Bladder Cancer in Patients With Multiple Sclerosis Treated With Cyclophosphamide

Ridder, Dirk De; Poppel, Hein Van; Demonty, L.; Dhooghe, Barbara; Gonsette, R; Carton, Herwig; Baert, Luc

doi:10.1097/00005392-199806000-00028

Cited by 19 publications

(19 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This issue is of particular importance given the potential risk for leukemia and the procarcinogenic activity of cyclophosphamide doses up to 25 g, especially in younger patients. [28][29][30][31] As Delgado For personal use only. on May 12, 2018.…”

Section: Discussionmentioning

confidence: 99%

Treatment of acquired hemophilia by the Bonn-Malmö Protocol: documentation of an in vivo immunomodulating concept

Zeitler

Ulrich‐Merzenich

Hess

et al. 2005

Blood

120

124

View full text Add to dashboard Cite

Acquired hemophilia (AH) is an extremely rare condition in which autoantibodies (inhibitors) against clotting factor VIII induce acute and life-threatening hemorrhagic diathesis because of abnormal blood clotting. The mortality rate of AH is as high as 16%, and current treatment options are associated with adverse side effects. We investigated a therapeutic approach for AH called the modified BonnMalmö Protocol (MBMP). The aims of MBMP include suppression of bleeding, permanent elimination of inhibitors, and development of immune tolerance, thereby avoiding long-term reliance on coagulation products. The protocol included immunoadsorption for inhibitor elimination, factor VIII substitution, intravenous immunoglobulin, and immunosuppression. Thirty-five high-titer patients with critical bleeding who underwent MBMP were evaluated. Bleeding was rapidly controlled during 1 or 2 apheresis sessions, and no subsequent bleeding episodes occurred. Inhibitor levels decreased to undetectable levels within a median of 3 days (95% confidence interval [95% CI], 2-4 days), factor substitution was stopped within a median of 12 days (95% CI, 11-17 days), and treatment was completed within a median of 14 days (95% CI, 12-17 days). Longterm follow-up (7 months-7 years) showed an overall response rate of 88% for complete remission (CR). When cancer patients were excluded, the CR rate was 97%. (Blood. 2005;105:2287-2293)

show abstract

Section: Discussionmentioning

confidence: 99%

Treatment of acquired hemophilia by the Bonn-Malmö Protocol: documentation of an in vivo immunomodulating concept

Zeitler

Ulrich‐Merzenich

Hess

et al. 2005

Blood

120

124

View full text Add to dashboard Cite

show abstract

“…The risk of cancer formation is greater when chronic inflammation is combined with exposure to urinary carcinogens. 39,41 In particular, chromosomal breakage and modification of p53 and CDKN2 tumor-suppressor genes have been documented in S. haematobium-associated bladder cancers in Egypt. 29,30,42,43 With this in mind, the increase in moderate and severe metaplastic changes seen in our older adults may reflect a progression to intermediate level proliferative transformation, with significant risk of cancer formation despite the observed age-related reduction in S. haematobium infection intensity after the age of 40.…”

Section: Discussionmentioning

confidence: 99%

Predisposition to urinary tract epithelial metaplasia in Schistosoma haematobium infection.

Hodder¹,

Mahmoud²,

Sorenson³

et al. 2000

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Although there is strong epidemiologic evidence linking Schistosoma haematobium infection with carcinoma of the bladder, the utility of cytologic screening for urinary tract cancer has not been critically evaluated in S. haematobium-endemic populations. The present cross-sectional study examined urine cytology findings among 1,014 residents (ages 1 to 91) of the S. haematobium-endemic Msambweni area of Coast Province, Kenya. Among 705 evaluable cytology specimens, prevalence of inflammation (39%), hyperkeratosis (30%), metaplasia (33%), and frank atypia (0.4%) was notably higher than in previously studied, non-endemic populations. Overall, S. haematobium infection was strongly associated with increased risk for cytologic abnormality (Ͼ 2.8-fold relative risk of metaplasia or hyperkeratosis; P Ͻ 0.001). Age-group analysis confirmed parallel increases in metaplasia and S. haematobium infection prevalence early in life (from age 1 to 15 for both boys and girls). However, above age 20, metaplasia prevalence persisted at 33-45% prevalence despite a decline in infection prevalence and intensity. Prevalence of advanced (moderate or severe) metaplasia showed two age-related peaks: the first at 10-14 years of age (at the time of peak infection), and the second among subjects Ն 60 years old. No cancers were detected in the study population either on cytology or on follow-up ultrasound examination. These data suggest an age-dependent progression of cellular abnormalities in the urinary epithelium that is associated with chronic S. haematobium infection, which becomes independent of concurrent infection intensity as subjects grow older. Implications for cancer screening are discussed.

show abstract

“…The mean time from the last dose of Cys until the diagnosis of neoplasm was 5.8 years (range 3-10 years). No other Cys-induced tumors emerged [28].…”

Section: Treatment Choices: Past and Present Experiencesmentioning

confidence: 97%

Induction treatment strategy in multiple sclerosis: a review of past experiences and future perspectives

Ruggieri

Pontecorvo

Tortorella

et al. 2018

Mult Scler Demyelinating Disord

View full text Add to dashboard Cite

The scenario of multiple sclerosis (MS) treatment has changed profoundly in recent decades. In this setting, one of two strategies is usually used: escalation or induction. The first involves a pyramid of possible treatments of increasing efficacy (but also increasing safety risks) that are introduced progressively as needed. The induction strategy, on the other hand, immediately pursues higher efficacy, since drugs with a higher risk profile are used from the outset. Understanding which of these treatment strategies is the more suitable for a given patient is the first step in the therapeutic decision-making process. Prognostic factors evaluated on the basis of the clinical presentation and any disease activity on magnetic resonance imaging (MRI) should guide and help clinicians in making their choices. Even though the pathogenesis of MS is not yet completely understood, specific pathological changes are known to occur in the adaptive and innate immune system over the course of the disease. To date, treatment has been based mainly on two drugs, mitoxantrone and cyclophosphamide, autologous haematopoietic stem cell therapy (within clinical trial setting), but new compounds are now emerging. Among the new treatments, alemtuzumab and cladribine appear to be valid candidates as induction drugs. In this review we provide an overview of induction strategies based on literature evidence and our own past experiences, providing descriptions of clinical cases. We also outline the future perspectives in this field.

show abstract

Bladder Cancer in Patients With Multiple Sclerosis Treated With Cyclophosphamide

Cited by 19 publications

References 23 publications

Treatment of acquired hemophilia by the Bonn-Malmö Protocol: documentation of an in vivo immunomodulating concept

Treatment of acquired hemophilia by the Bonn-Malmö Protocol: documentation of an in vivo immunomodulating concept

Predisposition to urinary tract epithelial metaplasia in Schistosoma haematobium infection.

Induction treatment strategy in multiple sclerosis: a review of past experiences and future perspectives

Contact Info

Product

Resources

About