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Therapy-induced neoplasms
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
It has been suggested that the immunodeficiency inherent to CLL may play a role in the subsequently increased risks for lung cancer as well as malignant melanoma.62 Similarly, increased risks of melanoma have been reported in patients with HL26 and NHL45,50,51 – two other lymphopoietic malignancies that are often associated with immune defects.41,63 Whether iatrogenic immunosuppression may enhance lung cancer risk in CLL patients was suggested in one study. Robak et al. reported lung cancer in 7 of 251 CLL patients (2.8 per cent) treated with cladribine and in 7 of 323 CLL patients (2.2 per cent) treated with cladribine and alkylating agents, compared with 3 of 913 CLL patients (0.3 per cent) who received alkyating agents alone (p < 0.001 and p < 0.01, respectively).64 It should be noted, however, that the calculated percentages, which are based on sparse numbers, represent crude estimates. Although the prevalence of tobacco use was comparable in the three described treatment groups, the estimates do not take into account any intergroup differences in age and gender distribution, which were not presented. It has been postulated that cladribine, a nucleoside analogue that has been associated with severe immunosuppressive and infectious complications,65 may add to the inherent immunodeficiency of CLL. However, Cheson et al. reported no increased risk of secondary malignancies among CLL patients given nucleoside analogue therapies.65 Hisada et al. examined the risk of second cancers among CLL patients treated during 1973–89 and 1990–96 in the SEER Programme database, with the former interval representing an era before the widespread use of nucleoside analogues.60 This surrogate measure was used, since data on specific drugs were not available. Risks for all solid tumours combined were comparable in the two calendar year intervals (SIR = 1.19 and 1.29, respectively). Lung cancer risk, however, was not specifically addressed.
Transfusion of blood components in a stem cell transplant programme
Published in Cut Adeya Adella, Stem Cell Oncology, 2018
Another issue to be considered in the patient case study, is the possibility of transfusion associated graft versus host disease (TA-GvHD), caused by the presence of immunocompetent lymphocytes in the donor blood system of immune-compromised patients. This can be prevented by gamma irradiation (25 Gy) of the cellular blood component. Gamma irradiation damages the blood cells that are capable of cell division (monocytes and lymphocytes) to such an extent that they can no longer multiply, and as a result, the mixed lymphocyte culture response disappears. Although it is not known how many immunocompetent lymphocytes are required to elicit TA-GvHD, it has been shown that transfusion of leukocyte reduced components decreases the incidence, but does not protect against TA-GvHD. Therefore, irradiation of cellular blood components are (amongst others):acquired immunodeficiency, as is the case with allogeneic stem cell transplantation (for at least six months after transplantation), if total body irradiation formed part of the conditioning;autologous stem cell transplantation (for at least three months after reinfusion), after use of donor lymphocyte infusion or infusion of cytotoxic T lymphocytes for one year after transfusion;transfusion between first and up to, and including, third degree relatives of cell-containing blood components;leukaemia treatments, where this is required in the protocol (see other considerations);peripheral blood stem cell apheresis from mobilisation until after collection;bone marrow collection from six weeks prior to collection and until after collection;HLA compatible platelet concentrates;use of purine/pyrimidine antagonists and related medication (e.g. Fludarabine, Pentosta- tin and Cladribine) for a year after cessation of the therapy;in the case of anti-T cell treatment (ATG, anti-CD52 and other T cell monoclonals) for aplastic anaemia or leukaemia from the start of administration through to half a year after completion of the treatment;Hodgkin’s lymphoma—some advocate for all stages, others only for stages 3 and 4;non-Hodgkin’s lymphoma.
DFT study on Fe and N decorated graphene as the drug delivery system for β-lapachone anticancer drug
Published in Molecular Physics, 2022
At present, the biggest challenge in β-lap delivery is that traditional polymer micelles usually have ultralow drug-loading capacities which largely reduce the treatment effect [1,14]. Thus, searching for new kinds of nano carriers is a hot topic in drug delivery research. Recently, two-dimensional (2D) materials have received much attention as efficient nano drug deliveries due to their leading properties such as high surface area, proper chemical stabilities, and high mechanical strength [15–19]. For example, functionalized graphene and graphene oxide demonstrated a high delivery efficiency showing great improvement in drug solubility and half-life extension [20–22]. Monolayer BC2N was reported to exhibit high binding energies for β-lap, and at the same time, it also presents high activities in drug release [23]. Additionally, Ni doped graphene was also studied to behave well in ampyra, cladribine, and cyclophosphamide multiple sclerosis drugs adsorptions [24]. Metal doped graphene used in β-lap delivery was also well investigated [25]. Until now, there are lots of kinds of 2D materials being reported as novel drug deliveries including g-C3N4, monolayer BC2N, BN, phosphorene, and so on [15,23,26,27].