The combination of hepatitis B immunoglobulin and potent nucleos(t)ide analogs after liver transplantation is considered as the standard of care for prophylaxis against hepatitis B virus recurrence. However, the recommended doses, route of administration, and duration of HBIG administration remain unclear. Moreover, hepatitis B immunoglobulin-free prophylaxis with potent nucleos(t)ide analogs has shown promising disease outcomes in preventing hepatitis B virus recurrence. The current recommendations, produced by the Turkish Association for the Study of the Liver, Acute Liver Failure and Liver Transplantation Special Interest Group, suggest a reduced need for hepatitis B immunoglobulin administration with effective long-term suppression of hepatitis B virus replication using potent nucleos(t) ide analogs after liver transplantation.
Introduction Acute toxic leukoencephalopathy (ATL) is a rare complication of cancer treatment, with symptoms varying from mild cognitive impairment to coma. Recognition and management of ATL are important because in most cases, the cessation of the responsible agent is essential. Case report We report a case of a 57-year-old male with relapsed right colon cancer who had multiple steps of chemotherapy, admitted to the emergency department (ED) with confusion and inability to talk, 4 days after FOLFIRI and bevacizumab treatment. To exclude cerebrovascular events cranial computed tomography and diffusion-weighted magnetic resonance imaging were evaluated. There was bilateral and symmetric diffusion restriction on white matter, which was consistent with ATL. Management and outcome Supportive treatment such as optimization of blood pressure and metabolic control was applied since there is no specific treatment for ATL other than cessation of the responsible agents. 12 days after the admission to the ED his neurologic symptoms were normalized and there was no diffusion restriction on control imaging. Discussion ATL is a rare complication of cancer treatment and responsible agents are increasing in number due to the development of cancer treatment. ATL is associated with drugs that are used frequently such as 5-fluorouracil. ATL is mostly reversible, but the progression of neurologic symptoms was also reported. The diagnosis and cessation of the responsible agent are important in management.
Amaç: Multipl miyelom (MM) hastalarında hepatit B virüsü (HBV) infeksiyon prevalansı %6-19 arasında değişmektedir ve otolog hematopoietik kök hücre nakli (HKHN) sonrası ters serokonversiyon sıklığı bilinmemektedir. Biz bu retrospektif çalışmada HBV reaktivasyon ve hepatotoksisite sıklığının belirlenmesini amaçladık.
Background: This study aims to assess the effect of primary tumour resection (PTR) on patients with metastatic colorectal cancer (mCRC) treated with cetuximab. Methods: This retrospective cohort study was conducted in a tertiary cancer center in Turkey. Patients with mCRC between January 2009 and December 2020 were extracted from the electronic hospital management system. Patients with RAS wild-type synchronous metastatic left-sided colon or rectum cancer who had cetuximab-containing treatment protocol were included in the study. The primary outcomes were overall survival (OS) and progression-free survival (PFS). The secondary outcome was response rates. Results: A total of 111 patients with mCRC were included in this study. PTR was performed in 57.7% of all patients. Fifty-nine (53.2%) and 52 (46.8%) patients had rectal and left colon tumours, respectively. The combination treatment with cetuximab was FOLFIRI in 62.2% and FOLFOX in 29.7% of all patients. In subgroup analysis, the median PFS was 7.9 and 9 months in PTR (+) and PTR (À) patients, respectively. The difference between the groups was not statistically significant (P = 0.3). The median OS was 33 months in all patients. In subgroup analysis, the median OS was 39 and 27.9 months in PTR (+) and PTR (À) patients, respectively. The difference between the groups was statistically significant (P = 0.002). After adjusting for confounding factors, PTR and ECOG performance score were the independent prognostic factors for OS. Conclusion: PTR improved the OS in patients with RAS wild-type synchronous left-sided colon or rectum cancer treated with cetuximab-containing chemotherapy regimens.
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