Objectives: 1) To correlate the methylation status of the O-6-methylguanine-DNA-methyltransferase (MGMT promoter gene) and response to alkylating agent-based treatment in high-grade gliomas. Background: The MGMT gene is epigenetically silenced by promoter hypermethylation in gliomas and this modification has emerged as a relevant predictor of therapeutic response. Methods: 20 cases of high-grade glioma were analyzed for MGMT promoter methylation by methylation-specific PCR. Response to treatment and overall survival data were recorded and data analysed. Results: MGMT promoter methylation was found in 60% of gliomas by methylation-specific PCR. The mean survival time of glioblastoma patients submitted to adjuvant therapy was significantly higher among patients with MGMT promoter methylation (P = 0.035) and methylation status was an independent predictive factor that was associated with improved prognosis. Discussion and Conclusion: MGMT promoter methylation status was a more reliable predictor of response to adjuvant therapy and prognosis of high-grade gliomas. A subset of patients received irinotecan and bevacizumab in the second line setting and patients with unmethylated MGMT seemed to do better than the MGMT promoter methylated group.
Anthracyclines are associated with cardiotoxic manifestations that are mainly dose-dependent, with onset varying from a few days to many years after stopping treatment. Frequent monitoring for toxic manifestations, early detection, cessation of anthracycline use and appropriate treatment is the key to preventing morbidity and mortality. Complete heart block with doxorubicin use in Hodgkin’s lymphoma is rarely reported, and is a severe toxic manifestation necessitating withdrawal or changing of regimen to etoposide + bleomycin + vinblastine + dacarbazine (EBVD), as in this case.
Plerixafor is a stem cell mobilising agent, and when administered along with G-CSF has been shown to improve CD34+ stem cell collections in lymphoma and multiple myeloma patients compared to G-CSF alone. Patients who failed to mobilize <2.0 × 10 6 cells/kg on Day 1 collection received Plerixafor and G CSF for further collections. Study population was divided into two groups as plerixafor yes (PY) who are poor mobilizers and Plerixafor No (PN) who are good mobilizers. Out of 49 patients, 28 patients were in PY group and 21 patients in PN group. Median value of apheresis CD34 of day 1 was 1.75 (range 0.258 to 8.52) in PY group and 2.63 (range 1.06 to 6.29) in PN group and that of day 2 was 3.845 (range 0.317 to 13.89) in PY group and 3.18 (range 0.88 to 6.348) in PN group. Median value of total apheresis CD34 was 8.10 (range 4.33 to 18.66) in PY group and 7.58 (range 4.06 to 9.8) in PN group. Median day of neutrophil engraftment was 11.5 (range 9-22) in PY group and 11 (range 9-36) in PN group whereas median day of platelet engraftment was 14 (range 9-98) in PY group and 13 (range 11-98) in PN group. It can be concluded that the use of plerixafor not only enabled poor mobilizers of Lymphoma and Multiple Myeloma to collect adequate stem cells to proceed to ASCT, but also had early neutrophil and platelet engraftment which was comparable with good mobilizers.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.