ContextMyeloma bone disease (MBD) is a devastating complication of multiple myeloma that leads to severe pain.ObjectivesThe aim of this study was to evaluate the efficacy and tolerability of tapentadol prolonged release (PR) in the management of patients with MBD suffering from moderate-to-severe cancer pain.MethodsA 12-week prospective study was carried out in 25 opioid-naïve MBD patients. Patients initially received twice-daily doses of tapentadol PR 50 mg. Doses were then managed to maintain adequate relief or dose-limiting toxicity. The following parameters were recorded at weekly intervals for 4 weeks, and then at weeks 8 and 12: pain, opioid-related adverse effects, use of other analgesics, DN4 (Douleur Neuropathique 4) score. Quality of life (SF-36 [36-item short-form health survey]) was measured at baseline and at final evaluation.ResultsOf 25 patients, 22 completed the study. Pain intensity significantly decreased from baseline to all the week intervals (P<0.01). Quality of life significantly improved with respect to all SF-36 subscale parameters (P<0.01), and so did both the physical and mental status (P<0.01). Tapentadol PR significantly reduced DN4 mean value (P<0.01) and the number of patients with neuropathic component (DN4 ≥4) (P<0.01). After 8 weeks of treatment, all patients were negative for the DN4 score. Tapentadol PR was well tolerated, and the use of other analgesics was reduced during the study period.ConclusionTapentadol PR started in doses of 100 mg/day was effective and well tolerated in opioid-naïve MBD patients with moderate-to-severe pain. Tapentadol PR can be considered a first-choice opioid in cancer patients suffering from mixed pain with a neuropathic component.

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ABSTRACThaematologica | 2010; 95(5) 837 © F e r r a t a S t o r t i F o u n d a t i o n Molecular analysisTotal RNA was extracted from cells cryopreserved in guanidium isothiocyanate according to the method of Chomczynsky and Sacchi. 15 The quality of RNA was assessed on an ethidium bromide-stained 1% agarose gel containing 2.2 M formaldehyde.In vitro reverse transcription of 1 mg total RNA to cDNA was performed using the commercial kit Gene Amp RNA PCR kit (Applied Biosystems, Foster City, CA) according to the manufacture's instructions. RT-PCR amplification of the ALL1(MLL)/AF4 fusion transcript and of the normal ALL1 gene were performed according to the methods previously described. 16 TreatmentThe GIMEMA 0496 and LAL 2000 studies included an identical induction therapy with 4 drugs (prednisone [PDN], vincristine [VCR], daunorubicin [DNR], and asparaginase [ASP]) with high-dose DNR (270 mg/m 2 ).10 A seven day prednisone pre-treatment was added in the GIMEMA LAL 2000 study. The two protocols differed in their post-induction treatments. The GIMEMA 0496 included two consolidation courses with high-dose Ara-C (2gr/m 2 every 12 hours as 3-hour infusion on days 1 and 2) and etoposide 11 followed by three years of maintenance treatment, whereas in the GIMEMA LAL 2000 patients received one course of highdose Ara-C (two daily doses at 3 gr/m 2 , days 1, 2, 3 and 4) and mitoxantrone (10 mg/m 2 , days 3, 4 and 5) followed by an allogeneic or autologous HSCT according to the availability of an HLA-compatible donor of hematopoietic stem cells. Response criteriaAll patients starting induction therapy have been considered for statistical analysis. Therapeutic responses were evaluated at the end of induction treatment in all cases. Complete Remission (CR) was defined as the normalization of peripheral blood count and less than 5% blasts in the bone marrow (BM) with normal cellularity. Relapse was defined as the reappearance of leukemic cells in the bone marrow (> 5% blasts) and/or reappearance of clinical evidence of the disease. Statistical analysisDifferences in the distribution of factors in subgroups were analyzed by χ 2 or Fisher's exact test, and by the Kruskal-Wallis test, as appropriate. Overall Survival (OS) was defined as the time from diagnosis to death or date of the last follow-up; Disease Free Survival (DFS) was calculated from the time of achieving CR to relapse, death or date of last follow-up. The probabilities of OS and DFS were estimated using the Kaplan-Meier method; differences between distribution were evaluated by means of the Log-Rank test; confidence intervals (C.I. 95%) were estimated using the Simon and Lee method. The hypothesis of proportionality was tested using Schoenfeld's partial residuals. All tests were twosided; P≤0.05 was considered statistically significant. All analyses where performed using the SAS software (SAS Institute, Cary, NC). Results and DiscussionIn the present study, we describe the clinical course of 46 ALL1(MLL)/AF4 positive adult ALL patients consecutively treated in two ...

Entecavir and tenofovir disoproxil fumarate are potent and effective antiviral drugs that now represent recommended treatment options for chronic HBV infection. However, no or very limited clinical evidence is currently available on these drugs for the management of HBV reactivation in patients with haematological malignancies. Herein, we report a case of HBV reactivation in a patient with non-Hodgkin's lymphoma following a rituximab-based regimen, and who was successfully treated with a combination antiviral treatment including entecavir and tenofovir disoproxil fumarate.

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