The use of prophylactic eye drops during high-dose cytosine arabinoside therapy

Article Abstract:

Cytosine arabinoside, often abbreviated ara-C, is a powerful chemotherapeutic drug used in the treatment of some leukemias and other cancers. One of the side effects of ara-C is inflammation of the conjunctiva, which lines the eyelids, and inflammation of the cornea of the eye (called conjunctivitis and keratitis, respectively). When high doses of ara-C are used, as many as 85 percent of patients are likely to experience these reactions. Since the high doses are considered to be critical for the success of treatment, attempts have been made to mitigate these side effects. One treatment that has shown promise is the use of steroid drugs dissolved in eye drops. Previous studies have shown that steroid eye drops are effective in some, but not all patients. Furthermore, steroid eye drops are not appropriate for certain patients. In a study involving 18 patients with leukemia, steroid eye drops were compared with a formulation approximating the composition of natural tears. All 18 patients had leukemia which either relapsed or did not respond to initial chemotherapy and they were schedules to receive ara-C treatment. Nine patients were given the artificial tears and nine patients were given eye drops containing prednisolone, a glucocorticoid drug. The eye drops were administered every four hours, starting before the first dose of ara-C and continuing for two days after the chemotherapeutic treatment had ended. Mild or moderate eye reactions were experienced by three of the patients using the artificial tears and by five of the patients treated with the steroid eye drops. These results indicate that artificial tears are just as effective as steroid eye drops. It seems likely, therefore, that the effect that was previously observed with the steroid eye drops had nothing to do with the anti-inflammatory effects of steroids. Rather, it seems now that the eye drops simply dilute the cytosine arabinoside which has found its way onto the surface of the eye and that artificial tears accomplish this dilution just as well. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Conjunctivitis, Keratitis, Cytarabine, Keratoconjunctivitis, Epidemic keratoconjunctivitis

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Serum immunoerythropoietin levels in patients with cancer receiving cisplatin-based chemotherapy

Article Abstract:

Cisplatin is a platinum-containing chemotherapeutic drug that has proved to be very useful in treating a variety of solid tumors. Like all chemotherapeutic drugs, cisplatin is associated with serious side effects. Cisplatin may cause kidney toxicity and myelosuppression; and bone marrow suppression may cause anemia in some patients. The authors speculated that perhaps the anemia in some patients taking cisplatin may result from the kidney impairment. The kidneys secrete erythropoietin, a hormone that stimulates the production of red blood cells. The kidney impairment may decrease the amount of erythropoietin and contribute to the development of anemia. A study was conducted to measure erythropoietin levels in 25 patients undergoing treatment with cisplatin. The measurements made in these patients were compared with measurements in 17 patients with anemia resulting from aplastic anemia or from nutritional abnormalities. Four of the 25 cancer patients had abnormally low levels of erythropoietin in their blood. There was a significant correlation between anemia and erythropoietin levels; the anemic patients with a hematocrit of less than 30 were more likely to have low levels of erythropoietin. However, the erythropoietin levels measured in these patients did not correlate with cisplatin doses or with the degree of kidney impairment in the individual patient. When 10 patients with head and neck cancer were measured both before and after cisplatin treatment, it was found that five had abnormally low levels before treatment began and an additional two developed low erythropoietin levels after treatment. These observations indicate that anemia in cancer patients may be a result of several factors, only one of which is low erythropoietin. Furthermore, the toxic effects of cisplatin is not the only factor that contributes to low erythropoietin in cancer patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Anemia, Causes of, Physiological aspects, Erythropoietin, Cisplatin

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