Stabilization of bone marrow infiltration by metastatic breast cancer with continuous doxorubicin

Pahouja, Gaurav; Wesolowski, Robert; Reinbolt, Raquel E.; Tozbikian, Gary; Berger, Michael; Mangini, Neha; Lustberg, Maryam B.

doi:10.1016/j.ctrc.2014.11.002

Cited by 12 publications

(16 citation statements)

References 27 publications

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“…The changes in the blood cells especially erythrocytes, platelets, and leucocyte count were all DOX dose dependent and were consistent with the findings reported by Manno et al [ 5 ]; Tacar et al [ 51 ], which could be attributed to the known bone marrow suppressive effect of DOX and iron-DOX interaction, thus causing RBC membrane rupture as previously reported by Vici et al [ 52 ] and Pahouja et al [ 53 ] since DOX did not limit its effects not only to cancer cell alone but also to proliferating haematopoietic cells.…”

Section: Discussionsupporting

confidence: 91%

Toxicity and Safety Evaluation of Doxorubicin-Loaded Cockleshell-Derived Calcium Carbonate Nanoparticle in Dogs

Danmaigoro

Selvarajah

Noor

et al. 2018

Advances in Pharmacological Sciences

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Doxorubicin (DOX) is a potent anticancer agent with cytotoxic effects which limit its clinical usage. This effect is due to its nonselective nature causing injury to the cells as a result of reactive free oxygen radical's release. Cockleshell-derived calcium carbonate nanoparticle (CS-CaCO3NP) is a pH-responsive carrier with targeted delivery potentials. This study aimed at evaluating the toxicity effects of repeated dose administration of DOX-loaded CS-CaCO3NP in healthy dogs. Fifteen dogs with an average body weight of 15 kg were randomized equally into 5 groups. Dogs were subjected to 5 doses at every 3-week interval with (i) normal saline, (ii) DOX, 30 mg/m2, and the experimental groups: CS-CaCO3NP-DOX at (iii) high dose, 50 mg/m2, (iv) clinical dose, 30 mg/m2, and (v) low dose, 20 mg/m2. Radiographs, electrocardiography, and blood samples were collected before every treatment for haematology, serum biochemistry, and cardiac injury assessment. Heart and kidney tissues were harvested after euthanasia for histological and ultrastructural evaluation. The cumulative dose of DOX 150 mg/m2 over 15 weeks revealed significant effects on body weight, blood cells, functional enzymes, and cardiac injury biomarkers with alterations in electrocardiogram, myocardium, and renal tissue morphology. However, the dogs given CS-CaCO3NP-DOX 150 mg/m2 and below did not show any significant change in toxicity biomarker as compared to those given normal saline. The study confirmed the safety of repeated dose administration of CS-CaCO3NP-DOX (30 mg/m2) for 5 cycles in dogs. This finding offers opportunity to dogs with cancer that might require long-term administration of DOX without adverse effects.

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Section: Discussionsupporting

confidence: 91%

Toxicity and Safety Evaluation of Doxorubicin-Loaded Cockleshell-Derived Calcium Carbonate Nanoparticle in Dogs

Danmaigoro

Selvarajah

Noor

et al. 2018

Advances in Pharmacological Sciences

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“…Bone marrow metastasis can frequently occur following development of metastatic breast cancer. [ 10 , 11 ] However, anemia and thrombocytopenia as the herald of breast cancer are not typically seen. Cases of breast cancer related microangiopathic hemolytic anemia (MAHA) has been reported, albeit rarely.…”

Section: Discussionmentioning

confidence: 99%

Anemia and thrombocytopenia as initial symptoms of occult breast cancer with bone marrow metastasis

Liu¹,

Zhang

Chen³

et al. 2017

Medicine

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Rationale:Occult breast cancer (OBC) is a rare type of breast cancer without any symptoms in the breast and is often presented with initial symptoms of axillary lymph node metastasis or other metastases. The low incidence rates of OBC make it a great challenge to diagnose and cure.Patient concerns:Our case was a 58-year-old female affected by dizziness and fatigue for nearly a month. Blood tests revealed anemia and thrombocytopenia, and pathological results of a bone marrow biopsy confirmed the metastatic carcinoma.Diagnoses:It was diagnosed as an OBC based on the positive immunohistochemical staining of cytokeratin (CK) and gross cystic disease fluid protein-15 (GCDFP-15).Interventions:Doctor advised her to check whether the bone metastases existed in order to choose an appropriate treatment. It is highly regrettable that the patient gave up all treatments and left the hospital.Outcomes:Recently, we conducted a telephone follow-up and received that the patient only took tramadol and other painkilling drugs to alleviate the pain caused by cancer.Lessons:The current case inferred that symptoms of anemia and thrombocytopenia should not be ignored for the diagnosis of OBC, and bone marrow biopsy is useful in reducing the rates of misdiagnosis and missed diagnosis of OBC.

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“…[6][7][8] Bone marrow infiltration by cancer cells is reported in solid tumors and the prognosis in patients presenting with pancytopenia is poor. [9][10][11][12][13][14] Hiroshige and Eguchi reported two cases of metastatic castrate-sensitive prostate cancer with bone marrow infiltration, moderate thrombocytopenia, and disseminated intravascular coagulation (DIC). 10 Both patients were treated with ADT with improvement in thrombocytopenia and DIC.…”

Section: Discussionmentioning

confidence: 99%

“…There are two case reports of breast cancer patient with severe pancytopenia treated with cytotoxic chemotherapy with significant improvement in pancytopenia. 13,14 Romiplostim is a thrombopoietin agonist approved for the treatment of immune thrombocytopenia. A retrospective study showed that the use of romiplostim prevented chemotherapy-induced delays.…”

Section: Discussionmentioning

confidence: 99%

A castrate-resistant metastatic prostate cancer patient with severe pancytopenia, successfully treated with docetaxel chemotherapy

Kunthur

2019

J Oncol Pharm Pract

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Introduction Prognosis of metastatic castrate-resistant prostate cancer is poor with a median survival of 12 to 36 months. Bone metastasis is common, and bone marrow metastasis occurs later in the disease course. The median survival in these patients after bone marrow involvement is less than six months. We report a case of castrate-resistant prostate cancer patient presented with severe pancytopenia due to bone marrow involvement of prostate cancer, treated successfully with docetaxel chemotherapy. Post chemotherapy, the patient became transfusion independent and prostate-specific antigen improved to 0.1 ng/ml from 1051 ng/ml. Case report A 70-year-old gentleman with a history of metastatic prostate cancer on androgen deprivation therapy and polycythemia vera presented to emergency room with dizziness and melena. Workup revealed severe pancytopenia with platelet count of 12k and hemoglobin of 4.5 gm/dl. Bone marrow biopsy confirmed diffuse involvement of bone marrow with prostate cancer. Prostate-specific antigen was 1051 gm/dl. Management and outcome: The patient received 14 units of packed red blood cell, 10 units of platelet transfusion within one week. Docetaxel chemotherapy was started along with thrombopoietin agonist romiplostim and pegylated filgrastim. He received five cycles of docetaxel treatment. Post chemotherapy, the patient became transfusion independent and prostate-specific antigen improved to 1.17 ng/ml from 1051 ng/ml. The patient is still alive one year after the presentation with good quality of life and the prostate-specific antigen further improved to 0.1 ng/dl. Conclusion This case suggests that selected patients with severe pancytopenia, due to bone marrow infiltration of prostate cancer, can be treated with docetaxel chemotherapy and romiplostim support with significant response. Docetaxel treatment may be beneficial to unpack the marrow and for quicker response in patients with good performance status.

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Stabilization of bone marrow infiltration by metastatic breast cancer with continuous doxorubicin

Cited by 12 publications

References 27 publications

Toxicity and Safety Evaluation of Doxorubicin-Loaded Cockleshell-Derived Calcium Carbonate Nanoparticle in Dogs

Toxicity and Safety Evaluation of Doxorubicin-Loaded Cockleshell-Derived Calcium Carbonate Nanoparticle in Dogs

Anemia and thrombocytopenia as initial symptoms of occult breast cancer with bone marrow metastasis

A castrate-resistant metastatic prostate cancer patient with severe pancytopenia, successfully treated with docetaxel chemotherapy

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