1
|
Joos L, Gonzalez Chiappe S, Neumann T, Mahr A. Use of mesna prophylaxis in patients with cyclophosphamide-treated ANCA-associated vasculitis: cross-sectional survey of practitioners. Rheumatol Int 2024:10.1007/s00296-024-05620-6. [PMID: 38935122 DOI: 10.1007/s00296-024-05620-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND There may be some diversity in the practice of co-prescribing 2-mercaptoethane sodium sulfonate (mesna) with cyclophosphamide (CYC) for ANCA-associated vasculitis (AAV). OBJECTIVES To assess the practice of prescribing mesna prophylaxis for CYC-treated patients with AAV. METHODS We invited authors of publications on AAV referenced in MEDLINE over the previous 10 years to participate in an anonymous online survey. Respondents were eligible if they were involved in CYC treatments for AAV. The survey asked about the characteristics of the respondents and their practice in using CYC and mesna to treat AAV and the underlying rationale. We compared 18 variables between mesna prescribers and their counterparts to identify factors associated with mesna use. RESULTS In total, 139 eligible individuals completed the survey. The participants were from 34 countries and were essentially physicians (98%). Overall, 68%, 19% and 13% of respondents prescribed mesna systematically, never, or on a selective basis. As compared with never/selective-prescribers, systematic-prescribers were more often ≤ 39 years old (P = 0.008), more often used intermittent pulse therapy as the exclusive/predominant CYC administration scheme (P < 0.001), were more frequently based in France/Germany/Italy than in England/United States (P < 0.001), and more often indicated adherence to local standards (P = 0.003) or (inter)national guidelines for AAV (P < 0.001) as a rationale for their mesna practice. Never/selective-prescribers more commonly reported that their mesna prescription pattern had changed as compared with their former practice (P < 0.001). CONCLUSIONS Systematic co-prescription of mesna is the prevailing practice for CYC treatments for AAV. The practice seems to involve practicability considerations and differs between generations.
Collapse
Affiliation(s)
- Lukas Joos
- Division of Rheumatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Solange Gonzalez Chiappe
- Division of Rheumatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Molecular Epidemiology Research Group, Max Delbrück Centre for Molecular Medicine, Berlin, Germany
| | - Thomas Neumann
- Division of Rheumatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Alfred Mahr
- Division of Rheumatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
- The Kusnacht Practice AG, Zurich-Zollikon, Switzerland.
| |
Collapse
|
2
|
Almeida de Oliveira LS, de Moura Bandeira SR, Gomes Gonçalves RL, Pereira de Sousa Neto B, Carvalho de Rezende D, dos Reis-Filho AC, Sousa IJO, Pinheiro-Neto FR, Timah Acha B, do Nascimento Caldas Trindade G, do Nascimento LG, de Sousa DP, de Castro Almeida FR, Lucarini M, Durazzo A, Arcanjo DDR, de Assis Oliveira F. The Isopropyl Gallate Counteracts Cyclophosphamide-Induced Hemorrhagic Cystitis in Mice. BIOLOGY 2022; 11:728. [PMID: 35625456 PMCID: PMC9138278 DOI: 10.3390/biology11050728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/07/2022] [Accepted: 05/08/2022] [Indexed: 01/08/2023]
Abstract
Hemorrhagic cystitis is the main adverse effect associated with the clinical use of oxazaphosphorine, resulting in increased oxidative stress and proinflammatory cytokines, which culminate in injury of the bladder tissue. The aim of this study was to evaluate the protective effect of isopropyl gallate (IPG) against ifosfamide (IFOS)-induced hemorrhagic cystitis in mice. The induction of the hemorrhagic cystitis model was carried out using a single dose of IFOS (400 mg/kg, i.p.) four hours after oral pretreatment with IPG (6.25, 12.5, 25, and 50 mg/kg) or saline (vehicle). Mesna (positive control; 80 mg/kg, i.p.) was administered four hours before and eight hours after induction of cystitis. In the present study, IPG 25 mg/kg significantly decreased edema and hemorrhage, with a reduction of the bladder wet weight (36.86%), hemoglobin content (54.55%), and peritoneal vascular permeability (42.94%) in urinary bladders of mice. Interestingly, IPG increased SOD activity (89.27%) and reduced MDA levels (35.53%), as well as displayed anti-inflammatory activity by decreasing TNF-α (88.77%), IL-1β (62.87%), and C-reactive protein (56.41%) levels. Our findings demonstrate that IPG has a substantial protective role against IFOS-induced hemorrhagic cystitis in mice by enhancing antioxidant activity and proinflammatory mechanisms. Thus, IPG represents a promising co-adjuvant agent in oxazaphosphorine-based chemotherapy treatments.
Collapse
Affiliation(s)
- Lucas Solyano Almeida de Oliveira
- Medicinal Plants Research Center, Federal University of Piauí, Av. Nossa Senhora de Fátima s/n, Teresina 64049-550, Brazil; (L.S.A.d.O.); (S.R.d.M.B.); (R.L.G.G.); (B.P.d.S.N.); (D.C.d.R.); (A.C.d.R.-F.); (I.J.O.S.); (F.R.P.-N.); (B.T.A.); (G.d.N.C.T.); (F.R.d.C.A.); (F.d.A.O.)
| | - Sara Raquel de Moura Bandeira
- Medicinal Plants Research Center, Federal University of Piauí, Av. Nossa Senhora de Fátima s/n, Teresina 64049-550, Brazil; (L.S.A.d.O.); (S.R.d.M.B.); (R.L.G.G.); (B.P.d.S.N.); (D.C.d.R.); (A.C.d.R.-F.); (I.J.O.S.); (F.R.P.-N.); (B.T.A.); (G.d.N.C.T.); (F.R.d.C.A.); (F.d.A.O.)
| | - Rodrigo Lopes Gomes Gonçalves
- Medicinal Plants Research Center, Federal University of Piauí, Av. Nossa Senhora de Fátima s/n, Teresina 64049-550, Brazil; (L.S.A.d.O.); (S.R.d.M.B.); (R.L.G.G.); (B.P.d.S.N.); (D.C.d.R.); (A.C.d.R.-F.); (I.J.O.S.); (F.R.P.-N.); (B.T.A.); (G.d.N.C.T.); (F.R.d.C.A.); (F.d.A.O.)
| | - Benedito Pereira de Sousa Neto
- Medicinal Plants Research Center, Federal University of Piauí, Av. Nossa Senhora de Fátima s/n, Teresina 64049-550, Brazil; (L.S.A.d.O.); (S.R.d.M.B.); (R.L.G.G.); (B.P.d.S.N.); (D.C.d.R.); (A.C.d.R.-F.); (I.J.O.S.); (F.R.P.-N.); (B.T.A.); (G.d.N.C.T.); (F.R.d.C.A.); (F.d.A.O.)
| | - Diana Carvalho de Rezende
- Medicinal Plants Research Center, Federal University of Piauí, Av. Nossa Senhora de Fátima s/n, Teresina 64049-550, Brazil; (L.S.A.d.O.); (S.R.d.M.B.); (R.L.G.G.); (B.P.d.S.N.); (D.C.d.R.); (A.C.d.R.-F.); (I.J.O.S.); (F.R.P.-N.); (B.T.A.); (G.d.N.C.T.); (F.R.d.C.A.); (F.d.A.O.)
| | - Antonio Carlos dos Reis-Filho
- Medicinal Plants Research Center, Federal University of Piauí, Av. Nossa Senhora de Fátima s/n, Teresina 64049-550, Brazil; (L.S.A.d.O.); (S.R.d.M.B.); (R.L.G.G.); (B.P.d.S.N.); (D.C.d.R.); (A.C.d.R.-F.); (I.J.O.S.); (F.R.P.-N.); (B.T.A.); (G.d.N.C.T.); (F.R.d.C.A.); (F.d.A.O.)
| | - Ian Jhemes Oliveira Sousa
- Medicinal Plants Research Center, Federal University of Piauí, Av. Nossa Senhora de Fátima s/n, Teresina 64049-550, Brazil; (L.S.A.d.O.); (S.R.d.M.B.); (R.L.G.G.); (B.P.d.S.N.); (D.C.d.R.); (A.C.d.R.-F.); (I.J.O.S.); (F.R.P.-N.); (B.T.A.); (G.d.N.C.T.); (F.R.d.C.A.); (F.d.A.O.)
| | - Flaviano Ribeiro Pinheiro-Neto
- Medicinal Plants Research Center, Federal University of Piauí, Av. Nossa Senhora de Fátima s/n, Teresina 64049-550, Brazil; (L.S.A.d.O.); (S.R.d.M.B.); (R.L.G.G.); (B.P.d.S.N.); (D.C.d.R.); (A.C.d.R.-F.); (I.J.O.S.); (F.R.P.-N.); (B.T.A.); (G.d.N.C.T.); (F.R.d.C.A.); (F.d.A.O.)
| | - Boris Timah Acha
- Medicinal Plants Research Center, Federal University of Piauí, Av. Nossa Senhora de Fátima s/n, Teresina 64049-550, Brazil; (L.S.A.d.O.); (S.R.d.M.B.); (R.L.G.G.); (B.P.d.S.N.); (D.C.d.R.); (A.C.d.R.-F.); (I.J.O.S.); (F.R.P.-N.); (B.T.A.); (G.d.N.C.T.); (F.R.d.C.A.); (F.d.A.O.)
| | - Gabriela do Nascimento Caldas Trindade
- Medicinal Plants Research Center, Federal University of Piauí, Av. Nossa Senhora de Fátima s/n, Teresina 64049-550, Brazil; (L.S.A.d.O.); (S.R.d.M.B.); (R.L.G.G.); (B.P.d.S.N.); (D.C.d.R.); (A.C.d.R.-F.); (I.J.O.S.); (F.R.P.-N.); (B.T.A.); (G.d.N.C.T.); (F.R.d.C.A.); (F.d.A.O.)
| | - Lázaro Gomes do Nascimento
- Laboratory of Pharmaceutical Chemistry, Federal University of Paraíba, João Pessoa 58051-900, Brazil; (L.G.d.N.); (D.P.d.S.)
| | - Damião Pergentino de Sousa
- Laboratory of Pharmaceutical Chemistry, Federal University of Paraíba, João Pessoa 58051-900, Brazil; (L.G.d.N.); (D.P.d.S.)
| | - Fernanda Regina de Castro Almeida
- Medicinal Plants Research Center, Federal University of Piauí, Av. Nossa Senhora de Fátima s/n, Teresina 64049-550, Brazil; (L.S.A.d.O.); (S.R.d.M.B.); (R.L.G.G.); (B.P.d.S.N.); (D.C.d.R.); (A.C.d.R.-F.); (I.J.O.S.); (F.R.P.-N.); (B.T.A.); (G.d.N.C.T.); (F.R.d.C.A.); (F.d.A.O.)
| | - Massimo Lucarini
- CREA-Research Centre for Food and Nutrition, Via Ardeatina 546, 00178 Rome, Italy; (M.L.); (A.D.)
| | - Alessandra Durazzo
- CREA-Research Centre for Food and Nutrition, Via Ardeatina 546, 00178 Rome, Italy; (M.L.); (A.D.)
| | - Daniel Dias Rufino Arcanjo
- Medicinal Plants Research Center, Federal University of Piauí, Av. Nossa Senhora de Fátima s/n, Teresina 64049-550, Brazil; (L.S.A.d.O.); (S.R.d.M.B.); (R.L.G.G.); (B.P.d.S.N.); (D.C.d.R.); (A.C.d.R.-F.); (I.J.O.S.); (F.R.P.-N.); (B.T.A.); (G.d.N.C.T.); (F.R.d.C.A.); (F.d.A.O.)
- Laboratory of Functional and Molecular Studies in Physiopharmacology, Department of Biophysics and Physiology, Federal University of Piauí, Teresina 64049-550, Brazil
| | - Francisco de Assis Oliveira
- Medicinal Plants Research Center, Federal University of Piauí, Av. Nossa Senhora de Fátima s/n, Teresina 64049-550, Brazil; (L.S.A.d.O.); (S.R.d.M.B.); (R.L.G.G.); (B.P.d.S.N.); (D.C.d.R.); (A.C.d.R.-F.); (I.J.O.S.); (F.R.P.-N.); (B.T.A.); (G.d.N.C.T.); (F.R.d.C.A.); (F.d.A.O.)
| |
Collapse
|
3
|
Engin S, Barut EN, Yaşar YK, Soysal AÇ, Arıcı T, Kerimoğlu G, Kadıoğlu M, Sezen SF. Trimetazidine attenuates cyclophosphamide-induced cystitis by inhibiting TLR4-mediated NFκB signaling in mice. Life Sci 2022; 301:120590. [PMID: 35504331 DOI: 10.1016/j.lfs.2022.120590] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/19/2022] [Accepted: 04/25/2022] [Indexed: 11/26/2022]
Abstract
AIM Cyclophosphamide (CP)-induced cystitis is a challenging clinical problem involving inflammation and dysfunction of bladder. Trimetazidine (TMZ) is an anti-anginal drug with anti-oxidant and anti-inflammatory properties. We aimed to investigate the protective effects of TMZ in CP-induced cystitis via inhibiting TLR4/NFκB signaling. MAIN METHODS Balb/c mice were administrated TMZ (10 or 20 mg/kg/day) intraperitoneally (i.p.) for 5 consecutive days before CP. On day 6, cystitis was induced by a single dose of CP (300 mg/kg, i.p.). Mesna (2-mercaptoethane sulfonate sodium; 30 mg/kg, i.p.) was administered 20 min before and at 4 and 8 h after the CP injection. After 24 h of cystitis induction, the bladders were removed for histopathological evaluation, contractility studies, biochemical analysis and western blotting. MTT assay was performed in a cancer cell line (MDA-MB-231) to evaluate the effect of TMZ on the cytotoxicity of CP. KEY FINDINGS CP-induced severe cystitis was confirmed by histological disturbances and the decrease in carbachol-evoked contractions of detrusor strips, which was partially improved by TMZ (20 mg/kg/day). SOD activity and GSH content were decreased whereas TNF-α and IL-1β levels were increased in the bladders of CP-treated mice, which were restored by TMZ or mesna. TMZ reduced the CP-induced increase in the protein expressions of caspase-3, TLR4 and phosphorylated-NFκB in bladder tissues. TMZ alone decreased the cell viability and TMZ also enhanced the cytotoxicity of CP. SIGNIFICANCE Our study provides the first preclinical evidence that TMZ attenuates CP-induced urotoxicity by enhancing anti-oxidant capacity and suppressing inflammation possibly via downregulating TLR4-mediated NFκB signaling while augmenting the cytotoxicity of CP.
Collapse
Affiliation(s)
- Seçkin Engin
- Department of Pharmacology, Faculty of Pharmacy, Karadeniz Technical University, Trabzon, Turkiye.
| | - Elif Nur Barut
- Department of Pharmacology, Faculty of Pharmacy, Karadeniz Technical University, Trabzon, Turkiye
| | - Yeşim Kaya Yaşar
- Department of Pharmacology, Faculty of Pharmacy, Karadeniz Technical University, Trabzon, Turkiye; Drug and Pharmaceutical Technology Application and Research Center, Karadeniz Technical University, Trabzon, Turkiye
| | - Aysun Çelik Soysal
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Bülent Ecevit University, Zonguldak, Turkiye
| | - Tuğba Arıcı
- Başaksehir Cam and Sakura City Hospital, İstanbul, Turkiye
| | - Gökçen Kerimoğlu
- Department of Histology and Embryology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkiye
| | - Mine Kadıoğlu
- Department of Medical Pharmacology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkiye
| | - Sena F Sezen
- Department of Pharmacology, Faculty of Pharmacy, Karadeniz Technical University, Trabzon, Turkiye; Drug and Pharmaceutical Technology Application and Research Center, Karadeniz Technical University, Trabzon, Turkiye
| |
Collapse
|
4
|
Effect of a Low Dose of Carvedilol on Cyclophosphamide-Induced Urinary Toxicity in Rats—A Comparison with Mesna. Pharmaceuticals (Basel) 2021; 14:ph14121237. [PMID: 34959638 PMCID: PMC8708009 DOI: 10.3390/ph14121237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/21/2021] [Accepted: 11/25/2021] [Indexed: 01/28/2023] Open
Abstract
One of the major side effects of cyclophosphamide (CPX)—an alkylating anticancer drug that is still clinically used—is urotoxicity with hemorrhagic cystitis. The present study was designed to evaluate the ability of carvedilol to protect rats from cyclophosphamide-induced urotoxicity. Rats were injected intraperitoneally (i.p.) with CPX (200 mg/kg) and administered carvedilol (2 mg/kg) intragastrically a day before, at the day and a day after a single i.p. injection of CPX, with or without mesna (40, 80, and 80 mg/kg i.p. 20 min before, 4 h and 8 h after CPX administration, respectively). Pretreatment with carvedilol partly prevented the CPX-induced increase in urinary bladder and kidney index, and completely protects from CPX-evoked alterations in serum potassium and creatinine level, but did not prevent histological alterations in the urinary bladder and hematuria. However, carvedilol administration resulted in significant restoration of kidney glutathione (GSH) level and a decrease in kidney interleukin 1β (IL-1β) and plasma asymmetric dimethylarginine (ADMA) concentrations. Not only did mesna improve kidney function, but it also completely reversed histological abnormalities in bladders and prevented hematuria. In most cases, no significant interaction of carvedilol with mesna was observed, although the effect of both drugs together was better than mesna given alone regarding plasma ADMA level and kidney IL-1β concentration. In conclusion, carvedilol did not counteract the injury caused in the urinary bladders but restored kidney function, presumably via its antioxidant and anti-inflammatory properties.
Collapse
|
5
|
Rohilla S, Dureja H, Chawla V. Cytoprotective Agents to Avoid Chemotherapy Induced Sideeffects on Normal Cells: A Review. Curr Cancer Drug Targets 2019; 19:765-781. [DOI: 10.2174/1568009619666190326120457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 03/01/2019] [Accepted: 03/10/2019] [Indexed: 01/16/2023]
Abstract
Anticancer agents play a vital role in the cure of patients suffering from malignancy. Though, the chemotherapeutic agents are associated with various adverse effects which produce significant toxic symptoms in the patients. But this therapy affects both the malignant and normal cells and leads to constricted therapeutic index of antimalignant drugs which adversely impacts the quality of patients’ life. Due to these adversities, sufficient dose of drug is not delivered to patients leading to delay in treatment or improper treatment. Chemoprotective agents have been developed either to minimize or to mitigate the toxicity allied with chemotherapeutic agents. Without any concession in the therapeutic efficacy of anticancer drugs, they provide organ specific guard to normal tissues.
Collapse
Affiliation(s)
- Seema Rohilla
- Department of Pharmaceutics, Hindu College of Pharmacy, Sonepat- 131001, India
| | - Harish Dureja
- Department of Pharmaceutical Sciences, Maharshi Dayanand University, Rohtak-124001, India
| | - Vinay Chawla
- Institute of Pharmaceutical Sciences, Baba Farid University of Health Sciences, Faridkot-151203, India
| |
Collapse
|
6
|
ERDOGAN O, KELES H. Pathologic Examination of the Protective Effect of Glycyrrhizin on Cyclophosphamide-induced Hemorrhagic Cystitis in Rats. ACTA ACUST UNITED AC 2019. [DOI: 10.30607/kvj.515979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
7
|
Ercan N, Aysegul E, Burcak B, Ilknur B. Sepsis like acute hypersensitivity syndrome related to mesna. J Eur Acad Dermatol Venereol 2017; 31:e393-e394. [PMID: 28271573 DOI: 10.1111/jdv.14198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- N Ercan
- Department of Pediatric Immunology and Allergy, Dr Sami Ulus Obstetrics, Children's Health and Diseases Training and Research Hospital, Health Sciences University, Ankara, 06080, Turkey
| | - E Aysegul
- Department of Pediatric Immunology and Allergy, Dr Sami Ulus Obstetrics, Children's Health and Diseases Training and Research Hospital, Health Sciences University, Ankara, 06080, Turkey
| | - B Burcak
- Department of Pediatric Hematology and Oncology, Dr Sami Ulus Obstetrics, Children's Health and Diseases Training and Research Hospital, Health Sciences University, Ankara, 06080, Turkey
| | - B Ilknur
- Department of Pediatric Immunology and Allergy, Dr Sami Ulus Obstetrics, Children's Health and Diseases Training and Research Hospital, Health Sciences University, Ankara, 06080, Turkey
| |
Collapse
|
8
|
Review of Advances in Uroprotective Agents for Cyclophosphamide- and Ifosfamide-induced Hemorrhagic Cystitis. Urology 2016; 100:16-19. [PMID: 27566144 DOI: 10.1016/j.urology.2016.07.030] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 07/21/2016] [Accepted: 07/26/2016] [Indexed: 10/21/2022]
Abstract
Cyclophosphamide and ifosfamide are widely used drugs for malignancies and rheumatologic conditions. One of the most significant adverse reactions to these drugs is hemorrhagic cystitis. Mesna is the most widely used uroprotective agent that acts to neutralize the caustic metabolite, acrolein, responsible for induction of hemorrhagic cystitis. However, mesna is not a perfect alternative, and studies since its discovery have investigated the use of alternative drugs and adjuncts to increase mesna's efficacy. This review details some of the recent work into novel uroprotective agents for drug-induced hemorrhagic cystitis.
Collapse
|
9
|
Robertson LM, Clark A. Looking beyond the angiotensin receptor blocker: A case of anaphylaxis to mesna. Ann Allergy Asthma Immunol 2016; 117:324-5. [PMID: 27424127 DOI: 10.1016/j.anai.2016.06.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 06/20/2016] [Accepted: 06/21/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Leanna-Marie Robertson
- Department of Internal Medicine, University Hospitals Case Medical Center, Cleveland, Ohio.
| | - Amanda Clark
- Department of Internal Medicine, University Hospitals Case Medical Center & Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio
| |
Collapse
|
10
|
Laberke S, Zenker I, Hirschberger J. Mesna and furosemide for prevention of cyclophosphamide-induced sterile haemorrhagic cystitis in dogs - a retrospective study. Vet Rec 2014; 174:250. [DOI: 10.1136/vr.101574] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- S. Laberke
- Clinic of Small Animal Medicine; Ludwig Maximilian University Munich; Veterinärstr. 13 80539 Munich Germany
| | - I. Zenker
- University of California, Davis School of Veterinary Medicine; Department of Radiation Oncology; 1 Shields Avenue Davis CA 95616 USA
| | - J. Hirschberger
- Clinic of Small Animal Medicine; Ludwig Maximilian University Munich; Veterinärstr. 13 80539 Munich Germany
| |
Collapse
|
11
|
Ruggiero A, Triarico S, Trombatore G, Battista A, Dell’Acqua F, Rizzari C, Riccardi R. Incidence, clinical features and management of hypersensitivity reactions to chemotherapeutic drugs in children with cancer. Eur J Clin Pharmacol 2013; 69:1739-46. [PMID: 23765411 DOI: 10.1007/s00228-013-1546-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 05/28/2013] [Indexed: 10/26/2022]
|
12
|
Kloos RQH, Boelens JJ, de Jong TPVM, Versluys B, Bierings M. Hemorrhagic cystitis in a cohort of pediatric transplantations: incidence, treatment, outcome, and risk factors. Biol Blood Marrow Transplant 2013; 19:1263-6. [PMID: 23711594 DOI: 10.1016/j.bbmt.2013.05.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 05/17/2013] [Indexed: 11/16/2022]
Abstract
Hemorrhagic cystitis (HC) can be a severe complication in hematopoietic stem cell transplantation (HSCT). To identify risk factors and etiology and to improve treatment, a number of factors were analyzed retrospectively in a cohort of 74 consecutive pediatric HSCTs between 2007 and 2009 in a single institution. The 74 transplantations were done in 67 children. Potential risk factors for HC were age, gender, underlying disease, ablative conditioning, graft-versus-host disease prophylaxis, unrelated donor, stem cell source, conditioning regime, acute graft-versus-host disease and cytomegalovirus reactivation. Fourteen patients developed HC (19%). In all but 4 cases (71%), HC appeared after engraftment. Severity was assessed as grade 1 in 1, grade 2 in 8, and grade 3 in 5 cases. In 79% of the patients with HC, urine samples showed BK virus. This may provide guidance for future prevention policies. In 11 children, treatment included forced hydration, spasmolytics, and bladder irrigation. Three children required cystoscopy, intravesical therapy and/or antiviral therapy. Statistical analysis revealed age over six years to be a risk factor for the development of HC. We conclude that current conditioning regimens lead to a still considerable incidence of HC in pediatric HSCT, necessitating the evaluation of screening protocols and preventive measures.
Collapse
|
13
|
Joerger M. Prevention and handling of acute allergic and infusion reactions in oncology. Ann Oncol 2012; 23 Suppl 10:x313-9. [DOI: 10.1093/annonc/mds314] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
|
14
|
Severe allergic reactions to thiol-based cytoprotective agents mesna and amifostine in a child with a supratentorial primitive neuroectodermal tumor. J Pediatr Hematol Oncol 2011; 33:e250-2. [PMID: 21646919 DOI: 10.1097/mph.0b013e31820c3403] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Both 2-mercaptoethane sulfonate sodium (mesna) and amifostine's active metabolite WR-1065 are thiol-based cytoprotective agents that are critical components of high-dose chemotherapy regimens used to treat various cancers in both adults and children. This case report describes a patient with a supratentorial primitive neuroectodermal tumor who developed severe drug reactions to both mesna and amifostine/WR-1065, suggesting that the thiol component of these agents triggered the adverse reactions. This report highlights the clinical presentation of drug-induced hypersensitivity syndrome in the context of pediatric oncology and the supportive care measures that, if implemented rapidly, may diminish the reaction severity and allow successful completion of chemotherapy.
Collapse
|
15
|
Boeira VT, Leite CE, Santos AA, Edelweiss MI, Calixto JB, Campos MM, Morrone FB. Effects of the hydroalcoholic extract of Phyllanthus niruri and its isolated compounds on cyclophosphamide-induced hemorrhagic cystitis in mouse. Naunyn Schmiedebergs Arch Pharmacol 2011; 384:265-75. [PMID: 21789632 DOI: 10.1007/s00210-011-0668-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 07/06/2011] [Indexed: 12/25/2022]
Abstract
The effects of Phyllanthus niruri hydroalcoholic extract and the isolated compounds quercetin, rutin, and gallic acid were examined in the mouse model of cyclophosphamide (CYP)-induced hemorrhagic cystitis (HC). HC was induced by a single CYP injection (300 mg/kg, IP), and the animals were evaluated 4 and 6 h after. Some animals were orally treated with the reference compound 2-mercaptoethane sodium sulfonate (Mesna) 80 mg/kg (30 min before CYP) and 160 mg/kg (2 h after CYP). Other groups were treated with P. niruri extract (30 and 50 mg/kg), or quercetin, rutin, and gallic acid (10 and 20 mg/kg), given orally, at the same intervals described for Mesna. P. niruri extract and its active components produced a significant attenuation of the nociception, edema, and hemorrhage evoked by CYP, which was similar to that seen for Mesna. Gallic acid and rutin displayed greater anti-inflammatory effects, whereas quercetin presented superior antinociceptive activities. Noteworthy is that P. niruri extract and compounds significantly reduced CYP-induced liver lipid peroxidation. Our results shed new light on the beneficial effects of P. niruri extract and its active compounds in attenuating the collateral effects elicited by the chemotherapeutic agent CYP.
Collapse
|
16
|
Hassan Z. Management of refractory hemorrhagic cystitis following hematopoietic stem cell transplantation in children. Pediatr Transplant 2011; 15:348-61. [PMID: 21504524 DOI: 10.1111/j.1399-3046.2011.01505.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
HC is a complication associated with HSCT, but occurs rarely in solid organ recipients. The reported incidence varies from <10% to more than 70%. HC is characterized by hemorrhagic inflammation in urinary tract mucosa with symptoms varying from asymptomatic microscopic hematuria to frank hematuria with clot formation and urinary tract obstruction. Early onset HC may be explained by toxicity of chemo- and/or radiotherapy, while multiple factors including viral infections and their interplay seem to be involved in late onset HC. So far, only incidence of cyclophosphamide-associated HC has been reduced with preventive treatment. Likely, once HC is established, the treatment principles are similar regardless of the etiology and depend on the intensity of HC. Prevention of urinary tract obstruction, transfusion support, analgesic, and spasmolytic therapy are generally accepted in HC management. Treatment beyond this conservative approach entails higher risk for side effects, and thus treatment escalation proportional to HC intensity is warranted. No standard and evidence-based treatment escalation algorithm has been widely adopted yet. As severe HC following HSCT is a potentially life-threatening complication, a multidisciplinary and individual approach is required in children suffering from this devastating complication.
Collapse
Affiliation(s)
- Zuzana Hassan
- Center for Allogeneic Stem Cell Transplantation, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
| |
Collapse
|
17
|
Santos AA, Leal PC, Edelweiss MIA, Lopes TG, Calixto JB, Morrone FB, Campos MM. Effects of the compounds MV8608 and MV8612 obtained from Mandevilla velutina in the model of hemorrhagic cystitis induced by cyclophosphamide in rats. Naunyn Schmiedebergs Arch Pharmacol 2010; 382:399-407. [PMID: 20809237 DOI: 10.1007/s00210-010-0555-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Accepted: 08/16/2010] [Indexed: 12/29/2022]
Abstract
Hemorrhagic cystitis (HC) is a common side effect observed in patients under chemotherapy with cyclophosphamide (CYP). The urotoxic side effects of CYP are attributed to the metabolic compound acrolein, and can be partially prevented by the uroprotector agent 2-mercaptoethene sulfate (Mesna). The present study analyzed the anti-inflammatory and the antinociceptive effects of compounds MV8608 and MV8612 obtained from Mandevilla velutina in the rat model of CYP-induced HC. Male Wistar rats were used (six to eight per group, 220-250 g). HC was induced by a single administration of CYP (100 mg/kg, ip). Three behavioral parameters--breathing rate, closing of the eyes, and specific posture--were used as nociception indexes, and scored at different time intervals (15-180 min) after cystitis induction. As inflammatory parameters, hemorrhage presence, edema formation, and bladder weight were determined at 24 h after CYP administration. The neutrophil migration was assessed by means of myeloperoxidase (MPO activity), 4 h after cystitis induction. As expected, Mesna treatment was able to reduce in a significant manner all the inflammatory and the nociceptive parameters induced by CYP. Of note, the administration of MV8608 significantly inhibited the hemorrhage formation and the neutrophil recruitment, while the MV8612 treatment markedly reduced the bladder weight, without interfering with neutrophil influx. Interestingly, the treatment with either MV8608 or MV8612 markedly reduced the nociceptive responses. The present results clearly indicate that MV8608 and MV8612 might represent important alternatives to prevent side effects, especially the nociception, following chemotherapy with CYP.
Collapse
Affiliation(s)
- André A Santos
- Programa de Pós-Graduação em Biologia Celular e Molecular, PUCRS, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | | | | | | | | |
Collapse
|
18
|
Pagani M. The complex clinical picture of presumably allergic side effects to cytostatic drugs: symptoms, pathomechanism, reexposure, and desensitization. Med Clin North Am 2010; 94:835-52, xiii. [PMID: 20609866 DOI: 10.1016/j.mcna.2010.03.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The number of drugs used for the treatment of different types of cancers is constantly increasing and actually exceeds 100 distinct chemical formulations. The use of most cytotoxic agents is associated with potential hypersensitivity reactions, and the constant increase of their administration has caused an increase in incidence of these adverse effects, thus becoming a relevant problem for clinicians. Hypersensitivity reactions are common with platinum compounds, L-asparaginase, taxanes, procarbazine, and epipodophyllotoxins, whereas they are unusual, but always possible, with the other chemotherapeutic drugs. Reactions associated with individual drugs are discussed in detail. The mechanism underlying these hypersensitivity reactions involves IgE-mediated hypersensitivity reactions, nonallergic hypersensitivity reactions, and a few pathogenetically unclear reactions. More studies are needed to better understand, diagnose, treat, and prevent these reactions. To achieve this goal, a multidisciplinary approach to treat patients with cancer who have potential allergies is needed.
Collapse
Affiliation(s)
- Mauro Pagani
- Allergology and Oncology Service, Medicine Department, Asola Hospital, Mantova, Italy.
| |
Collapse
|
19
|
Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2008. [DOI: 10.1002/pds.1485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|