Bismuth adjuvant ameliorates adverse effects of high-dose chemotherapy in patients with multiple myeloma and malignant lymphoma undergoing autologous stem cell transplantation: a randomised, double-blind, prospective pilot study
| Autor: | Milena Penkowa, Per Boye Hansen |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Transplantation Conditioning Lymphoma medicine.medical_treatment Pilot Projects Transplantation Autologous Double blind 03 medical and health sciences High dose chemotherapy 0302 clinical medicine Autologous stem-cell transplantation Double-Blind Method medicine Neoplasm Humans Prospective Studies Adverse effect Multiple myeloma Aged business.industry Hematopoietic Stem Cell Transplantation Middle Aged medicine.disease Surgery 030104 developmental biology Treatment Outcome Oncology 030220 oncology & carcinogenesis Female Stem cell business Multiple Myeloma Adjuvant Bismuth |
| Zdroj: | Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 25(4) |
| ISSN: | 1433-7339 |
| Popis: | High-dose chemotherapy prior to autologous stem cell transplantation (ASCT) leads to adverse effects including mucositis, neutropenia and bacteremia. To reduce the toxicity, we treated myeloma and lymphoma patients with peroral bismuth as an adjuvant to chemotherapy to convey cytoprotection in non-malignant cells.This trial was a prospective, randomised, double-blind, placebo-controlled pilot study of hematological inpatients (n = 50) receiving bismuth or placebo tablets, in order to identify any potential superiority of bismuth on toxicity from chemotherapy.We show for the first time that bismuth significantly reduces grade 2 stomatitis, febrile neutropenia and infections caused by melphalan in multiple myeloma, where adverse effects also were significantly linked to gender. In lymphoma patients, bismuth significantly reduces diarrhoea relative to placebo. Also, lymphoma patients' adverse effects were linked to gender. For the first time, bismuth is demonstrated as a safe strategy against chemotherapy's toxicity without interfering with intentional anti-cancer efficiency. Also, we show how gender significantly influences various adverse effects and response to treatment in both multiple myeloma and malignant lymphomas.These results may impact clinical prevention of chemotherapy's cytotoxicity in certain patient groups, and also, this study may direct further attention towards the impact of gender during the course and treatment outcome of malignant disorders. |
| Databáze: | OpenAIRE |
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