11514 Background: Hormone receptor positive patents historically had a better prognosis than their receptor negative counterparts when other parameters are balanced. However not all the patients expressing Estrogen and progesterone respond well to the hormonal manipulation. Therefore we thought of doing a retrospective analysis of our hospital data to find out the differences in the prognostic factors in therapy responders and non responders. Methods: The study was conducted at tertiary care cancer center from India. Between 2002–2003 a total of 120 breast cancer patients who expressed either Estrogen receptor (ER) or progesterone receptor (PR) were analyzed. Only patients with metastatic breast cancer were analyzed. The patients were treated with our standard institutional protocol at the beginning according to the stage of the disease. The details and baseline characters were shown in table . Results: The responders tend to be post menopausal, having low grade, node negative tumors, expressed both ER and PR, and had long interval from the date of initial diagnosis. However tumor size and the site of metastasis (visceral vs. non visceral) did not alter the outcome to hormone therapy. Conclusion: patients who are having higher age, lower tumor grade, lower number of nodes, longer disease free interval after adjuvant therapy and expressing both receptors tend to respond to hormone therapy better than those who had the opposite characters. However as thought earlier, presence of visceral metastasis or larger tumors at the time of initial diagnosis dose not preclude response to hormonal manipulation. [Table: see text] No significant financial relationships to disclose.
Chronic myeloid leukemia (CML) is a rare disease in children, accounting for 2-3% of leukemias in this age group. Few studies have reported on efficacy of imatinib in childhood CML. The purpose of this retrospective study was to determine the efficacy of imatinib in children. A total of 43 patients from age 7 years to 20 years with newly diagnosed CML received imatinib daily at 260 mg/m(2). Response rates, survival and toxicity were evaluated. The median follow-up was 43 months. All patients achieved a complete hematological response. Twenty-five (58.1%) patients achieved a complete cytogenetic response and 18 (41.9%) achieved a major molecular response at any time during their follow-up period. Both overall survival and progression-free survival at 43 months' median follow-up were 100%. Event-free survival was 92.8%. Imatinib was well tolerated. We conclude that imatinib is effective in children and adolescents with CML.
Background: Febrile neutropenia (FN) is a common but serious complication of chemotherapy in patients with solid tumors (ST) and hematological malignancies (HM). The epidemiology of FN keeps changing. Objective: The objective was to study the epidemiology of FN in adult patients with ST and HM at Kidwai Memorial Institute of Oncology, Bangalore – A tertiary cancer care center. Materials and Methods: Data of all episodes of FN that occurred during the period July 2011 to December 2011 were collected prospectively and analyzed. Results: A total of 75 episodes of FN was observed during study period involving 55 patients. Febrile neutropenic episodes were more frequent in HM than in ST (57% vs. 43%). The rate of bloodstream infection was 14.7%. Gram-negative organisms were the predominant isolates (56.25%). Overall mortality rate was 13.3%. Presence of medical co-morbidity and positive culture predicted high mortality. Mortality rate did not differ significantly between HM and ST (14% vs. 12.5%; P = 1.0). Gram-positive bacteremia was associated with greater mortality than Gram-negative bacteremia (P = 0.02). Conclusion: Empiric antibiotic treatment for FN should be tailored to the locally prevalent pathogens and their susceptibility patterns.
20710 Background: The long duration and frequent administration of chemotherapy in cancer patients requires long term venous access. Subclavian central venous catheters (SCVC) and peripherally inserted central venous catheters (PICC) are the most commonly used methods. We hereby present our experience of central venous catheters from a tertiary cancer centre in South India. Methods: A total of 101 patients with various malignancies (hematological and solid tumour malignancy) requiring long term venous access were included in the study. Aim was to review our experience of central venous catheters used over a 2 year period and to analyse the outcome in cancer patients in Indian setting. Intravascular devices like SCVC and PICC were used. A record of all complications and catheter loss and final outcome were analysed and compared with PICC and SCVC. Results: A total of 101 catheters were placed in 101 patients. Of which 15 were PICC and 86 were SCVC. In patients with SCVC, disease distribution included hematologic malignancies (51.1%) and solid tumours (48.8%), whereas for PICC, it was 80% and 20% respectively. Median duration of catheter indwelling period for SCVC was 92 days with range of 1–370 days, whereas, for PICC it was 30 and 1–215 days respectively. Reasons for central catheter removal. Conclusions: Long term venous access using PICC or SCVC is a simple, safe and reliable method for prolonged intravenous administration and blood sampling in patients intensively treated for hematologic and solid malignancies.The incidence of various complications and catheter loss was acceptable and overall patient satisfaction was good. Thus, we conclude that use of central venous catheters is a safe and reliable way of administration of chemotherapy even in developing countries.However, patient needs to be properly counselled and educated as there was a high incidence of accidental removal in our study. SCVC PICC Accidental removal 10 (11.6%) 2 (13.3%) Treatment over 38 (44.2%) 2 (13.3%) Patients death 25 (29%) 5 (33.3%) Suspected infection 9 (10.5%) 2 (13.3%) Leaks 1 (0.1%) 3 (20%) Thrombosis 3 (0.3%) 1 (6.6%) No significant financial relationships to disclose.
17521 Background: Two single centre experiences from India on the use of Imatinib mesylate in the treatment of chronic myeloid leukemia chronic phase (CML-CP) have shown somewhat similar results. While complete hematological response (CHR) achieved in the two studies was comparable to Western data, major cytogenetic response (MCR) and complete cytogenetic response (CCR) were much lower. Both studies had included newly diagnosed as well as previously treated patients. This study was undertaken to evaluate the efficacy and safety of imatinib mesylate, only in newly diagnosed patients of CML-CP and to compare the results obtained with those reported in literature. Methods: The study population included 100 newly diagnosed patients of CML-CP. Therapy was initiated with imatinib mesylate 400mg orally daily and patients monitored carefully for any adverse effects. After 6 months of treatment, bone marrow aspiration and cytogenetics were repeated to ascertain the response. In patients not achieving a MCR, the dose of imatinib was increased to 600mg daily and therapy continued. Results: In the present study, although imatinib produced CHR in 90% of the patients; only 50% achieved a MCR at 6 months and 55% at 12 months as compared to the 86- 87% reported in major trials involving newly diagnosed patients of CML-CP. The drug was safe and well tolerated. A comparison of patient characteristics with those in the Western studies revealed that majority of the Indian patients probably presented late in the disease course. A higher incidence of adverse genomic factors at diagnosis leading to rapid progression of disease could be the probable explanation for this. Conclusions: Thus based on our present study, we conclude that there is a difference in the efficacy profile of imatinib in Indian patients as compared to the West, the reasons for which needs to be investigated and validated. No significant financial relationships to disclose.
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