Secondary acute nonlymphocytic leukemia following successful chemotherapy combining cisplatin, doxorubicin, and cyclophosphamide for stage IV epithelial ovarian cancer

Panax ginseng is superior to vitamin E as a hepatoprotector against cyclophosphamide-induced liver damage

BACKGROUND AND AIMS

Cyclophosphamide (CPh) is a frequently used drug, in human and animals for its immunosuppressive and anticancer potential. However, it is metabolized by the liver yielding damaging toxicants (to the liver itself and other non-target vital organs) via oxidative stress, apoptosis induction and finally necrosis. Since there is no escaping of using such harmful medications, we focused on alleviating its side-effects. Panax ginseng Meyer is a potent candidate, and we still lack adequate information on its hepatoprotective role against cyclophosphamide-induced liver-damage.

METHODS

Here, we used P. ginseng (Korean Red Ginseng) compared to vitamin-E (natural antioxidant) in combating CPh-induced liver damage. Forty-eight albino rats were divided into 6 groups, Control, Ginseng, Vitamin E, Cyclophosphamide (CPh), CPh + Ginseng or CPh + Vitamin-E. Blood samples were taken for biochemical analyses and liver samples were collected for histopathology, oxidative stress evaluation, and gene expression analyses.

RESULTS

In CPh group, typical CPh-liver damage was evident (higher levels of AST, ALT, ALP; lower albumin and total proteins levels; lower liver tissue concentrations of SOD, GPX and CAT and higher MDA; injured liver histopathological picture; and finally increased TNF-α, IL-1β and Caspase3 and decreased BCL-2 genes expression). All these were abolished with either P. ginseng or vitamin-E administration. However, P. ginseng was overall superior to vitamin-E, especially in restoring blood biochemical findings and damaged histopathological picture.

CONCLUSIONS

Therefore, P. ginseng is a potent hepatoprotector (vitamin-E to a lesser extent) and should be considered where liver damage is expected secondary to damaging medications; as cyclophosphamide.

Isoliquiritigen enhances the antitumour activity and decreases the genotoxic effect of cyclophosphamide

The aim of this study was to evaluate the antitumour activities and genotoxic effects of isoliquiritigenin (ISL) combined with cyclophosphamide (CP) in vitro and in vivo. U14 cells were treated with either of ISL (5-25 μg/mL) or CP (0.25-1.25 mg/mL) alone or with combination of ISL (5-25 μg/mL) and CP (1.0 mg/mL) for 48 h. The proliferation inhibitory effect in vitro was evaluated by MTT and colony formation assays. KM mice bearing U14 mouse cervical cancer cells were used to estimate the antitumour activity in vivo. The genotoxic activity in bone marrow polychromatic erythrocytes was assayed by frequency of micronuclei. The DNA damage in peripheral white blood cells was assayed by single cell gel electrophoresis. The results showed that ISL enhanced antitumour activity of CP in vitro and in vivo, and decreased the micronucleus formation in polychromatic erythrocytes and DNA strand breaks in white blood cells in a dose-dependent way.

Therapy-related acute myelogenous leukemia with an 11q23/MLL translocation following adjuvant cisplatin and vinorelbine for non-small-cell lung cancer

Cisplatin-based chemotherapy has become an accepted standard in the adjuvant treatment of non-small-cell lung cancer (NSCLC). We present a case of acute myelogenous leukemia with an 11q23/MLL rearrangement diagnosed 1 year after the completion of 4 cycles of cisplatin and vinorelbine for resected NSCLC. To our knowledge, this is the first case of therapy-related acute myelogenous leukemia (t-AML) associated with this chemotherapy combination. The literature on t-AML with the 11q23/MLL rearrangement is reviewed.

Ginsenoside Rh2 Enhances Antitumour Activity and Decreases Genotoxic Effect of Cyclophosphamide

Ginsenoside Rh(2), a panaxadiol saponins, possesses various antitumour properties. Cyclophosphamide, an alkylating agent, has been shown to possess various genotoxic and carcinogenic effects, however, it is still used extensively as an antitumour agent and immunosuppressant in the clinic. Previous reports reveal that cyclophosphamide is involved in some secondary neoplasms. In this study, the antitumour activity and genotoxic effect of oral intake of ginsenoside Rh(2) combined with intraperitoneal injection of cyclophosphamide was investigated. Meanwhile, C57BL/6 mice bearing B16 melanoma and Lewis lung carcinoma cells were respectively used to estimate the antitumour activity in vivo. The clastogenic activity in bone marrow polychromatic erythrocytes was assayed by frequency of micronucleus. The DNA damage in peripheral white blood cells was assayed by single cell gel electrophoresis as well. The results indicated that oral administration of Rh(2) (5, 10 and 20 mg/kg body weight) alone has no obvious antitumour activity and genotoxic effect in mice, while Rh(2) synergistically enhanced the antitumour activity of cyclophosphamide (40 mg/kg body weight) in a dose-dependent manner. Rh(2) decreased the micronucleus formation in polychromatic erythrocytes and DNA strand breaks in white blood cells in a dose-dependent way. Our results suggest that ginsenoside Rh(2) is able to enhance the antitumour activity and decrease the genotoxic effect of cyclophosphamide.

Natural product inhibitors of ovarian neoplasia

The present work constitutes a review of the literature on natural products with potential antitumor activity against ovarian neoplasias. The review refers to five plant extracts and sixty-nine compounds isolated from higher plants and microorganisms, which are classified in appropriate chemical groups and model tested, and cites their activity. Some aspects of recent research with natural products directed to ward producing drugs which are inhibitors of ovarian neoplasia are discussed.