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Antineoplastic Drugs during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
No reports are published of mitomycin use during human pregnancy and infant outcome (Shepard and Lemire, 2010; Schardein, 2000). The frequency of congenital anomalies was increased in several mouse teratology studies that employed several times the usual human therapeutic dose of the drug during pregnancy (Tanimura, 1968; Friji and Nahatsuka, 1983; Gregg and Snow, 1983; Snow and Tam, 1979). Approximately 6 percent of mitomycin crossed the placenta in pregnant rats (Boike et al., 1989). Unpublished embryo studies in mice suggest that at the four-cell embryo stage, mitomycin may have epigenetic effects that was expressed in future generations.
An Overview of Drug-Induced Nephropathies *
Published in Robin S. Goldstein, Mechanisms of Injury in Renal Disease and Toxicity, 2020
Jean Paul Fillastre, Michel Godin
Renal failure was preceded by hemolytic anemia and subsequently a full hemolytic-uremic syndrome occurred. Nephrotoxicity was rarely noted after the first course and generally appeared after the fourth or sixth course. The dosage of mitomycin was the usual 10 to 15 mg/m2. Clinical manifestations included abrupt, severe hemolysis, thrombocytopenia, elevated lactic dehydrogenase, decreased or absent haptoglobin, reticulocytosis, and nucleated erythrocytes and schizocytosis, together with a negative Coombs/test. Proteinuria was detected, lower than 2 g/24 h; nephrotic syndrome was never reported. Hypertension occurred in about half of the cases. Renal failure was of variable severity; the serum creatinine rose up to a final concentration of 10 mg/100 ml over a period of approximately 3 weeks; in 12 cases, the severity of renal failure required immediate hemodialysis. Progression to death was frequent, and renal insufficiency was reported as the cause in many cases. Associated pulmonary or neurological manifestations were of poor prognosis. Blood transfusions could precipitate death.
High-Performance Liquid Chromatography
Published in Adorjan Aszalos, Modern Analysis of Antibiotics, 2020
Joel J. Kirschbaum, Adorjan Aszalos
Mitomycin C in biological fluids was first extracted into ethyl acetate, and after evaporation of this layer, was redissolved in methanol. It could be quantified at concentrations as low as 40 μg/ml using an octadecylsilane column, a mobile phase of methanol-water (35:65) flowing at 1 ml/min, and a detector operated at 365 nm [114]. Responses were linear from 1 to 25 μg mitomycin injected. This system was applied to pharmaceutical preparations using a 254 nm detector [115].
Progress in the use of plasma rich in growth factors in ophthalmology: from ocular surface to ocular fundus
Published in Expert Opinion on Biological Therapy, 2022
E Anitua, B de la Sen-Corcuera, G Orive, RM Sánchez-Ávila, P Heredia, F Muruzabal, J Merayo-Lloves
Corneal haze after photorefractive keratectomy (PRK) surgery is a common side effect triggered by the inflammatory process and myofibroblast proliferation [113]. The use of mitomycin C is an accessible and common treatment for the prevention of this haze formation [114]. However, its use may increase the risk of inducing endothelial damage [115] and diffusion into the bloodstream [116]. A recent study in 44 patients showed that PRGF is as effective as mitomycin C in haze inhibition, while no statistically significant differences were found in reepithelization time or visual acuity outcomes [117]. Moreover, hyperemia eye pain and superficial keratitis were observed in 11.1% of the mitomycin C group requiring additional treatment. No adverse events were observed in the PRGF group assessing its safety profile for intraoperative use in PRK surgeries.
Treatment and prevention of ocular motility restrictions with amniotic membrane transplantation
Published in Strabismus, 2021
Héctor Fernández Jiménez-Ortiz, Raúl Sampedro Yañez, Beatriz Villarrubia Torcal, Borja Maroto Rodriguez, Sara Nava Pérez, Natalia Monja
In the healing process after surgery, although initially beneficial, the repair process becomes pathologic when it is not controlled appropriately.2 When uncontrolled, it results in extracellular deposition of components in which normal tissue is replaced by permanent scar tissue.3 Trophic growth factor β (TGFβ) has been the most intensively studied regulator of the extracellular matrix, it has been linked with the development of fibrosis.8 That is why there is a growing interest of mediators that could be used as antifibrotic therapy,9 although all of them are in experimental phase. These include cytokine,10 chemokine and fibroblast activation antagonists,11 angiogenesis inhibitors, anti-hypertensive drugs, cytokines signaling modifiers,12 B cell-depleting antibodies and stem cell transplantation strategies.13 The demand for antifibrotic drugs that are both safe and effective, is great and will likely continue to increase in the coming years.14 Only AM and Mitomycin C have been used in clinical studies.
Safety considerations with new treatment regimens for anal cancer
Published in Expert Opinion on Drug Safety, 2021
Sarah K Cimino, Kristen K. Ciombor, A Bapsi Chakravarthy, Christina E. Bailey, M Benjamin Hopkins, Timothy M. Geiger, Alexander T. Hawkins, Cathy Eng
An interdisciplinary team approach is essential to mitigate risks associated with the treatments for anal cancer. Some of the specific concerns with chemoradiation include chemotherapy and radiation-related toxicities. Mitomycin has been associated with profound myelosuppression which may lead to neutropenic infections or other complications [10]. Therefore, it is recommended that doses of mitomycin do not exceed 12 mg/m2 and are also capped at a maximum dose of 20 mg [12]. In addition, radiation has established risks including acute and delayed toxicities. Furthermore, in the metastatic setting, carboplatin and paclitaxel can both be associated with life-threatening hypersensitivity reactions, and immunotherapy may lead to overactivation of the immune system and subsequent thyroiditis, colitis, or pneumonitis. Further details regarding safety considerations for the current treatments of anal cancer are listed in Tables 1 and 2.