Hepatocellular carcinomas are one of the most common malignancies in the world. However, no effective therapeutic modality has been proven to prolong the survival of patients in an inoperable stage. The purpose of this study was to determine the response rate and the toxicities of a combination of pirarubicin, UFT and leucovorin in patients with non-embolizable hepatocellular carcinomas, or who had progressed during their transcatheter arterial chemoembolization treatment. MATERIALS AND METHODS: Of 23 patients with a hepatocellular carcinoma, 11 had progressed during a transcatheter arterial chemoembolization, with the other 12 being transcatheter arterial chemoembolization-naive. All the patients were treated with pirarubicin (70 mg/m2 i.v., day 1), UFT (350 mg/m2 P.O., day 1~21), and leucovorin (25 mg/m2 P.O., day 1~21). RESULTS: Twenty patients were able to be evaluated, with a partial response being achieved in four, giving an overall response rate of 20% (95% confidence interval, 7~44%). The median overall survival time was 6 months, and the median survival time of the transcatheter arterial chemoembolization-naive patients was significantly longer than that of those treated by transcatheter arterial chemoembolization (p=0.012). The most significant dose-limiting toxicity was leucopenia and thrombocytopenia. CONCLUSION: The combination of pirarubicin, UFT and leucovorin therapies showed marginal antitumor activity and significant toxicity in patients with non-embolizable or failed transcatheter arterial chemoembolization hepatocellular carcinomas.
Carcinoma, Hepatocellular* ; Drug Therapy* ; Humans ; Leucovorin* ; Thrombocytopenia

Child ; China ; Humans ; Purpura, Thrombocytopenic, Idiopathic/therapy* ; Thrombocytopenia/therapy*

Female ; Hemangioma ; therapy ; Humans ; Infant, Newborn ; Syndrome ; Thrombocytopenia ; therapy

China ; Clinical Protocols ; Hospital Units ; Humans ; Physicians ; Thrombocytopenia ; diagnosis ; therapy

Hepatitis, Viral, Human ; complications ; Humans ; Thrombocytopenia ; etiology ; therapy

Humans ; Medicine, Chinese Traditional ; methods ; Thrombocytopenia ; etiology ; therapy

Thrombocytopenia is frequently seen in patients with multiple myeloma when most often the etiology is either chemotherapy induced marrow suppression or bone marrow replacement by myeloma cells. But immune thrombocytopenia has only rarely been documented in patients with multiple myeloma. Also ascites caused by peritoneal infiltration with myeloma cell rarely develops in patients with multiple myeloma. We report a patient with nonsecretory multiple myeloma associated with immune thrombocytopenia and complicated by malignant ascites and periumbilical nodules.
Ascites* ; Bone Marrow ; Drug Therapy ; Humans ; Multiple Myeloma* ; Thrombocytopenia*

Immune thrombocytopenia (ITP) is a common acquired hemorrhagic disease. Conventional view considered its pathogenesis as the destruction of platelets induced by platelet associated antibodies, the target of treatment are inhibiting the production of antibodies and blocking the destruction of platelets in reticuloendothelial system, but they are ineffective in part of ITP patients, who transform to chronic/refractory ITP (C/RITP). As to children's C/RITP, the effect of first-line therapy is low, while the second-line therapy isn't effective definitely and has obvious side effects. The safe and effective second-line drugs to prevent disease progressing are urgently required. Recently, a pathogenesis that decrease the platelet production has been confirmed, thrombopoietic drugs, including thrombopoietin (TPO) and its receptor agonist (TRA), are under research and clinical application gradually. Recombinate human TPO (rhTPO) has accomplished Phase III clinical trails in adult C/RITP and tumor children. The Phase III clinical trails of romiplostim and eltrombopag, as the representative of TRA, in adult C/RITP have been performed. There are also two clinical trails of TRA for children's C/RITP, the efficacy and safety have been approved, with the convenience for using. In pediatric population, they have a good clinical application. In this article the research and development of thrombopoietic drugs and their perspective in pediatric clinical use are reviewed.
Child ; Clinical Trials, Phase III as Topic ; Humans ; Thrombocytopenia ; drug therapy ; etiology ; Thrombocytopenia, Neonatal Alloimmune ; drug therapy ; Thrombopoietin ; therapeutic use

Humans ; China ; Consensus ; Purpura, Thrombocytopenic, Idiopathic/therapy* ; Thrombocytopenia/therapy* ; Thromboembolism/therapy*

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