Background Osteosarcoma is a relatively common bone tumour; with an incidence of 0.2 to 3/100 000, it is an orphan disease. Mifamurtide has managed to increase survival without increasing side effects. PurposeTo evaluate the safety and efficacy of mifamurtide in two paediatric patients diagnosed with osteogenic sarcoma. Materials and MethodsWe conducted a prospective study of two paediatric patients diagnosed with osteogenic sarcoma. Weekly, we attended the oncology sessions and we tracked them during the chemotherapy, and after that, through the electronic clinical history. Mifamurtide is indicated in children, adolescents and young adults for the treatment of high-grade resectable non-metastatic osteosarcoma after surgical resection. It is used in combination with post-operative chemotherapy. In the two cases, the treatment followed the SEOP-SO-2010 guidelines of the Spanish Society of Paediatric Oncology for 37 weeks. After surgery (week 15) mifamurtide was started as adjuvant treatment: 2 mg/m2 twice weekly for the first 12 weeks and followed by once-weekly for an additional 24 weeks, for a total of 48 infusions in 36 weeks. Results Chemotherapy started according to protocol, the patients were aged 12 and 15 years (July and November 2010, respectively). One patient had a flu-like reaction after the first dose of mifamurtide, so the following doses were administered with premedication (acetaminophen and dexchlorpheniramine). Other side effects: anaemia and thrombocytopenia, requiring human stimulating factors and platelet concentrates; vomiting was treated with aprepitant. When chemotherapy finished, the patients were in complete remission, this situation continues today, 10 and 13 months later. Conclusions The SEOP protocol plus mifamurtide achieved complete remission in both cases. The use of mifamurtide can be considered safe and it did not increase side effects, we observed only a flu-like reaction attributed to mifamurtide which resolved with premedication. The effectiveness of mifamurtide in osteogenic sarcoma treatment cannot be considered as assessed due to the small sample size. No conflict of interest.
Background Romiplostim is a new second-generation thrombopoietic agent that stimulates thrombopoietin receptors and platelet production. Purpose To evaluate the efficacy and safety of romiplostim in a splenectomised man with idiopathic thrombocytopenic purpura (ITP) who had not responded to other treatments. Materials and methods Follow-up over 2 years of treatment with romiplostim in a 64-year-old patient diagnosed with ITP in 2005. Previously high doses of steroids and non-specific intravenous immunoglobulins (IVIG) had been tried with a bad response; the patient was splenectomised in 2007. In spite of treatment with IVIG 2 g/kg and rituximab 375 mg/m2/week the platelet count did not rise. In September 2009 he started romiplostim 1 mcg/kg/week (dose=75 mcg), increasing gradually as indicated in the SPC. The authors evaluated the efficacy through the platelet count (noted in the clinical history), aim: 50–200 109/litre without bleeds. The adverse effects evaluated the safety. Results Splenectomy, treatment with IVIG and rituximab increased the platelet count in a short time to over 50×109/litre; but this count reduced drastically. After the first dose of romiplostim the platelet count rose from 12 to 99×109/litre. The right platelet count was achieved with a dose of 3 mcg/kg (225 mcg) reduced to 150 mcg when the count was over 200×109/litre. During this period the dose was: 19 weeks of 225 mcg, 30 weeks of 150 mcg and 4 weeks of 75 mcg, aligned with the blood test results. During the 2-year follow-up the average platelet count has been 147×109/litre (between 30 and 323×109/litre). There were no episodes of bleeding (hematomas or epistaxis). The only adverse effect has been colds when the dose was administered. Conclusions Romiplostim has proved as an effective option for maintaining the platelet count in this splenectomised patient with ITP who was resistant to other treatments. Romiplostim is well tolerated with no need to reduce the dose because of adverse effects. Although this drug does not cure the disease it improves the quality of life of the patients without causing bleeds.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.