Arteriosclerosis ; drug therapy ; Coumaric Acids ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Flavonoids ; Humans ; Phenols ; therapeutic use ; Phytotherapy ; Polymers ; therapeutic use ; Polyphenols ; Pyrazines ; therapeutic use

This study was purpose to explore the therapeutic efficacy and safety of VD regimen and VAD regimen for patients with multiple myeloma. The clinical data of 59 patients with multiple myeloma in our hospital from June 2008 to June 2011 were analyzed retrospectively. The 59 patients with multiple myeloma were divided randomly into VD and VAD groups. The patients in VD group were treated with bortezomib combined dexamethasone. The patients in VAD group were treated with vincristine, doxorubicin and dexamethasone. The efficacy, median survival time, 1-and 2-year survival rate, and toxicity were estimated for the patients in VD group and VAD group. The results showed that the efficacy in the VD group and VAD group was 83.78% and 59.09% respectively. The efficacy in the VD group was significantly higher than that in the VAD group (P < 0.05). The median survival time and 1-and 2-year survival rate in VD group were significantly higher than that in VAD group (P < 0.05). The side effects in VD group mainly were haematologic toxicity, gastrointestinal disorder and peripheral neuropathy. The adverse events were mild and tolerable. The main side effects in the VAD group were haematologic toxicity, infection and hair loss. Most of the infectious in VAD group were at Grade III-IV. It is concluded that VD regimen is an effective and safe therapy regimen for multiple myeloma, and it seems significantly superior to VAD regimen and its side effect can be tolerable for the patients.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Boronic Acids ; administration & dosage ; therapeutic use ; Bortezomib ; Dexamethasone ; therapeutic use ; Doxorubicin ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; drug therapy ; Pyrazines ; administration & dosage ; therapeutic use ; Vincristine ; therapeutic use

Boronic Acids ; therapeutic use ; Dexamethasone ; therapeutic use ; Female ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Male ; Multiple Myeloma ; drug therapy ; therapy ; Pyrazines ; therapeutic use

OBJECTIVETo review this efficacy and safety of bortezomib, a proteasome inhibitor, in the setting of the sensitized transplant candidate.

DATA SOURCESThe data used in this review were from articles published (PubMed) between 2000 to 2010. Additionally abstracts from medical meetings related to transplant were also used.

STUDY SELECTIONArticles were selected if they were trial results or case studies for the use of bortezomib in the sensitized patient population.

RESULTSThe early data using bortezomib as a part of desensitization regimens has shown success. Although one cycle (4 doses) of bortezomib seems to have affect on many patients, it also seems likely that to provide complete desensitization multiple cycles will be required. Regarding safety, bortezomib has been shown to have minimal side effects. The most common side effects reported are those of thrombocytopenia and anemia. These side effects are dose related and self limiting upon discontinuation of the treatment.

CONCLUSIONSBortezomib with plasmapheresis is a promising new alternative to desensitization protocols that use either high dose intravenous immune globulin (IVIG) or low dose IVIG and plasmapheresis. The efficacy on antibody reduction looks to be batter that that of the IVIG based regimens without significant addition toxicity. The results of ongoing prospective trials are positive and their complete results are greatly anticipated.

Boronic Acids ; therapeutic use ; Bortezomib ; Graft Rejection ; immunology ; prevention & control ; Humans ; Protease Inhibitors ; therapeutic use ; Proteasome Endopeptidase Complex ; metabolism ; Pyrazines ; therapeutic use ; Transplants ; adverse effects

Calcium Channel Blockers ; pharmacology ; therapeutic use ; Cerebral Infarction ; drug therapy ; Coronary Disease ; drug therapy ; Humans ; Pyrazines ; pharmacology ; therapeutic use ; Vasodilator Agents ; pharmacology ; therapeutic use

The proteasome is primarily responsible for intracellular protein degradation. The abnormality of its activity is sign of tumorigenesis. It was confirmed that proteasome inhibitors have activities against a variety of malignancies. Bortezomib, the first proteasome inhibitor, obtained permission of clinical trial and on sale. Multiple myeloma patients treated with bortezomib have gained a high overall response rate and complete remission rate. A lot of studies on effects of proteasome inhibitors on leukemias, including plasma cell leukemia; chronic lymphocytic leukemia, adult T cell lymphoma/leukemia, chronic myeloid leukemia and acute myeloid leukemia, were reviewed in this article.
Animals ; Boronic Acids ; therapeutic use ; Bortezomib ; Humans ; Leukemia ; drug therapy ; enzymology ; Multiple Myeloma ; drug therapy ; Protease Inhibitors ; therapeutic use ; Proteasome Inhibitors ; Pyrazines ; therapeutic use

Many advances in the treatment of multiple myeloma have been made due to the use of transplantation and the introduction of novel agents including thalidomide, lenalidomide, and bortezomib. The first step is recognizing the symptoms and starting prompt treatment. Different strategies should be selected for young and elderly subjects. Young patients are commonly eligible for transplantation, which is now considered the standard approach for this setting, and various inductions therapies containing novel agents are available before transplantation. Elderly patients are usually not eligible for transplantation, and gentler approaches with new drugs combinations are used for their treatment.
Age Factors ; Antineoplastic Agents/therapeutic use ; Boronic Acids/therapeutic use ; Humans ; Immunologic Factors/therapeutic use ; Multiple Myeloma/diagnosis/epidemiology/*therapy ; Prognosis ; Pyrazines/therapeutic use ; Stem Cell Transplantation ; Thalidomide/analogs & derivatives/therapeutic use

Cerebral ischemia is also known as ischemic stroke. In recent years, research on neuroprotection after ischemia has became a hot spot as stroke can result in symptoms of nerve damages such as hemiplegia, learning and memory disorders. The key factors that cause the death of cells include excitotoxicity, oxidative damage, nitrosative stress and inflammation. However, there is no effective preparation for the treatment of post-ischemic nerve defects at present, so it is urgent to find and develop effective drugs for the treatment of nerve damages after ischemia. Traditional Chinese medicine has advantages and potentials in the treatment of neurological diseases. Many scholars have carried out related researches on the active ingredients of traditional Chinese medicine and achieved some good results. In this context, the researches on the neuroprotective effects of traditional Chinese medicines such as tetramethylpyrazine, butylphthalide and total saponins of Panax notoginseng were reviewed. The author found that the neuroprotective researches of traditional Chinese medicine mostly focused on anti-apoptosis, anti-inflammatory and anti-oxidative stress, but those effects were not sounique to the nervous system. Furthermore, most ingredients of traditional Chinese medicine showed a poor water-soluble property. In view of the research status and existing problems of traditional Chinese medicine in nerve injury, the suggestions for the research and development of the potent neuroprotective agents were proposed in this study from the perspective of pharmacological mechanism research and preparation theory.
Benzofurans/therapeutic use* ; Brain Ischemia/drug therapy* ; Cerebral Infarction/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Humans ; Medicine, Chinese Traditional ; Neuroprotective Agents/therapeutic use* ; Panax notoginseng ; Pyrazines/therapeutic use* ; Saponins/therapeutic use*

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Boronic Acids ; administration & dosage ; Bortezomib ; Humans ; Multiple Myeloma ; drug therapy ; Pyrazines ; administration & dosage

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Boronic Acids ; administration & dosage ; Bortezomib ; Humans ; Multiple Myeloma ; diagnosis ; drug therapy ; Pyrazines ; administration & dosage