OBJECTIVE: To examine the influence of erythropoietin (Epokaine prefil(R)) on transfusion requirements, serum hemoglobin levels in patients with gynecologic malignancies under polychemotherapy and chemotherapy associated anemia. METHODS: From January 2001 to March 2003, 70 patients treated with chemotherapy due to gynecologic cancer from Severance hospital were included into this study. Patients were assigned to one of two groups (case group (n=28) and control group (n=42)). Patients in case group received 2000 U or 6000 U Epokaine(R) subcutaneously two or three times a week for more than 3 cycles (9 weeks), and patients in control group didn't received Epokaine(R) (n=42). If the hemoglobin levels of 1st, 2nd and 3rd cycle >1 g/dL above the baseline value and/or >12 g/dL, patients were classified as responders. Patients who required blood transfusions or if the hemoglobin levels of 1st, 2nd and 3rd cycle <1 g/dL were as non-responders. RESULTS: 28 cases of 70 patients were assessable for response and complication to Epokaine(R) application. In the Epokaine(R) group, 53%, 64%, 71% of the patients responded to the treatment (at 1st, 2nd and 3rd cycle, respectively) and only 7 patients (21.4%) required blood transfusions, whereas 28 patients in control group (66.7%) needed transfusion. Mean transfused units were 1.56 in case group and 3.55 in the control group (P=0.03). In case group, mean hemoglobin levels were significantly increased after the 1st, 2nd and 3rd cycle of chemotherapy (0.73 g/dL, 1.34 g/dL, 1.65 g/dL, respectively) compared with the mean baseline value. CONCLUSION: We concluded that Epokaine(R) significantly decreases transfusions requirements and increases serum hemoglobin levels in patients with gynecological malignancies who are undergoing polychemotherapy. Therefore, Epokaine(R) would be effective in the treatment of anemia of gynecologic cancer patients receiving polychemotherapy.
Anemia* ; Blood Transfusion ; Drug Therapy ; Drug Therapy, Combination ; Erythropoietin* ; Humans*

Anemia is one of the important causes compromising normal growth, development, and immune function in children. In outpatient clinics, we can see patients with anemia caused by various etiologies, whether congenital or acquired. Most cases of childhood anemia are caused by incomplete supplements of nutrients for erythropoiesis, despite the improved socioeconomic situation. Sometimes we need to treat the underlying diseases to correct the anemia. Also, we have to evaluate the etiology of anemia according to age, and consider medical treatments on the basis of the underlying causes. In this article, the author reviews pharmacotherapy in childhood anemia.
Ambulatory Care Facilities ; Anemia* ; Child ; Drug Therapy* ; Erythropoiesis ; Humans

PURPOSE: To evaluate the therapeutic activity and safety of paclitaxel and cisplatin combination chemotherapy in patients with advanced or metastatic gastric cancers that are unresponsive to primary chemotherapy. MATERIALS AND METHODS: Advanced or metastatic gastric cancer patients unresponsive to first line chemotherapy were entered into this trial. The treatment regimen consisted of paclitaxel, 175 mg/m(2) by 3-hour infusion on day 1, and cisplatin, 60 mg/m(2) by 1 hour infusion on day 1, with the treatment repeated every 3 weeks. RESULTS: 37 patients were entered in this study, with 32 fully evaluable for response. 4 (13%), 13 (40%) and 15 (47%) patients achieved a partial response, stable disease and progressed, respectively. The median time to progression was 4.0 months (95% CI: 2.0~6.0 months), and the median overall survival was 12.6 months (95% CI: 5.5~19.7 months), with a 1-year survival rate of 54%. Of a total of 135 cycles of chemotherapy, grades 3 and 4 hematological toxicities were neutropenia (14%) and anemia (3%). Grade > or =2 neuropathy was observed in 6 patients (17%). CONCLUSION: The combination of paclitaxel and cisplatin is an effective and tolerable salvage treatment modality for advanced gastric cancer.
Anemia ; Cisplatin* ; Drug Therapy ; Drug Therapy, Combination ; Humans ; Neutropenia ; Paclitaxel* ; Salvage Therapy* ; Stomach Neoplasms* ; Survival Rate

Cold agglutinin disease is a kind of autoimmune hemolytic anemia, caused by cold agglutinin, serum autoantibodies activated at reduced body temperatures to produce red blood cell agglutination and hemolysis. In this paper we described a case of severe hemolytic anemia in a cold agglutinin disease patient treated with therapeutic plasma exchange. Therapeutic plasma exchanges were performed four times every other day. Over the same period, a total of 8 units of washed red blood cells were transfused. Then hemoglobin was increased from 4.0 g/dL to 7.8 g/dL. On the 12th hospital day hemoglobin level was decreased again to 4.2 g/dL and fludarabine chemotherapy was started on the 14th hospital day. The patient's symptoms were relieved and she was discharged on the 30th hospital day. As in this case, therapeutic plasma exchange could be considered as secondary therapy for temporary improvement of acute severe hemolytic anemia in cold agglutinin disease.
Agglutination ; Anemia, Hemolytic ; Anemia, Hemolytic, Autoimmune* ; Autoantibodies ; Body Temperature ; Drug Therapy ; Erythrocytes ; Hemolysis ; Humans ; Plasma Exchange*

OBJECTIVE: To investigate the efficacy and safely of DAC and CAG/HAG preexcitation chemotherapy regimens for the treatment of patients with MDS-RAEB (refractory anemia with excess blasts, RAEB). METHODS: The clinical data of 86 MDS-RAEB patients were analyzed retrospectively from February 2014 to February 2018. According to therapeutic regimem, the 86 patients were divided into 2 groups: group A (41 patients) with DAC preexcitation chemotherapy regimen, and group B (45 patients) with CAG/HAG preexcitation chemotherapy regimen; and the disease control effect, effective treatment course, median survival time and incidence of adverse reactions were compared between these 2 groups. RESULTS: The CR rate and ORR rate were not significantly different between these 2 groups (P＞0.05). The mCR rate in group A was significantly higher than that in group B (P＜0.05). The numbers of cases obtained therapeutic efficacy at 2 rd and 3 rd conrse in group A significantly more than those in group B (P＜0.05), but the number of cases obtained efficacy at 1 st course in group B was significantly higher than that in group A (P＜0.05). The median OS time was not significanly different between 2 groups (P＞0.05). The duration of neutrophils deficiency in group A was significantly shorter than that in group B (P＜0.05). The transfusion volume of red blood cells and platelets in group A was significantly less than that of group B (P＜0.05). The incidence of neutropenia, anemia and thrombocytopenia of III-IV grade at different treatment courses of group A were significantly lower than that in group B (P＜0.05). The incidence of infection of III-IV grade in group A at 3rd treatment course was significantly lower than that in group B (P＜0.05). CONCLUSION Preexcitation chemotherapy regimens of DAC and CAG/HAG for the treatment of MDS-RAEB possess the same effects for disease control; application of DAC regimen can efficiently reduce the risk of adverse reaction, but CAG/HAG regimen can be helpful to accelerate the effective process of treatment.
Anemia, Refractory ; Anemia, Refractory, with Excess of Blasts ; drug therapy ; Humans ; Myelodysplastic Syndromes ; drug therapy ; Retrospective Studies ; Treatment Outcome

For evaluation of the response and toxicity of the combination chemotherapy, forty six patients with malignant ovarian tumors who had prior surgery were treated with combination chemotherapy from January 1985 to March 1991 at the Department of Obstetrics and Gynecology, Kyung-pook National University Hospital. The results were as follows : 1. The responses were in complete 20 cases(43.5%), in partial 9 cases(19,6%), in stable 6 cases(13.0%), in progressive 11 cases(23.9%) among 46 patients. 2. By the response rates of various combination chemotherapy regimens, the response rate of CAP was 64%(16/25), CP 57.1%(8/14), VAC 100%(3/3), VBP 50%(1/2), FAM 0%(0/1), and Melphalan 100%(1/1) respectively. 3. As the chemotoxicities of combination chemotherapy, leukopenia 20 cases(46.5%), thrombocytopenia 2 cases(4.7%), anemia 20 cases(46.5%), nephrotoxity 6 cases(14.6%), hepatotoxicity 7 cases(18.4%) were observed.
Anemia ; Drug Therapy* ; Drug Therapy, Combination ; Gynecology ; Humans ; Leukopenia ; Melphalan ; Obstetrics ; Thrombocytopenia

PURPOSE: Platinum-based chemotherapy has conferred a modest but significant survival benefit and the introduction of newer drugs has led to achieve higher response rate in patients with advanced non-small cell lung cancer (NSCLC). We performed a phase II trial in order to evaluate the efficacy and toxicity of combination chemotherapy with vinorelbine (Navelbine) and cisplatin in advanced NSCLC. MATERIALS AND METHODS: Patients with previously untreated, unresectable stage IIIB or IV NSCLC with measurable lesion (s) were eligible for entry into the study. NP chemotherapy consisted of intravenous vinorelbine 25 mg/m2, on day 1 and 8, and intravenous cisplatin 80 mg/m2 on day 1; this cycle was repeated every three weeks. RESULTS: A total of 33 patients were enrolled in the study between July 1999 and Feb 2000. Of the 30 patients deemed eligible for analysis, thirteen patients achieved a partial response and thirteen showed a stable disease. The overall response rate was 43.3%. The median duration of response was 5.7 months (95% CI: 2.8~8.5 months). The median time to progression was 7.6 months (95% CI: 5.5~9.7 months) and the overall median survival time was 15.1 months (95% CI: 9.8~20.4 months) in the intent-to-treat analysis. Chemotherapy-related grade 3 or 4 toxicities were anemia in 1.5%, leukopenia in 4.5%, nausea/vomiting in 2.3%, alopecia in 13.3%, and neurotoxicity in 3.3%. CONCLUSION: The combination of vinorelbine and cisplatin chemotherapy seems to be active and fairly tolerable in patients with advanced NSCLC.
Alopecia ; Anemia ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Drug Therapy* ; Drug Therapy, Combination ; Humans ; Leukopenia

BACKGROUND: The combination chemotherapy of gemcitabine and cisplatin has been proven effective in the treatment of advanced non-small cell lung cancer (NSCLC). However, the optimal schedule for administration of the two drugs has not yet been determined. We therefore started a phase II trial to evaluate efficacy, toxicity and dose intensity (DI) as three-week scheduled chemotherapy of gemcitabine and cisplatin. METHODS: Between October 2000 and March 2003, a total of 56 patients with stage IIIB and IV NSCLC were enrolled in this study. Treatment schedule consisted of gemcitabine 1200 mg/m2 i.v. on days 1 and 8, and cisplatin 80 mg/m2 i.v. on day 1 of each chemotherapy cycle followed by two weeks of rest. RESULTS: Forty-eight patients were evaluable in response and adverse effects in this study. The median DI was 529 mg/m2/week for gemcitabine (66%) and 22 mg/m2/week for cisplatin (83%). Partial response was observed in 23 patients. The overall response rate was 47.8% (95% confidence interval [CI], range from 33.6% to 61.9%). Anemia and thrombocytopenia were the main hematologic adverse effects, with 8.3% and 8.3% of patients experiencing grade III to IV toxicity, respectively. The median survival time was 11.78 months (95% CI, range from 8.59 to 14.97months). No significant differences in response rate were observed according to sex, age, histology and DI of gemcitabine and cisplatin. CONCLUSION: The 3-week-scheduled combination chemotherapy of gemcitabine and cisplatin has feasibility to treat advanced stage IIIB and IV NSCLC with modest adverse effects. The regimen deserves further evaluaton in a phase III prospective randomized trial.
Anemia ; Appointments and Schedules ; Carcinoma, Non-Small-Cell Lung ; Cisplatin* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Thrombocytopenia

PURPOSE: This study was performed to estimate the response rate and toxicity of a combination chemotherapy, which included infusional 5-Fluorouracil, Leucovorin and Docetaxel in the treatment of patients with an advanced gastric carcinoma. MATERIALS AND METHODS: Twenty two advanced gastric cancer patients, with a bidimensionally measurable or an evaluable disease, were enrolled in this study. The patients received a 5-fluorouracil 1, 000 mg/m2 intravenous (IV) 24 hour infusion (Day 1~3), leucovorin 20 mg/m2 (Day 1~3) and docetaxel 75 mg/m2 intravenously (Day 2) every 3 weeks. RESULTS: The overall response rate was 45.0%. The median duration of response was 10.0 weeks (range: 4~24), the median time to response was 8 weeks (range: 8~20) the median time to progression was 30.0 weeks (95% CI: 16.3~43.2) and the median overall survival duration was 36.0 weeks (95% CI: 1.7~70.2). The median cumulative dose of 5-fluorouracil were 316.2 mg/m2/week and docetaxel was 23.9 mg/m2/week. WHO grade III, IV neutropenia, thromocytopenia and anemia occurred in 50.0%, 4.5% and 4.5% of patients, respectively. There were no occurrence of WHO grade III and IV nausea, vomiting, mucositis, conspitation, diarrhea, or neurotoxicity. CONCLUSION: This chemotherapy regimen, including infusional 5-fluorouracil, leucovorin and docetaxel was an active agent against advanced gastric cancer patients, especially for previous chemotherapy naive patients.
Anemia ; Diarrhea ; Drug Therapy ; Drug Therapy, Combination ; Fluorouracil* ; Humans ; Leucovorin* ; Mucositis ; Nausea ; Neutropenia ; Stomach Neoplasms* ; Vomiting

PURPOSE: To evaluate the response and toxicity of gemcitabine and cisplatin combination chemotherapy in advanced transitional cell carcinomas. MATERIALS AND METHODS: Twenty two patients with advanced transitional cell carcinoma received gemcitabine combined chemotherapy. Nineteen of them were scheduled to receive 1,000mg/m2 gemcitabine intravenously for 30 minutes on days 1, 8, and 15 and 70mg/m2 cisplatin for 1 hour on day 1 of a 28-day cycle. In addition, 3 patients with decreased renal function were scheduled to receive 1,200mg/m2 gemcitabine on day 1, 8, and 15. The toxicity of each cycle and the response after more than 4 cycles were evaluated. RESULTS: There were 5 complete responses and 4 partial responses in the 15 assessable patients, giving an overall response rate 60%. The toxicity was primarily hematologic, with 3 out of 22 patients (14%) with grade 3 thrombocytopenia, 10 out of 22 patients (45%) with grade 1 & 2 leukopenia and 10 out of 22 patients (45%) having grade 1 & 2 anemia. The most common non-hematologic toxic response was nausea and vomiting. CONCLUSIONS: Gemcitabine based chemotherapy for advanced transitional cell carcinoma has larger response rate compared to M-VAC. Furthermore, it has much less systemic toxicity than M-VAC combination chemotherapy.
Anemia ; Carcinoma, Transitional Cell ; Cisplatin ; Drug Therapy* ; Drug Therapy, Combination ; Humans ; Leukopenia ; Nausea ; Thrombocytopenia ; Vomiting