Abstract:
:Vincristine-adriamycin-dexamethasone (VAD) regimen with intermittent high-dose dexamethasone (HD) has been used as primary chemotherapy for multiple myeloma (MM) patients who are candidates for high-dose therapy or present with renal failure. However, dexamethasone increases the risk of infection in MM patients. We retrospectively evaluated treatment efficacy and infectious events in MM patients undergoing VAD with or without HD. Seventy-seven consecutive patients who received VAD without HD (n = 37) or VAD-HD (n = 40) at our institution were assessed. Characteristics of patients and VAD regimens were retrospectively analyzed to detect correlations with the incidence of infections. During 218 VAD cycles, 48 infectious episodes were documented in 39 patients. Of these, 32 episodes in 26 patients were severe (grade ≥ 3). By analyzing each patient, VAD-HD was associated with risk of all-grade and severe bacterial infection, while International Staging System stage ≥ 2 was independently correlated with severe bacterial infection. Response rates after two cycles were comparable between the 2 VAD regimens. In conclusion, risk of infection is lower in VAD without HD than in VAD-HD, and the clinical response is equivalent. VAD-HD should thus be avoided for MM patients with high risk of infection.
journal_name
Int J Hematoljournal_title
International journal of hematologyauthors
Isoda A,Matsumoto M,Nakahashi H,Mawatari M,Manaka A,Sawamura Mdoi
10.1007/s12185-010-0735-1subject
Has Abstractpub_date
2011-01-01 00:00:00pages
59-65issue
1eissn
0925-5710issn
1865-3774journal_volume
93pub_type
杂志文章abstract::Homeostasis of the hematopoietic system has its roots in the maintenance of hematopoietic stem cells (HSCs) in the bone marrow (BM). HSCs change both phenotypically and functionally with physiological age. The alterations noted in aged HSCs are thought to be a consequence of both cell-intrinsic and extrinsic changes. ...
journal_title:International journal of hematology
pub_type: 杂志文章,评审
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journal_title:International journal of hematology
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doi:10.1532/ijh97.04017
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journal_title:International journal of hematology
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journal_title:International journal of hematology
pub_type: 杂志文章,评审
doi:10.1007/BF02981898
更新日期:2001-01-01 00:00:00
abstract::We retrospectively reviewed clinical and hematologic features of nine patients with acquired idiopathic sideroblastic anemia (AISA). Seven of them had ringed sideroblasts (RS) more than 15% of marrow nucleated cells. RS persisted in the marrow even in the remaining two patients who had a relatively low marrow erythrob...
journal_title:International journal of hematology
pub_type: 临床试验,杂志文章
doi:10.1016/s0925-5710(97)00112-6
更新日期:1998-02-01 00:00:00
abstract::We and others have reported that human hematopoietic stem cells (HSCs) are also present in the CD34-negative (CD34-) fraction of human cord blood (CB). Here, we examined the hematopoietic engraftment potential of 13 or 18 lineage-negative (13Lin- or 18Lin-) CD34+/- cells from human CB in mice and sheep. Both 13Lin- an...
journal_title:International journal of hematology
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journal_title:International journal of hematology
pub_type: 杂志文章,评审
doi:10.1007/s12185-010-0619-4
更新日期:2010-07-01 00:00:00
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journal_title:International journal of hematology
pub_type: 杂志文章
doi:10.1007/s12185-019-02796-7
更新日期:2020-03-01 00:00:00
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journal_title:International journal of hematology
pub_type: 杂志文章,评审
doi:10.1007/s12185-013-1347-3
更新日期:2013-06-01 00:00:00
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journal_title:International journal of hematology
pub_type: 杂志文章
doi:10.1007/s12185-010-0591-z
更新日期:2010-06-01 00:00:00
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journal_title:International journal of hematology
pub_type: 杂志文章,评审
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journal_title:International journal of hematology
pub_type: 杂志文章
doi:10.1532/ijh97.e0430
更新日期:2005-07-01 00:00:00
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journal_title:International journal of hematology
pub_type: 杂志文章
doi:
更新日期:1999-04-01 00:00:00
abstract::Under influence of hematopoietic growth factors, particularly thrombopoietin (TPO), hematopoietic stem cells in the bone marrow go through a process of commitment, proliferation, differentiation, and maturation and become mature megakaryocytes. At this critical point, terminally differentiated megakaryocytes face a ne...
journal_title:International journal of hematology
pub_type: 杂志文章,评审
doi:10.1007/BF02982078
更新日期:2001-12-01 00:00:00
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journal_title:International journal of hematology
pub_type: 临床试验,杂志文章
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更新日期:1998-12-01 00:00:00
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journal_title:International journal of hematology
pub_type: 杂志文章,评审
doi:10.1007/BF02986610
更新日期:2003-06-01 00:00:00
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journal_title:International journal of hematology
pub_type: 杂志文章
doi:10.1007/BF02982088
更新日期:2001-12-01 00:00:00
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journal_title:International journal of hematology
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doi:
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abstract::Systemic fungal infections remain a major clinical problem in immunocompromised patients. Presumed systemic fungal infections (PSFI) are treated empirically with an intravenous antifungal agent to reduce the occurrence of documented infections and associated mortality. The objective of this study was to compare the co...
journal_title:International journal of hematology
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更新日期:2014-08-01 00:00:00
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journal_title:International journal of hematology
pub_type: 杂志文章,评审
doi:10.1016/0925-5710(96)00440-9
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journal_title:International journal of hematology
pub_type: 杂志文章
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abstract::Bone marrow transplantation is widely accepted as the first line therapy for patients with severe aplastic anemia. Patients with less severe forms of aplastic anemia are treated with immunosuppressive agents, hematopoietic growth factors or androgenic steroids. The use of rabbit anti-human thymocyte globulin allowed u...
journal_title:International journal of hematology
pub_type: 杂志文章
doi:
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abstract::A 50-year-old woman presented with CML-CP and was initially treated with branded imatinib (Glivec) 400 mg/day. She rapidly achieved a complete hematologic response (CHR), at which point she switched therapy to a copy version of imatinib (Imatib). She received 400 mg/day of Imatib for 3 months, during which time her pl...
journal_title:International journal of hematology
pub_type: 杂志文章
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更新日期:2010-01-01 00:00:00
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journal_title:International journal of hematology
pub_type: 杂志文章
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journal_title:International journal of hematology
pub_type: 杂志文章
doi:10.1016/s0925-5710(96)00530-0
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journal_title:International journal of hematology
pub_type: 杂志文章
doi:
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abstract::Hematopoiesis is closely linked with angiogenesis, because they interact with each other and have common ancestors: hemangioblasts or hematogenic endothelial cells. The relationship is reasonable, because vascular and hematopoietic systems must develop together in order to establish the body's oxygen-delivery system d...
journal_title:International journal of hematology
pub_type: 杂志文章,评审
doi:
更新日期:2000-02-01 00:00:00