Bone disease sarcomas

The [ Tc-diphosphonate] agents are administered to diagnose fracture, bone tumor, metastatic lesion, sarcoma, arthritis, osteomyelitis, and other bone diseases that result in the occurrence of growing bone with readily accessible coordination of calcium in the hydroxyapatite bone structure [132]. The bone scanning is performed 2-3 h post-injection to reduce the background radioactivity in the body. In 24 h 75 to 85 % of the activity is excreted in the urine [84]. 

Cancer is a disease characterised by uncontrolled proliferation of cells that produces a tumour, from which the cells can invade local tissues and then spread to give rise to metastases. Cancers are classified into three groups carcinomas, sarcomas and leukaemias/lymphomas. Carcinomas, the most common, arise in epithelial cells, sarcomas in connective tissue (e.g. bone, cartilage) and leukaemias and lymphomas from white blood cells. 

Ewing s sarcoma is the second most common malignant bone tumor in children. The majority of patients have microscopic metastases at diagnosis the lung is the most common metastatic site. This sarcoma is a relatively rare disease with limited therapeutic options. The majority of patients are initially responsive to chemotherapy with vincristine, doxorubicin (Adriamycin), and cyclophosphamide. However, relapsed disease is usually extremely difficult to treat because of its resistance to chemotherapy (Zhou et al., 2001). 

Using the Bodansky (B18, 52) procedure with 8-glycerophosphate as substrate, Woodard (W8) was unable to obtain such elevations. She determined the serum acid phosphatase activities in 83 females and 342 males, or a total of 425 patients with miscellaneous diseases. Of these, 61 had various types of infectious or metabolic disorders, including 11 cases of inflammatory disease of bone and 12 cases of hepatic cirrhosis. The remainder had some type of neoplastic disease and about one-third had metastases to bone from cancer of various primary sites. There were 15 cases of osteogenic sarcoma and 32 cases of osteitis deformans. All these cases, whether their serum alkaline phosphatase activities were elevated or not, had serum acid phosphatase values that were essentially within the normal range, 0.06-0.89 Bodansky unit for females and 0.11-0.88 unit for males. In contrast to the Gutman method (GIO, G14), there-... 

The safety and activity of subcutaneous GM-CSF (300 micrograms/day for 1 week and 150 micrograms twice weekly for 11 weeks) has been compared with no treatment in 244 leukopenic HIV-infected patients (62). Adverse effects were reported in most of the patients treated with GM-CSF and consisted of flu-like symptoms (98%), bone pain (42%), and injection site reactions (85%). There was a two-fold increase in serum transaminase and alkaline phosphatase activities in 5.7% of patients. There was a moderate, but not significant, increase in HIV p24 antigen concentration. The few relevant clinical trials have provided no convincing evidence that GM-CSF enhances HIV replication or accelerates HIV-associated diseases (for example infections or neoplasms) in patients with AIDS (63). Only one patient with AIDS and ultrasonographic confirmation of enhanced Kaposi s sarcoma lesions temporally related to GM-CSF used for interferon- and zidovudine-related severe neutropenia has been reported (SEDA-19, 343). 

ALL, acute lymphocytic leukemia ANLL, acute non lymphocytic leukemia BMT, bone marrow transplantation BP, blood pressure CIcr, creatinine clearance HD, Hodgkin s disease KS, Kaposi s sarcoma LVEF, left ventricular ejection fraction MDS, myelodysplastic syndrome NHL, non-Hodgkin s lymphoma NSCLC, non-small-cell lung cancer SCLC small cell lung cancer. 

Cancers are classified by the tissues affected. The vast majority of cancerous tumors are carcinomas (tumors derived from epithelial tissue cells such as skin, various glands, breasts, and most internal organs). In the leukemias, cancers of the bone marrow, excessive leukocytes are produced. Similarly, the lymphocytes produced in the lymph nodes and spleen proliferate uncontrollably in the lymphomas. Tumors arising in connective tissue are called sarcomas. Despite the differences among this diverse class of diseases, they also have several common characteristics, among which are the following ... 

The response of cells to radiotherapy also depends upon the rate of cell division, and the cell s physiological environment. Normal tissues that are characterized by a comparatively high rate of cell division (e.g., bone marrow, lymph nodes, gonads, intestinal mucous membrane, skin) have a high radiosensitivity. Among the most radiosensitive cancerous diseases are leukemia, malignant lymphoma (lymph-node cancer), Ewing s sarcoma (tumor of the skeleton), and myeloma. Even moderately radiosensitive tumors, e.g., cervical cancer in women, can often be treated successfully with radiotherapy alone. 

Vinblastine, with the commercial names Velbe , Velban and Vinblastine , is used alone and as a component of combined regimens with other anticancer drugs in the treatment of Hodgkin s disease and other lymphomas, in advanced carcinoma of the testis, in Kaposi s sarcoma and histiocytosis X. It can also be used in the treatment of breast carcinoma and choriocarcinoma. The use of vinblastine is mainly limited by its hematological toxicity due to destruction of the bone marrow [13-15]. 

In rats, teriparatide increased the incidence of bone tumors, including osteogenic sarcoma. The clinical relevance of this is unclear, especially since higher PTH levels in patients with primary hyperparathyroidism are not associated with an increased tumor risk. Nevertheless, teriparatide use should be limited to 24 months, and the drug should not be used in patients at increased risk for osteosarcoma (e.g., those with Paget s disease, unexplained elevations of alkaline phosphatase, open epiphyses, or prior radiation therapy involving the skeleton). 

The HHV-8 virus is found in association with Kaposi s sarcoma, rare forms of B-cell lymphoma, multiple myeloma, primary effusion lymphoma, Castleman s disease and sarcoidosis. HHV-8 has been detected in the majority of bone marrow samples taken from multiple myeloma patients. Recently HHV-8 was described in association with the pulmonary and extrapulmonary inflammatory pseudotumor (inflammatory myoflbroblastic tumor). 

In January 1893, Dr. William B. Coley began the administration of a heat-sterilized combined culture of Streptococcus pyogenes (the virulent cause of the disease erysipelas) and Serratia marcescens (a mild pathogen involved in eye and urinary infections), His patient was a 16 year old boy with a large inoperable abdominal sarcoma tumor (a sarcoma is a cancerous growth derived from muscle, bone, cartilage, or connective tissue). The boy developed the chills, headache, fever, local redness, and swelling of an erysipelas infection. The tumor shrank by 80% and the patient remained cancer-free for more than 20 years (Hobohm, 2009). 

Doxorubicin [10 ] 1982 Acute lymphoblastic leukaemia, Acute myeloblastic leukaemia, Wilms tumour, neuroblastoma Soft tissue and bone sarcomas Breast carcinoma Ovarian carcinoma Transitional cell bladder carcinoma Thyroid carcinoma Gastric carcinoma Hodgkin s disease Malignant lymphoma Bronchogenic carcinoma 60-75 mg/m IV 21 day intervals as monotherapy 40-60mg/m2 IV 21-28day intervals in combination therapy Max recommended cumulative dose 450-500mg/m ... 

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