Secondary Raynaud's phenomenon and other late vascular complications following chemotherapy for testicular cancer

Berger, C; Bokemeyer, Carsten; Schneider, Manuela; Kuczyk, M.; Schmoll, H.-J.

doi:10.1016/0959-8049(95)00460-2

Cited by 97 publications

(53 citation statements)

References 35 publications

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“…Only two of ten patients with elevated FSH levels who were also studied before ctx had previously shown elevated FSH values. The occurrence of gonadal toxicity correlated significantly with cisplatin-induced neuro-and ototoxicity in our patients, confirming the impact of cisplatin-based ctx on gonadal impairment (Berger et al, 1995;Bokemeyer et al, 1993).…”

Section: Materials and Methods Patientssupporting

confidence: 86%

“…The frequency of cholesterol elevations in 32% of our patients was accordingly higher than would normally be expected in a rather young population and age-stratified comparisons with reference groups (Assmann et al, 1986) showed significantly higher cholesterol levels especially in the 19-29 year-old patients. This finding is of concern as an increased incidence of arterial hypertension and of myocardial infarctions after ctx for testicular cancer has been postulated (Berger et al, 1995;Bissett et al, 1990;Gietema et al, 1992;Roth et al, 1988;Schwabe et al, 1992 …”

Section: Materials and Methods Patientsmentioning

confidence: 98%

“…The interactions between these hormones and cholesterol metabolism may influence the risk of cardiovascular disease. Cases of myocardial infarctions have been observed in the young cohort of patients treated for testicular cancer (Berger et al, 1995;Roth et al, 1988).…”

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confidence: 99%

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Endocrinological late effects after chemotherapy for testicular cancer

Berger

Bokemeyer²,

Schuppert³

et al. 1996

Br J Cancer

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Summary Type and extent of endocrinological alterations were studied in long-term disease-free survivors after cisplatin-based chemotherapy for testicular cancer. A total of 63 patients with a median age of 30 (19 -53) years, and median follow-up of 42 (16-128) months were included. Elevated serum follicle-stimulating hormone (FSH) levels were found in 63% of patients, 24% showed pathologically elevated luteinising hormone (LH) levels with normal and 10% with subnormal testosterone levels. The degree of gonadotropin elevation was highly significantly correlated with the cumulative platinum (P) dose. Patients treated with platinumvinblastine -bleomycin regimens showed higher gonadotropin levels than those treated with platinumetoposide-bleomycin. The adrenal androgen dehydroepiandrosterone (DHEA), pathologically elevated in 68% of patients, was significantly correlated with the cumulative doses of chemotherapy (ctx) used and to the gonadotropin levels. Treatment variables, such as type and dose of cytotoxic agents used, as well as degree of gonadotropin elevation were further correlated with changes in oestron, testosterone and 17a-OH-progesterone levels. Cholesterol levels were elevated in 32% of patients and significant interactions between the steroid hormone levels and cardiovascular risk factors could be shown.

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Section: Materials and Methods Patientssupporting

confidence: 86%

Section: Materials and Methods Patientsmentioning

confidence: 98%

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Endocrinological late effects after chemotherapy for testicular cancer

Berger

Bokemeyer²,

Schuppert³

et al. 1996

Br J Cancer

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“…Recent evidence also shows that mechanical allodynia and thermal hyperalgesia in CIPN rats can be alleviated by systemic treatment with agents that reduce reactive oxygen 20 and nitrogen 22 species, both of which are elevated in association with microvascular dysfunction. Clinically, in addition to CIPN it has often been reported that chemotherapy induces Raynaud's phenomenon 4,5,86 , a condition where patients develop poor capillary blood flow in the fingers and toes. Evidence indicates that this complication of chemotherapy can be treated with spinal cord stimulation 86 (which increases peripheral blood flow) or with PDE5 inhibitors, which were shown to increase blood flow 4 .…”

Section: Discussionmentioning

confidence: 99%

Topical Combinations Aimed at Treating Microvascular Dysfunction Reduce Allodynia in Rat Models of CRPS-I and Neuropathic Pain

Ragavendran

Laferrière

Xiao

et al. 2013

The Journal of Pain

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Growing evidence indicates that various chronic pain syndromes exhibit tissue abnormalities caused by microvasculature dysfunction in the blood vessels of skin, muscle or nerve. We tested whether topical combinations aimed at improving microvascular function would relieve allodynia in animal models of complex regional pain syndrome type I (CRPS-I) and neuropathic pain. We hypothesized that topical administration of either α 2 -adrenergic (α 2A ) receptor agonists or nitric oxide (NO) donors combined with either phosphodiesterase (PDE) or phosphatidic acid (PA) inhibitors would effectively reduce allodynia in these animal models of chronic pain. Single topical agents produced significant dose-dependent anti-allodynic effects in rats with chronic post- CIHR Author ManuscriptCIHR Author Manuscript CIHR Author Manuscript ischemia pain, and the anti-allodynic dose-response curves of PDE and PA inhibitors were shifted 2.5-10 fold leftward when combined with non-analgesic doses of α 2A receptor agonists or NO donors. Topical combinations also produced significant anti-allodynic effects in rats with sciatic nerve injury, painful diabetic neuropathy and chemotherapy-induced painful neuropathy. These effects were shown to be produced by a local action, lasted up to 6 h after acute treatment, and did not produce tolerance over 15 days of chronic daily dosing. The present results support the hypothesis that allodynia in animal models of CRPS-I and neuropathic pain is effectively relieved by topical combinations of α 2A or NO donors with PDE or PA inhibitors. This suggests that topical treatments aimed at improving microvascular function may reduce allodynia in patients with CRPS-I and neuropathic pain.Perspective-This article presents the synergistic anti-allodynic effects of combinations of α 2A or NO donors with PDE or PA inhibitors in animal models of CRPS-I and neuropathic pain. The data suggest effective clinical treatment of chronic neuropathic pain may be achieved by therapies that alleviate microvascular dysfunction in affected areas.

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“…Following doxorubicin administration, we observed an acute reduction in ovarian blood flow and impairment in blood vessel walls [10]. Few studies have addressed the issue of chemotherapy-induced vascular toxicity as a precursor to acute and late organ toxicity and cardiovascular complications as well as a possible contributor to the initiation and progression of atherosclerosis [11][12][13]. In patients with disseminated testicular cancer treated with the bleomycin, etoposide, and cisplatin regimen, an increase in plasma von Willebrand factor (vWF) levels and common carotid intima media thickness (IMT) were noted [13].…”

Section: Introductionmentioning

confidence: 99%

Chemotherapy-Induced Ovarian Failure as a Prototype for Acute Vascular Toxicity

Ben‐Aharon

Meizner

Granot³

et al. 2012

The Oncologist

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Background. Chemotherapy-related amenorrhea is a frequent side effect observed in young breast cancer patients. Studies in mice revealed that chemotherapy-induced gonadal toxicity may result from vascular damage. We prospectively evaluated ovarian blood flow and function in young breast cancer patients following chemotherapy.Methods. Young female patients with localized breast cancer undergoing adjuvant or neoadjuvant anthracycline-or taxane-based chemotherapy were evaluated using transvaginal ultrasound prior to initiation of and immediately after cessation of chemotherapy. Doppler-flow velocity indices of the ovarian vasculature-resistance index (RI), pulsatility index (PI)-and size measurements were visualized. Hormonal profiles, anti-Mü llerian hormone (AMH) levels, and menopausal symptoms were assessed at the same time points.Results. Twenty breast cancer patients were enrolled in the study. The median age was 34 ؎ 5.24 years. Ovarian blood

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Secondary Raynaud's phenomenon and other late vascular complications following chemotherapy for testicular cancer

Cited by 97 publications

References 35 publications

Endocrinological late effects after chemotherapy for testicular cancer

Endocrinological late effects after chemotherapy for testicular cancer

Topical Combinations Aimed at Treating Microvascular Dysfunction Reduce Allodynia in Rat Models of CRPS-I and Neuropathic Pain

Chemotherapy-Induced Ovarian Failure as a Prototype for Acute Vascular Toxicity

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