Low dose cepharanthine ameliorates immune thrombocytopenic purpura associated with multiple myeloma

Tabata, Rie; Tabata, Chiharu; Tazoh, Ayako; Nagai, Tomoko

doi:10.1016/j.intimp.2012.04.015

Cited by 23 publications

(17 citation statements)

References 10 publications

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“…CEP therapy, alone or in combination with prednisolone, improves symptoms of chronic immune thrombocytopenia (Takahata et al, 2012). The drug was found to be effective in halting the progression of immune thrombocytopenic purpura in a patient with multiple myeloma (Tabata et al, 2012). A link can be established between the capacity of CEP to inhibit the platelet activation and its capacity to alter phospholipid dynamics and functions.…”

Section: Immuno-modulation -Treatment Of Sepsis Chronic Immune Thrommentioning

confidence: 99%

Cepharanthine: An update of its mode of action, pharmacological properties and medical applications

2019

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A B S T R A C TBackground: Cepharanthine (CEP) is a drug used in Japan since the 1950s to treat a number of acute and chronic diseases, including treatment of leukopenia, snake bites, xerostomia and alopecia. It is the only approved drug for Human use in the large class of bisbenzylisoquinoline alkaloids. This natural product, mainly isolated from the plant Stephania cephalantha Hayata, exhibits multiple pharmacological properties including anti-oxidative, anti-inflammatory, immuno-regulatory, anti-cancer, anti-viral and anti-parasitic properties. Purpose: The mechanism of action of CEP is multifactorial. The drug exerts membrane effects (modulation of efflux pumps, membrane rigidification) as well as different intracellular and nuclear effects. CEP interferes with several metabolic axes, primarily with the AMP-activated protein kinase (AMPK) and NFκB signaling pathways. In particular, the anti-inflammatory effects of CEP rely on AMPK activation and NFκB inhibition. Conclusion: In this review, the historical discovery and development of CEP are retraced, and the key mediators involved in its mode of action are presented. The past, present, and future of CEP are recapitulated. This review also suggests new opportunities to extend the clinical applications of this well-tolerated old Japanese drug.

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Section: Immuno-modulation -Treatment Of Sepsis Chronic Immune Thrommentioning

confidence: 99%

Cepharanthine: An update of its mode of action, pharmacological properties and medical applications

2019

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“…In the case series by Gupta et al ], their patient with concurrent ITP and MM, thrombocytopenia responded to treatment with IVIg and was subsequently started on chemotherapy with VAD for MM treatment. In the case report by Tabata et al [9], initially, the patient was diagnosed with MM with mild thrombocytopenia noted with increased megakaryocytes in the bone marrow. He was treated for MM with melphalan and prednisone but could not receive subsequent rounds of chemotherapy due to severe neutropenic infections.…”

Section: Discussionmentioning

confidence: 99%

“…M proteins in all patients were of IgG type. Four cases (1,6,9,10) were diagnosed with ITP after receiving chemotherapy for MM, while three cases of ITP (4, 5, 11) were diagnosed before MM. As per the literature review, there are only three cases (3,7,8) of Multiple Myeloma and ITP being diagnosed concurrently (2,4,5).…”

Section: Discussionmentioning

confidence: 99%

Multiple myeloma with concurrent immune thrombocytopenic purpura

Sarfraz

Anand

Liu

et al. 2020

ecancer

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Multiple myeloma (MM) is the second most common haematological malignancy in the USA. MM has been linked to various autoimmune disorders in many studies; one systemic review even suggested an increased risk of MM among patients with autoimmune disorders. MM is associated with many haematological, rheumatologic and neurological conditions. A few case reports suggest that MM can be associated with immune thrombocytopenic purpura (ITP), although this is rare. We present a case of MM with concurrent ITP which was refractory of steroids and intravenous immunoglobulin but had a response with anti-neoplastic therapy for MM. We also review all the cases of ITP with MM described in the literature. If conventional treatment for ITP associated with MM fails to improve platelet count, anti-neoplastic therapy for MM should be considered.

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“…Immune dysregulation results from the disruption of signals that regulate normal B cell activation, and age can lead to autoantibody production and autoimmunity; several other possible mechanisms have been proposed for the development of lymphomas in autoimmune diseases. [32][33][34][35] Five out of six of our patients with ITP-associated solid cancer were diagnosed concurrently with ITP (secondary), while only one patient had a diagnosis of primary ITP that preceded the diagnosis TA B L E 4 The characteristics of patients with secondary immune thrombcytpenia (ITP)-associated cancer characteristics The strength of our study is that none of our patients had received any immunomodulatory or immunosuppressive drugs, which could potentially induce lymphomagenicity. The histological subtype analysis showed that three patients had classical HL, with nodular sclerosis in one patient and mixed cellularity in the other two patients.…”

Section: Discussionmentioning

confidence: 99%

Immune thrombocytopenia among patients with cancer and its response to treatment

Yousef

Alawneh

Zahran

et al. 2018

European J of Haematology

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Low dose cepharanthine ameliorates immune thrombocytopenic purpura associated with multiple myeloma

Cited by 23 publications

References 10 publications

Cepharanthine: An update of its mode of action, pharmacological properties and medical applications

Cepharanthine: An update of its mode of action, pharmacological properties and medical applications

Multiple myeloma with concurrent immune thrombocytopenic purpura

Immune thrombocytopenia among patients with cancer and its response to treatment

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