MIDDLE EAST JOURNAL OF CANCER
Year:2011 | Volume:2 | Issue:1|Papers Count:8

Being diagnosed with cancer can be a devastating experience. In the midst of this crisis, it would be heartening to be in the hands of a professional, well qualified, experienced and sympathetic health provider. Health providers from several specialties form a team to give cancer patients the best chance for a good quality, normal, long life.

Antiemetics are given to cancer patients prior to their chemotherapy sessions to protect them from nausea and vomiting induced by chemotherapy. The responsible health care team member will choose the type of antiemetic required to prevent the patient from developing nausea and vomiting according to the chemotherapy ematogenicity level.Current guidelines recommend using a single antiemetic agent or a combination of antiemetic agents such as a 5-hydroxytrypt-amine3 receptor antagonist, dexamethasone, or the neurokinin-1 receptor antagonist aprepitant. This review discusses the role of aprepitant in preventing and managing nausea and vomiting induced by chemotherapy.

Background: Nonmyeloablative chemotherapy followed by adoptive immunotherapy is an attractive strategy for depleting regulatory T cells in the host.However, its efficacy is transient. Here, we aim to investigate whether cyclic chemoimmunotherapy has therapeutic efficacy against cancer.Methods: We examined the efficacy of cyclic chemoimmunotherapy with cyclophosphamide and adoptively transferred effector T cells against 5-day, established MCA205 murine skin sarcomas.Results: Cyclophosphamide administration followed by adoptive immunotherapy augmented the trafficking of effector T cells into established tumors. Further, multiple cyclophosphamide administrations helped effector T cells to persist at the sites.Chemoimmunotherapy achieved complete tumor regression even with the transfer of a limited number of effector T cells (5x106).Conclusion: Cyclic chemoimmunotherapy, which maintains adoptively transferred T cells by impairing regulatory T cells, is a potentially suitable treatment for established tumors.

Background: Several recent studies demonstrated that transforming growth factor beta (TGF-b), by stimulating T regulatory cells, and interleukins 6 and 17 (IL-6, IL-17), by inducing inflammatory reactions, may be critical factors in cancer pathogenesis.Methods: We used quantitative real-time polymerase chain reaction assays to quantify the expression of IL-17, IL-6 and TGF-b mRNA in peripheral blood mononuclear cells and lymphocytes from draining lymph nodes of 60 women with breast cancer. The results were compared according to the patients’ clinical or pathological status.Results: Higher amounts of IL-17 and IL-6 mRNA, but not TGF-b transcripts, were found in patients compared to controls. There were no significant differences between patients with negative or positive nodes or with different histological grades or stages of disease.Conclusion: Most women in this analysis had stage I or II disease. We thus conclude that IL-17, a prominent proinflammatory cytokine, may play an important role in recruiting and infiltrating antitumor immune responses in early stages of breast cancer.

Background: b-thalassemia trait is one of the most common genetic disorders in Mediterranean countries. Previous studies have shown that b-thalassemia trait has a protective effect against malaria, coronary artery disease, hypertension and Alzheimer disease. We hypothesize that due to the shorter life span of red blood cells and increased hematopoiesis, these patients are at increased risk of developing hematological malignancies. Thus, this study investigated the possible effect of b-thalassemia trait on childhood malignancies.Methods: This was a case-control study that included 432 children with malignancies (leukemias and lymphomas as well as solid tumors) as the case group and 432 healthy individuals who referred for premarital b-thalassemia trait screening as the control group. All patients underwent a complete blood count as well as hemoglobin electrophoresis. Hemoglobin A2³3.5% or hemoglobin F between 2% and 10% were considered diagnostic for b-thalassemia trait. The results were compared between groups with the chi-squared test.Results: Mean age of the patients was 7.08±5.1 years and mean age in the control group was 25.46±7.3 years. There were 253 (58.6%) boys and 179 (41.4%) girls among the patients and 308 (71.3%) men and 124 (28.7%) women among the controls. The prevalence of b-thalassemia trait was 5.6% in the case group and 11.3% in the control group (P=0.001). The mean hemoglobin level was 9.81±3.1 g/dL in those with malignancies and 15.3±1.7 g/dL in healthy individuals (P<0.001).Conclusion: b-thalassemia trait is a protective factor against developing childhood malignancies in an unselected Iranian population. However, more studies are needed to clarify this issue.

Neuroblastoma is the most common extracranial solid tumor in children. The cooccurrence of neuroblastoma and acute lymphoblastic leukemia is rare. We report a rare case of advanced-stage neuroblastoma in a 3.5-year-old girl that was accompanied by acute lymphoblastic leukemia following treatment. Her leukemia may have been due to chemotherapy (secondary leukemia) or may have been de novo.

Osteopoikilosis is a rare benign osteosclerotic bone disorder that may be misdiagnosed as skeletal metastases. Here we describe a case of coincidental breast cancer and osteopoikilosis mimicking skeletal metastases. A 41-year-old woman underwent right modified radical mastectomy in April 2007. Twenty-eight months after initial treatment, the patient complained of bilateral knee and foot pain. Plain X-rays of the feet and knees showed multiple well-defined osteosclerotic lesions. According to the radiographic appearance, the most likely differential diagnoses included skeletal metastases from breast cancer and osteopoikilosis. A whole-body bone scintigraphy showed no increase in uptake by the sclerotic lesions, and serum lactic dehydrogenase, carcinoembryonic antigen, alkaline phosphatase and cancer antigen 15-3 were not elevated. We therefore diagnosed the patient’s skeletal lesions as osteopoikilosis. This case and our literature review suggest that the radiographic appearance of osteopoikilosis may mimic or mask skeletal metastases, potentially leading to misdiagnosis in patients with cancer.

Neurofibromatosis type 1, also known as von Recklinghausen disease, is an autosomal dominant disorder with an incidence of 1 per 4000. Neurofibromas are benign, heterogeneous tumors arising from the connective tissue of peripheral nerve sheaths, especially the endoneurium. Visceral involvement in disseminated neurofibromatosis is rare. Neurofibroma occurs most frequently in the stomach and jejunum, but the colon and anorectal canal may also be involved. Gastrointestinal neurofibromas may lead to bleeding, obstruction, intussusception, protein-losing enteropathy and bowel perforation.We present a case of diffuse involvement of the anorectal area by a huge neurofibroma, with pelvic pain, watery diarrhea and urgency.