0.02). In multivariate analysis, administration of high-dose cytarabine was associated with increased OS and PFS (p?=?0.02 and p?=?0.007, respectively). Comorbidities and relative dose intensity for methotrexate are important for the prognosis of elderly patients with PCNSL. These results must be confirmed in prospective trials.     

Eprinomectin in goat: assessment of subcutaneous administration

Eprinomectin is only available as a topically applied anthelmintic for dairy cattle. To determine whether eprinomectin can be administered in the goat as an injectable formulation, it was subcutaneously delivered to six goats and measured in the plasma at different times after administration. The area under the concentration-time curve (AUC) reported after subcutaneous administration of 0.2 mg kg(-1) eprinomectin (68.5+/-23.2 ng day(-1) ml(-1)) was similar to the AUC previously reported for goats after a pour-on administration of 0.5 mg kg(-1) eprinomectin. Thus, our results clearly show that subcutaneous administration is 2.5 times more effective than pour-on administration, in terms of amount of drug present in the organism. This work should encourage the development of a subcutaneous formulation of eprinomectin and should contribute to defining optimal therapeutic conditions for goat anthelmintic treatment.     

Advantage of a two-dose versus one-dose varicella vaccine in healthy non-immune teenagers and young adults

This study was undertaken to compare the immunogenicity and reactogenicity of two vaccines based on the attenuated Oka-strain of Varicella zoster virus (VZV), in adolescents and young adults. One hundred and eighty-six subjects, aged 13 to 29 years, were randomized to one of two groups to receive a one- or a two-dose VZV vaccine. Pre- and post-vaccination blood samples were assayed for VZV-specific IgG. Solicited local and general symptoms, as well as unsolicited symptoms, were recorded post-vaccination. Seroconversion rates were 94.9% in the one-dose, and 100% in the two-dose, regimen. The two-dose vaccine elicited significantly higher geometric mean antibody titer, 392.5 vs 86.8 pfu. Transient local injection site pain was the most frequently-reported symptom per dose in both groups (one dose: 48.9%; two-dose: 32.8%). The two-dose vaccine regimen afforded the advantage of higher antibody titers and potential increased protection from disease, without significantly increased reactogenicity.     

Eprinomectin in dairy zebu Gobra cattle (Bos indicus): plasma kinetics and excretion in milk

The pharmacokinetics and mammary excretion of eprinomectin were determined in zebu Gobra following topical administration of 0.5 mg kg⁻¹. The kinetics of plasma and milk was analysed using a one-compartment model. The maximum plasma concentration of 8.83±2.15 ng ml⁻¹ occurred 1.30 days post-administration. The area under the plasma concentration–time curve was 30.63±5.56 ng day⁻¹ ml⁻¹ and the mean residence time was 3.38±0.60 days. Eprinomectin was detected in milk at the first sampling time and thereafter for at least 8 days. The systemic availability of eprinomectin was significantly lower than that for other breeds of cattle. Comparison of the milk and plasma data demonstrated the parallel disposition of the drug in the milk and plasma with a milk/plasma ratio of 0.094. The very low extent of mammary excretion supports the permitted use of eprinomectin in lactating zebu Gobra.     

Simultaneous measurement of prednisone, prednisolone and hydrocortisone in plasma by high performance liquid chromatography

The authors describe a normal phase liquid chromatographic assay suitable for therapeutic monitoring of prednisone, prednisolone, hydrocortisone in human and animal plasma. The compounds were extracted into dichloromethane using flumethasone as internal standard. The separation was obtained by using a silica normal phase (5 mu) and a mobile phase of dichloromethane, methanol, acetic acid (95.6; 4; 0.4 v/v/v). The absorbance of the compounds was monitored at 254 nm with a sensitivity limit of 2 ng/ml for all the products. This method was applied to pharmacokinetic studies in animal and therapeutic monitoring in man.     

Identification of human and rabbit cytochromes P450 1A2 as major isoforms involved in thiabendazole 5-hydroxylation

Summary— This report characterized one of the major cytochrome P450 isozyme involved in thiabendazole metabolism. This study was undertaken by using both cultured rabbit hepatocytes treated or not with drugs known to specifically induce various cytochromes P450 isoenzymes (ie, P450 1A1/2 by β-naphthoflavone, P450 2B4 by phenobarbital, P450 3A6 by rifampicine and P450 4A by clofibrate) and human liver (THLE-5) and bronchial (BEAS-2B) epithelial cells expressing or not the major constitutive human cytochromes P450 (ie, CYP1A2, 2A6, 2B6, 2C9, 2D6, 2E1 or 3A4). Only hepatocytes exposed to β-naphthoflavone and clofibrate significantly metabolized thiabendazole to 5-hydroxythiabendazole. Extensive biotransformation of this anthelmintic only occurred in human cells expressing CYP1A2. Moreover, experiments performed on rabbit preparations showed good correlations between thiabendazole 5-hydroxylase activity and both ethoxyresorufin and methoxyresorufin O -dealkylase activities. Thus, CYP1A2 is a major isoenzyme involved in thiabendazole 5-hydroxylation.     

Identification of a polygalacturonase (Cup s 2) as the major CCD‐bearing allergen in Cupressus sempervirens pollen

As IgE glyco‐epitopes, also referred to as cross‐reactive carbohydrate determinants (CCDs), can share significant structural homologies between different plants, they are prone to extensive cross‐reactivity among allergen pollen extracts. Here, cypress pollen allergens, especially a polygalacturonase (PG), were further characterized using double one‐dimensional electrophoresis (D1‐DE). The presence of specific IgE directed against CCDs was investigated by bromelain IgE inhibition and concanavalin A binding assays using sera of cypress pollen‐sensitized patients. Our results showed that IgE reactivity to CCDs in Cupressus sempervirens pollen extracts is mainly related to bromelain‐type epitopes of a newly identified cypress PG. This glycoprotein has been further characterized through an immunoproteomic approach and officially indexed as Cup s 2 by the WHO/IUIS allergen nomenclature. Cup s 2 could thus be associated with the increased prevalence of IgE reactivity to cypress pollen extracts because of CCD interference.     

Enhanced absorption of pour-on ivermectin formulation in rats by co-administration of the multidrug-resistant-reversing agent verapamil

The effect of verapamil, a multidrug-resistance (Mdr)-reversing agent on the absorption of a pour-on formulation of ivermectin was evaluated in rats. Absorption of ivermectin was effectively enhanced (40%) by the presence of verapamil, suggesting that absorption of ivermectin involves Mdr-P-glycoprotein and that verapamil should act as a competitive inhibitor for the transport and extrusion of ivermectin by P-glycoprotein. This hypothesis is consistent with other studies describing verapamil as a blocking agent of P-glycoprotein involved in the efflux of ivermectin in a resistant strain of Haemonchus contortus. Received: 12 April 1999 / Accepted: 6 May 1999