Carcinogenic potential of antitumor therapies - is the risk predictable?

The growing number of successfully cured cancer patients has created a new field in oncogenesis. The life expectancy of such patients has increased, however this favorable event may create enough time for epigenetic events to occur which can cause a new carcinognic event, i.e.

Acute Poisoning with Dapsone and Olanzapine: Severe Methemoglobinemia and Coma with a Favourable Outcome.

Dapsone is a drug commonly used in the treatment of leprosy. In Europe it is rarely prescribed, mostly for the treatment of skin diseases such as dermatitis herpetiformis. Poisoning with dapsone is rare and reports of such cases are of interest for toxicological practice.

Multiple myeloma in association with second malignancy.

Purpose: To look at the frequency of second primary malignancies (SECMAL) in patients with multiple myeloma (MM).

Methods: The medical files of 332 patients with MM (whole group), diagnosed and treated at the University Multiprofile Hospital for Active Treatment "Sv. Georgi" and the Comprehensive Oncology Hospital (Plovdiv) for a 20-year period (1990-2010) were retrospectively analyzed.

Non-Hodgkin lymphomas and carrier state of viral hepatitis B and C.

Purpose: To establish the characteristics and prognosis of newly diagnosed patients with non-Hodgkin lymphoma (NHL), who were carriers of hepatitis B (HBV) and C (HCV) viral infection.

Methods: 542 patients with NHL, diagnosed and treated in the University Hospital "Sv. Georgi", Plovdiv, were retrospectively analysed.

From Virchow's triad to metastasis: circulating hemostatic factors as predictors of risk for metastasis in solid tumors.

Tumor growth is characterized by disturbances of hemostatic mechanisms towards subclinical activation of coagulation. In cancer patients there is an increased risk up to 4-6 fold for developing idiopathic thrombosis due to the tumor-associated prothrombotic status. The molecular basis for the interrelationship between malignant phenotype and hemostatic disbalance includes several specific properties of tumor cells such as production of proinflammatory and proangiogenic cytokines, exhibition of procoagulant / fibrinolytic activities by tumor cells themselves and direct cell-to-cell interactions between tumor cells and cellular components of the hemostatic system.

Electrophoretic finding of bisalbuminemia.

Background: Bisalbuminemia or alloalbuminemia is a rare inherited or acquired condition characterized by the presence of two albumin fractions during electrophoretical separation of serum proteins.

Methods: Bisalbuminemia was incidentally detected by agarose gel electrophoresis (AGE) during standard laboratory investigation of a 36-year old female patient, referred to our laboratory with the diagnosis of immune thrombocytopenia.

Results: The electrophoregram showed dysproteinemia with the presence of two distinct albumin bands.

Intraperitoneal perfusion chemotherapy with hyperthermia in some malignant ascites.

Intraperitoneal administration of chemotherapeutic drugs with hyperthermia (HIPEC) increases their local effect on malignant peritoneal diseases and reduces systemic cytotoxicity. The most commonly used are cisplatin, doxorubicin, and mitomycin C. A major disadvantage of intraperitoneal chemotherapy is limited penetration of the drug in the tumor lesion depth (1-3 mm).

Changes of serum prohepcidin, iron status and zinc-protoporphyrin in a random group of patients with malignant diseases.

Purpose: To investigate the changes in the serum levels of prohepcidin (pHp) and markers of iron homeostasis for gathering more data on the pathogenesis of anemia in malignancies.

Methods: In 84 patients with advanced solid malignant tumors, but without iron or vitamin B12 and folate deficiency anemia, we measured serum pHp levels and common markers of iron status, erythropoiesis and inflammation. Two months later the same tests were repeated to determine possible changes in the levels of the measured parameters.

[Extent of resection as a prognostic factor in patients with non-small cell lung cancer].

Unlabelled: Despite the new methods of treatment during the last two decades, prognosis in lung cancer remains unfavourable. Only 20-25% of the patients are suitable for surgery, and the surgical resection is the unique alternative with curable intent. The extent of resection is an important prognostic factor in lung cancer patients.

[Postoperative survival in patients with inoperable lung cancer].

Unlabelled: Despite the advances in treatment in the last two decades, the prognosis in lung cancer remains infavourable. Only 20-25% of the patients are suitable for operative treatment. Almost 75% of the patients are inoperable at the time of diagnosis.

[Stage of disease as a prognostic factor in radically operated patients with non-small cell lung cancer].

Unlabelled: Despite the better diagnostic and therapeutic opportunities, lung cancer is still the major cause for cancer mortality. The surgical-pathological TNM-stage is known as the most reliable prognostic factor for survival in patients with lung cancer.

Material And Methods: We present 440 patients with non-small cell lung cancer, radically operated in the Clinic of Thoracic and abdominal surgery of University Hospital "St.

Risk index score for bacteremia in febrile neutropenic episodes in children with malignancies.

Purpose: To prospectively determine risk factors for bacteremia in febrile neutropenic children with malignancies.

Patients And Methods: We studied 199 episodes of febrile neutropenia in 80 children with malignancies, treated by conventional chemotherapy for a 4-year period (2000 - 2004). A standardized computer database with a set of variables for each febrile neutropenic episode was used.

Pseudomembranous necrotizing tracheobronchitis caused by Aspergillus spp--contribution of one case with acute myeloid leukemia.

Acute tracheobronchitis is a rare clinical manifestation of respiratory tract invasive aspergillosis, sporadically reported in patients with hematological malignancies against the background of conventional chemotherapy. The authors report on a case of pseudomembranous necrotizing form of histologically proven tracheobronchitis, caused by Aspergillus spp in the time of induction chemotherapy in a patient with acute myeloid leukemia. The clinical evolution is gradual: from mild non-specific manifestations of acute tracheobronchitis against the background of a prolonged fever unaffected by antibiotic therapy to the onset of severe acute respiratory insufficiency and unilateral bronchial obstruction syndrome.

Therapy-related acute promyelocytic leukemia after treatment with radioiodine for thyroid cancer: case report with literature review.

Therapy-related acute promyelocytic leukemia (t-APL) is a rare but known complication of chemotherapy and/or radiation therapy. Approximately 200 cases of t-APL have been reported in the literature up until now. The development of t-APL after radioiodine therapy is very rare, keeping in mind the very low doses of radiation exposure of the patient.

Philadelphia variant, t(5;9;22)(q13;q34;q11), in a case with chronic myeloid leukemia.

In this paper we report on a case of chronic myeloid leukemia (CML) with a Philadelphia variant involving chromosome 5 as a second change of the standard Philadelphia chromosome (Ph). Molecular analysis found a fusion gene BCR-ABL with participation of exons b3 and a2, respectively (b3a2). The molecular variant of the fusion gene BCR/ ABL or the rare involvement of chromosome 5 could possibly explain the mild course of the disease.

Cancer and venous thromboembolism.

Clinical examples of coagulation abnormalities may occur from single or multiple abnormailties and include both inherited and acquired defects. Risk factors that further increase clotting include obesity, recent surgery, pregnancy and cancer. Venous thrombosis is a common complication in patients with malignant diseases.

New options in the treatment of myelodysplastic syndrome.

Myelodysplastic syndrome (MDS) is a heterogeneous group of progressive chronic hematopoietic disorders, usually presenting as refractory anemia or cytopenia, with an approximately 25% risk of progression toward acute myeloid leukaeima (AML), and no proven curative treatment. Novel biological treatment strategies targeting both the malignant blood cell and its microenvironment can overcome resistance to current therapies, and represent a promising treatment paradigm for improving patient outcome. Many of these agents have multiple biologic activities.

Cellular therapy--the possible future of regenerative medicine.

Stem cells are a unique cell population capable of self-renewal and differentiation into different cell lines. There are two main types of stem cells: embryonic stem cells (pluripotent) and somatic/adult stem cells (multipotent cells differentiated into the specific types of the tissue they originate from). Scientists are now interested in finding the sources of cells that can be used for therapeutic cloning as a method of saving human life and a new trend in regenerative medicine.

The prognostic value of clinical and laboratory parameters in patients with chronic lymphocytic leukemia.

Purpose: Chronic lymphocytic leukemia (CLL) is heterogeneous in its clinical course. The aim of the present study was to identify some clinical and laboratory parameters with prognostic value in relation to survival of patients with CLL.

Patients And Methods: One hundred thirty one patients with CLL, treated in the Clinic of Hematology, Plovdiv, between 1992 and 2003 were studied.

Pulmonary, gastrointestinal and liver vascular malformations in Rendu-Osler disease.

Hereditary hemorrhagic telangiectasia (HHT) is an angiodysplastic disorder transmitted in autosomal dominant fashion. This case report describes a 46-year-old woman with multiple arteriovenous malformations that eventually caused multiorgan failure. The diagnosis was made in the early childhood based on frequently recurring episodes of severe epistaxis.

[Skin symptoms in malignant hemopathies].

Aim: To investigate specific and non-specific skin lesions in malignant hemopathies.

Material And Methods: The study enrolled 862 patients (394 females and 468 males) with hematological malignancies treated in the hematological clinic from 1990 to 1998. The patients were divided into three groups according to the primary disorder: lymphoproliferative processes (541 patients), myeloproliferative processes (296 patients) and bone marrow hypoplasia (25 patients).

Acute hemolytic anemia as an initial clinical manifestation of Wilson's disease.

Wilson's disease is an inherited disorder of copper transport in the organism, transmitted in autosomal recessive fashion. It is caused by dysfunction in homologous copper-transporting adenosine triphosphatases. The main clinical symptoms are usually due to hepatic (42%) or/and neurologic (34%) involvement, which is the reason for the name hepatolenticular degeneration.

A study of Helicobacter pylori infection in patients with pernicious anemia.

Introduction: Chronic atrophic gastritis presents with atrophy of the gastric mucosa, hypochlorhydria or achlorhydria and unstable gastrin level. Type A chronic atrophic gastritis associated with hypergastrinemia is regarded as the principle causative factor for pernicious anemia.

Aim: The study aimed at evaluation of the incidence of H.

Biomechanical measurement of skin distensibility in scleredema of Buschke associated with multiple myeloma.

We report a case of scleredema of Buschke associated with IgG kappa monoclonal hypergammaglobulinaemia. After myeloma polychemotherapy an improvement in skin involvement was observed and confirmed by means of noninvasive skin elasticity measurements. This suggests a relationship between the two diseases.

Antifungal prophylaxis with low doses fluconazole in patients with hematological malignancies.

Introduction: The incidence of mycotic infections in immunocompromised patients has reached a 20-fold rise for the last two decades.

Aim: The goal of the study was to evaluate fluconazole efficacy as antifungal prophylaxis in patients with hematological malignancies.

Material And Methods: Sixty nine patients with hematological malignancies and neutrophil count less than 1.