CART: Cell-free and Concentrated Ascites Reinfusion Therapy against malignancy-related ascites

Ito, Tetsuya; Hanafusa, Norio

doi:10.1016/j.transci.2017.08.018

Cited by 23 publications

(38 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In brief, ascites fluid is collected by paracentesis, filtered, and concentrated, and then, the concentrated fluid is reinfused via a peripheral vein. There is growing evidence for the usefulness of concentrated ascites reinfusion therapy in advanced EOC, although adverse events, such as fever, hemodynamic change and coagulation abnormality, have been reported . To decrease fluid accumulation, Diuretics can be used to decrease fluid accumulation.…”

Section: Discussionmentioning

confidence: 99%

The usefulness of bevacizumab for relief from symptomatic malignant ascites in patients with heavily treated recurrent ovarian cancer

Shimizu

Kajiyama

Yoshida

et al. 2019

J of Obstet and Gynaecol

View full text Add to dashboard Cite

Aim: Accumulation of ascites fluid is a major obstacle in the late phase of epithelial ovarian cancer. However, there is no consensus on a specific treatment for malignant ascites. The present study evaluated the clinical benefit of half-dose bevacizumab therapy (7.5 mg/kg every 3-4 weeks).Methods: This was a single-arm interventional study performed at Aichi Cancer Center Hospital. Four patients with platinum-resistant epithelial ovarian cancer and symptomatic malignant ascites were no longer considered candidates for standard chemotherapy. As a palliative approach, half-dose bevacizumab therapy (7.5 mg/kg every 3-4 weeks) was used with informed consent. The clinical data of these patients were retrospectively reviewed. Results: All patients had been heavily pretreated and showed progressive disease. Thus, standard chemotherapy was no longer feasible, and palliative paracentesis for malignant ascites was clinically needed. Among the four patients, three did not require additional paracentesis after bevacizumab therapy, and there were no adverse events. One patient needed paracentesis owing to lymphorrhea. Conclusion: The use of bevacizumab therapy as a palliative approach for malignant ascites might be an option in patients with terminal-stage ovarian cancer. However, further evaluation is needed with regard to the possibility of severe side effects and medical expenses.

show abstract

Section: Discussionmentioning

confidence: 99%

The usefulness of bevacizumab for relief from symptomatic malignant ascites in patients with heavily treated recurrent ovarian cancer

Shimizu

Kajiyama

Yoshida

et al. 2019

J of Obstet and Gynaecol

View full text Add to dashboard Cite

show abstract

“…A systematic review of drainage techniques reported that symptom control was achieved in approximately 97% of patients after ascites drainage and, importantly, PROs and QoL were also improved after drainage [75]. However, drainage of ascites is associated with fatigue and hemodynamic instability [76], thought to be related to the loss of proteins in the drainage fluid. Cell-free and concentrated ascites reinfusion therapy (CART) has been established in the treatment of patients with ascites from hepatic cirrhosis and is being investigated in patients with malignancy ( Fig.…”

Section: Supportive Treatments For Ascitesmentioning

confidence: 99%

“…Cell-free and concentrated ascites reinfusion therapy (CART) has been established in the treatment of patients with ascites from hepatic cirrhosis and is being investigated in patients with malignancy ( Fig. 1b) [76]. CART involves filtering ascites to remove cell components (but not vital proteins), concentration to reduce volume during reinfusion (using a plasma-separating membrane), and intravenous reinfusion of the concentrated fluid.…”

Section: Supportive Treatments For Ascitesmentioning

confidence: 99%

“…CART involves filtering ascites to remove cell components (but not vital proteins), concentration to reduce volume during reinfusion (using a plasma-separating membrane), and intravenous reinfusion of the concentrated fluid. Within 24 h of undergoing CART, patients reported that symptoms such as gastric symptoms, respiratory distress, and fatigue were improved [76]. In general, CART is a relatively safe procedure, with AEs limited to fever, hemodynamic changes (associated with paracentesis), and thrombocytopenia [76].…”

Section: Supportive Treatments For Ascitesmentioning

confidence: 99%

“…Within 24 h of undergoing CART, patients reported that symptoms such as gastric symptoms, respiratory distress, and fatigue were improved [76]. In general, CART is a relatively safe procedure, with AEs limited to fever, hemodynamic changes (associated with paracentesis), and thrombocytopenia [76]. However, care must be taken regarding the free hemoglobin, endotoxin, and heparin that may be added to the original ascites, as these cannot be removed during the CART procedure and will, therefore, be reinfused.…”

Section: Supportive Treatments For Ascitesmentioning

confidence: 99%

See 2 more Smart Citations

Achieving sequential therapy in advanced gastric cancer: the importance of appropriate patient management for the elderly and/or those with ascites

2020

View full text Add to dashboard Cite

Treatment options for patients with advanced gastric cancer (AGC) are limited. One approach to improving survival in patients with AGC is to optimize the available agents via sequential therapy. However, clinical trial reports of first-line chemotherapy indicate that elderly patients and patients with massive ascites are less likely to receive subsequent lines of therapy. In addition, clinical trials of second-and third-line chemotherapy generally exclude these two patient populations because they are likely to have poor performance status and additional issues that are difficult to manage. Good patient management is likely to be key to the successful use of sequential therapy in these two patient populations by minimizing adverse effects to allow patients to derive benefit from the additional treatment. This narrative review summarizes the available information on AGC treatment and patient management in elderly patients and patients with massive ascites. The available data suggest that elderly patients benefit from chemotherapy; however, monitoring toxicity is essential to avoid chemotherapy-related toxicities. Important aspects of patient management for elderly patients include symptom monitoring, nutritional support, and fall prevention. The available data for patients with massive ascites show limited success for a range of treatment approaches, including systemic chemotherapy. The management of ascites is also challenging, with no clear guidance on the preferred strategies. To address these gaps in knowledge, future clinical trials should incorporate more inclusive eligibility criteria to enroll populations of patients with AGC that are more reflective of the real-world population with respect to age, complications, and overall health status.

show abstract

Successful treatment of systemic AL amyloidosis with autologous hematopoietic stem cell transplantation combined with cell‐free and concentrated ascites reinfusion therapy

Oka

Ôno

2023

Clinical Case Reports

View full text Add to dashboard Cite

Key Clinical Message AL patients develop the unique toxicities of fluid retention and non‐cardiogenic pulmonary edema during the course of stem cell mobilization. We propose mobilization with CART as effective and safe treatment for AL patients with refractory anasarca. Abstract We describe a 63‐year‐old male with systemic immunoglobulin light chain (AL) amyloidosis with cardiac, renal, and liver involvement. After four courses of CyBorD, mobilization with G‐CSF at 10 μg/kg was initiated and CART was simultaneously performed for fluid retention. No adverse events were observed during collection or reinfusion. Anasarca gradually disappeared and he underwent autologous hematopoietic stem cell transplantation. The complete remission of AL amyloidosis has been maintained, and the condition of the patient has remained stable for 7 years. We propose mobilization with CART as an effective and safe treatment option for AL patients with refractory anasarca.

show abstract

CART: Cell-free and Concentrated Ascites Reinfusion Therapy against malignancy-related ascites

Cited by 23 publications

References 26 publications

The usefulness of bevacizumab for relief from symptomatic malignant ascites in patients with heavily treated recurrent ovarian cancer

The usefulness of bevacizumab for relief from symptomatic malignant ascites in patients with heavily treated recurrent ovarian cancer

Achieving sequential therapy in advanced gastric cancer: the importance of appropriate patient management for the elderly and/or those with ascites

Successful treatment of systemic AL amyloidosis with autologous hematopoietic stem cell transplantation combined with cell‐free and concentrated ascites reinfusion therapy

Contact Info

Product

Resources

About