عنوان : بررسي تاثير پروتوكول درماني 5 فلوئوراسيل و فولينيك اسيد در كانسر پيشرفته كولوركتال در دو بيمارستان دانشگاهي

نويسنده ، نويسندگان : بهمن شفائيان ، محمدرضا قنواتي ، منوچهر كيهاني

نشاني : دانشگاه علوم پزشكي تهران

مقدمه و اهداف :

كانسر كولوركتال سومين كانسر شايع مردان و شيوع آن در ايران رو به افزايش است . 30 بيمار مبتلا به كانسر پيشرفته كولوركتال تحت درمان با فلوئور اوراسيل و فولينيك اسيد قرار گرفتند .

فلوئوراوراسيل يك گرم روزانه و فولينيك اسيد 90 تا 120 ميلي گرم روزانه به مدت 4 روز به فواصل 25 روز براي 6 ماه تجويز گرديد .

84 % بهبود در علائم

36% كاهش در ميزان سطح خوني CEA مشاهده گرديد .

22 ماه بقاء عمر عاري از بيماري

18 ماه بقاء عمر پس از عود بيماري ديده شد .

رژيم درماني فلوئوراوراسيل و فولينيك اسيد در درمان سرطان پيشرفته كولون و ركتوم موثر و مناسب است .

Title of Article : Evaluation of Efficacy and T oleability of 5 Fluoro-Unacil and Folinic acid in Advanced Colorectal cancer .

Author(s) : B. Shafayan,M.Ghanavati

Address : Amir – Alam Hospital . Saadi street . Tehran Tel : 6708103

Introduction & Objectives :

Colo-fectal cancer the third mot common in men shows increased incidence in Iranian people younger han 30 .

30 patients were treated with 5 FU 1 gr daily and Folinic acid 90-120 my/day for four days every month up to 6 six months .

Five cases of diarrhea , one case of chest pain and one case of cevere neutropenia encounterd and all were recovered .

84% symptomatic response , 36% lecrease in CEA levels , 22 months Event free survival and 18 months survival after relapae were encountered .

This combination chemotherapy is an effective protocol for the management of advanced colo-rectal cancer .

Title of Article : Fr 8/9 , IVSInt6 AND IVSInt 110 ARE ASSOCIATED WITH 4 FOUR DIFFERENT HAPLOTYPES IN IRANIAN POPULATION

Author( s): Zeinali.S-Lotfi.V-Zeinali.Mo – Masrouri .M – Zeinali . M

Address : Medical genetics Lab of Dr .Zeinali, Leon Build fatemi sq TEHRAN , IRAN

E.mail : zeinali@institute . Pasteur.ac.Ir , Tel : 0218956343

Introduction & Objectives :

B-thalassemia is the maor hereditry blood disorder in the country .Prenatal diagnosis (PND) have become an important tool to prevent the birth of an affected child . There are two main methods for performing PND , direct mutation analysis and indirect method using polymorphic markers like RFLPs . In this regard we analysed the association of several beta-globin linked RFLP and three mutations known to cause beta-thalassemia .

Method :

We used a modified method for analyzing three beta-globin linked RFLPs by ARMS method . In this method no restriction enzyme is needed and the result is accurate and quick .

Results :

We compared haplotype ssociation of three β-globin linked RFLPs (i.e HincII/3’ψ β , AvaII/ β and Hinf I/ β ) with three β-globin gene mutations (i.e. Fr 8/9 , IVSInt6 and IVSInt 110 ) in 100 cases of PND using a modified ARMS tehnique to analyse known RFLPs . Couples reffered for PND were screened for 17 mutations routinely tested in IRAN and the above 3 RFLPs. We found that Fr 8/9 mutation was associated with 4 different haplotypes [i.e+ - +(4chromosomes ) - - + , - + + and + + + ( 2 chromosomes each) , IVSInt6 was ongly associated with - - + (5 choromosomes ) and IVSInt 110 was associated with - + + (4 chromosomes ) and + + + (3 choromosomes ) haplotypes respectively . Due to low number of cases for these mutations the real value of these associations can not be defermind ard have to be judged against the frequeancies of these haplotypes in normal Iranian population ( see our abstract for normal Iranians ) .

Title of Article : A GLANCE TO SEQUENTIAL HIGH-DOSE AGGRESSIVE CHEMOTHERAPY FOR ADULTS WITH AML

Author(s) : Dr.B.Najafi , A.Ghavamzadeh , M.Jahani , B.Najafi , K.Alimoghaddam , B.Bahar , A.Khodabandeh , E.Baybordi , M.Irvani , N.Aghdami , B.Khoien , and P.Tavassoli .

Address : Hematology – Oncology and BMT Research Center , Shariati Hospital Karegar 14114 , Tehran , Iran Tehran University of Medical Sciences

Tel : +98(21)8029390 Fax : +98(21)80004140

E-mail c/o arshamshiri@hotmail.com

Introduction & Objectives :

Given preliminary evidence of Timed sequential chemotherapy of high dose cytosine arabinoside the current study was initiated to assess the side effects and efficacy of this regimen in pstients with newly AML .

Methods and materials :

19 adults enrolled the case series from Aug 1999 to Nov 2000 . All patients had a Kornofski classification above 60% with adequate cardiopulmonary and hepatorenal function . At this time induction therapy consisted of ARA-C 100mg/m² intravenously by continuous infusion on days 1-7 , and Dounorubicin of Idarubicin given at a dose of 60 mg/m² and 12 g/m² IV respectively on days 1-3 , followed by ARA-C 1000mg/m² given on day 8-10 every 12 hours by IV infusion .

Consolidation therapy started after 35^th day which was comprised of ARA-C 100 mg/m² for 5 days and Dounorubicin or Idarubicin given at the same mentioned dose on days 1-2 followed by ARA-C 1000mg/m² given on day 6-7 .

Results :

Of 19 fully evaluable patients , 15 pateints (83.3 % , 95% CI , 51.6-97.9 ) achieved a complete rmission , whereas 6/19 patients (26.3% ) succumbed to death ( befor consolidation therapy ) due to regeneration failure . There was no early death before 10 days of induction therapy . One patient was excluded because of intolerance to regimen . In consolidateion phase there was one death on 44^th day of chemotherapy . The clinical data show the Overall survival rate from diagnosis is 55.5% ( 95% CI, 30.8-78.5 ) at 6 months for the entire cohort of the patients . Disease free survival (DFS) is also 50% (95% CI , 26-74 ) .

The causes of death were CNS hemorrhage in 1 patient , Sepsis in 5 due to treatment was 20 days (range 17-29 ) after beginning the regimen .

The median duration of meutropenia (<500/L) and thrombocytopenia (<20,000 / L ) were 19 and 28 days . WBC counts , French-Amirican-British Fever , diarrhea , nausea and vomiting and GI hemorrhage was seen in 15 6,4,7 patients respectively .

Conclusions :

It seems the 3+7+3 regimen is a promising approach for the AML patients regarding to high Complete Remission (CR) rate , but more supportive care should be considered . Furthermore any benefit in long-term outcome cannot be determined without regard to the choice of post remission therapy (eg, GCSF , appropriate Antibiotics , . . . ) .