Displaying publications 21 - 40 of 83 in total

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  1. Wang CL, Wang F, Bosco JJ
    Lupus, 1995 Feb;4(1):11-4.
    PMID: 7767332 DOI: 10.1177/096120339500400103
    Ninety-two women with systemic lupus erythematosus treated with oral cyclophosphamide were studied to ascertain the prevalence and the factors associated with ovarian dysfunction. Menstrual disturbance during treatment occurred in 55% of patients: 36% had amenorrhoea and 19% had oligomenorrhoea. Sustained oligomenorrhoea occurred in 12% patients. Permanent amenorrhoea (> 12 months) after cessation of oral cyclophosphamide occurred in 27% of patients. Hormonal studies in these patients were consistent with ovarian failure. Older age at initiation of treatment and high cumulative dose of cyclophosphamide were found to be associated with this outcome. There was a trend towards linear relationship between the age of initiation of cyclophosphamide therapy and frequency of amenorrhoea. A statistically significant association between amenorrhoea and cumulative dose of cyclophosphamide after adjustment for age was found whereas no such association was linked to the duration of treatment. Fourteen of the 23 women who wished to become pregnant after cessation of treatment conceived resulting in 20 live births and two abortions.
    Matched MeSH terms: Cyclophosphamide/administration & dosage; Cyclophosphamide/adverse effects*
  2. Chow SK, Looi LM, Loh CS, Yeap SS
    Intern Med J, 2002 Mar;32(3):114-6.
    PMID: 11885838 DOI: 10.1046/j.1445-5994.2002.d01-29.x
    Matched MeSH terms: Cyclophosphamide/adverse effects*; Cyclophosphamide/therapeutic use
  3. Jasmin R, Sockalingam S, Shahrizaila N, Cheah TE, Zain AA, Goh KJ
    Lupus, 2012 Sep;21(10):1119-23.
    PMID: 22433918 DOI: 10.1177/0961203312440346
    Peripheral neuropathy is a known manifestation of systemic lupus erythematosus. However, the association of primary autoimmune inflammatory neuropathies such as chronic inflammatory demyelinating polyneuropathy (CIDP) with SLE is uncommon. We report a 26-year-old man who simultaneously presented with severe CIDP and photosensitive rash, but was unresponsive to intravenous immunoglobulin infusion and continued to progress. He was found to have underlying SLE and improved with combined corticosteroid and immunosuppressive therapy with oral cyclophosphamide. CIDP with underlying SLE may be more resistant to conventional therapy with IVIG, requiring the addition of other immunosuppressive agents.
    Matched MeSH terms: Cyclophosphamide/administration & dosage; Cyclophosphamide/therapeutic use*
  4. Ong LM, Hooi LS, Lim TO, Goh BL, Ahmad G, Ghazalli R, et al.
    Nephrology (Carlton), 2005 Oct;10(5):504-10.
    PMID: 16221103 DOI: 10.1111/j.1440-1797.2005.00444.x
    BACKGROUND: The aim of the present study was to evaluate the efficacy of mycophenolate mofetil in the induction therapy of proliferative lupus nephritis.
    METHODS: Forty-four patients from eight centres with newly diagnosed lupus nephritis World Health Organization class III or IV were randomly assigned to either mycophenolate mofetil (MMF) 2 g/day for 6 months or intravenous cyclophosphamide (IVC) 0.75-1 g/m(2) monthly for 6 months in addition to corticosteroids.
    RESULTS: Remission occurred in 13 out of 25 patients (52%) in the IVC group and 11 out of 19 patients (58%) in the MMF group (P = 0.70). There were 12% in the IVC group and 26% in the MMF group that achieved complete remission (P = 0.22). Improvements in haemoglobin, the erythrocyte sedimentation rate, serum albumin, serum complement, proteinuria, urinary activity, renal function and the Systemic Lupus Erythematosus Disease Activity Index score were similar in both groups. Twenty-four follow-up renal biopsies at the end of therapy showed a significant reduction in the activity score in both groups. The chronicity index increased in both groups but was only significant in the IVC group. Adverse events were similar. Major infections occurred in three patients in each group. There was no difference in gastrointestinal side-effects.
    CONCLUSIONS: MMF in combination with corticosteroids is an effective induction therapy for moderately severe proliferative lupus nephritis.
    Matched MeSH terms: Cyclophosphamide/administration & dosage*; Cyclophosphamide/adverse effects
  5. Koh KH, Tan CH, Hii LW, Lee J, Ngu LL, Chai AJ, et al.
    Toxicol Rep, 2014;1:490-495.
    PMID: 28962262 DOI: 10.1016/j.toxrep.2014.06.010
    Paraquat poisoning resulted in multiorgan failure and is associated with high mortality. We audited 83 historical cases of paraquat poisoning in past 2 years treated with conventional decontamination and supportive treatment, followed by enrolling 85 patients over a 2 year period into additional immunosuppression with intravenous (i.v.) methylprednisolone and i.v. cyclophosphamide. Our results showed that age, poor renal function and leucocytosis are the main predictors of fatal outcome. Immunosuppression regime rendered higher survival (6 out of 17 patients (35.3%)) versus historical control (1 out of 18 patients (5.6%)) (p = 0.041) in the cohort with admission eGFR < 50 ml/min/1.73 m(2) and WBC count > 11,000/μL. In contrast, there was no difference in survival with immunosuppression regime (38 out of 64 patients (59.4%)) compared to historical control (30 out of 52 patients (57.7%)) (p = 0.885) in those with eGFR > 50 ml/min/1.73 m(2) or WBC < 11,000/μL at presentation. Multivariable logistic regression showed survival probability = exp(logit)/(1 + exp(logit)), in which logit = 13.962 - (0.233 × ln(age (year))) - (1.344 × ln(creatinine (μmol/L))) - (1.602 × ln(rise in creatinine (μmol/day))) - (0.614 × ln(WBC (,000/μL))) + (2.021 × immunosuppression) and immunosuppression = 1 if given and 0 if not. Immunosuppression therapy yielded odds ratio of 0.132 (95% confidential interval: 0.029-0.603, p = 0.009). In conclusion, immunosuppression therapy with intravenous methylprednisolone and cyclophosphamide may counteract immune mediated inflammation after paraquat poisoning and improve survival of patients with admission eGFR < 50 ml/min/1.73 m(2) and WBC count > 11,000/μL.
    Matched MeSH terms: Cyclophosphamide
  6. Razak RNHA, Ismail F, Isa MLM, Wahab AYA, Muhammad H, Ramli R, et al.
    Malays J Med Sci, 2019 Jan;26(1):44-57.
    PMID: 30914892 MyJurnal DOI: 10.21315/mjms2019.26.1.4
    Background: Cyclophosphamide (CP) is a widely used anti-neoplastic and immunosuppressive agent that is associated with adverse side effects including reproductive toxicity. Aquilaria malaccensis (AM) is a traditional medicinal plant which was reported to exhibit high anti-oxidant and free radical scavenging properties. The present study was aimed to evaluate the protective effects of AM leaves extract on sperm quality following toxic exposure to CP.

    Methods: Forty-eight male Sprague Dawley rats were allocated into eight groups of six rats (n = 6): control, CP only (200 mg kg-1), AM only (100 mg kg-1, 300 mg kg-1 and 500 mg kg-1) and CP + AM (100 mg kg-1, 300 mg kg-1 and 500 mg kg-1). Animals were sacrificed after 63 days of treatment and the sperm from the caudal epididymis was taken for sperm analysis.

    Results: The body and the reproductive organs weight, sperm count and motility did not differ between CP and other groups (P > 0.05). A significant increase (P < 0.05) in percentage of the dead and abnormal sperm were seen in the CP alone treated group compared to the control group. Co-administration of AM to the CP exposed rats significantly reduced the (P < 0.05) percentage of abnormal sperm as compared to the CP only group.

    Conclusion: Overall, the present results represent the potential of AM to protect against CP induced reproductive toxicity.

    Matched MeSH terms: Cyclophosphamide
  7. Lin GSS, Abdul Ghani NRN, Ismail NH, Singbal KP, Yusuff NMM
    Eur J Dent, 2020 Jul;14(3):448-455.
    PMID: 32599624 DOI: 10.1055/s-0040-1713951
    OBJECTIVES:  This study aimed to compare the polymerization shrinkage and degree of conversion of new zirconia-reinforced rice husk nanohybrid composite with commercialized microhybrid and nanofilled composites.

    MATERIALS AND METHODS:  Overall, 180 samples were used for polymerization shrinkage (buoyancy and optical methods) and degree of conversion tests in which they were divided into Group 1, nanofilled composite (Filtek-Z350- XT; 3M ESPE, St Paul, MN 55144-1000, USA), Group 2, microhybrid composite (Zmack-Comp), and Group 3, nanohybrid composite (Zr-Hybrid). Polymerization shrinkage test was performed using buoyancy and optical methods. For buoyancy method, samples were weighed in air and water to calculate the shrinkage value, whereas, for optical method, images of nonpolymerized samples were captured under a digital microscope and recaptured again after light-cured to calculate the percentage of shrinkage. Degree of conversion was tested using Fourier-transform infrared spectroscopy spectrometer.

    STATISTICAL ANALYSIS:  Data were analyzed using one-way analysis of variance complemented by post hoc Dunnett's T3 test for polymerization shrinkage and Tukey's honestly significant difference test for degree of conversion. Level of significance was set at p < 0.05.

    RESULTS:  Group 3 demonstrated similar polymerization shrinkage with Group 1, but lower shrinkage (p < 0.05) than Group 2 based on buoyancy method. However, optical method (p < 0.05) showed that Group 3 had the lowest shrinkage, followed by Group 1 and lastly Group 2. Besides, Group 3 showed a significantly higher degree of conversion (p < 0.05) than Group 1 and comparable conversion value with Group 2.

    CONCLUSIONS:  Zirconia-reinforced rice husk nanohybrid composite showed excellent shrinkage and conversion values, hence can be considered as an alternative to commercially available composite resins.

    Matched MeSH terms: Cyclophosphamide
  8. PONNAMPALAM J
    Am J Trop Med Hyg, 1963 Sep;12:775-6.
    PMID: 14070771
    Matched MeSH terms: Cyclophosphamide
  9. Said MS
    J Clin Med Res, 2010 Aug 18;2(4):189-93.
    PMID: 21629538 DOI: 10.4021/jocmr412w
    Wegeners Granulomatosis is a condition associated with systemic vasculitis which can present with upper respiratory tract symptoms initially. On September 2001, a 15-year-old girl presented with symptoms of nasal block for 3 weeks. She later developed joint pains and worsening renal status requiring dialysis. A renal biopsy was performed which showed pauci-immune cresentric glomerulonephritis. Her cANCA levels were positive. She was treated with oral cyclophosphamide and steroids and later responded.

    KEYWORDS: Wegener granulomatosis; Young girl; Cyclophophamide; cANCA.

    Matched MeSH terms: Cyclophosphamide
  10. Lai Y, Nik Yahya NH, Ong SG
    Med J Malaysia, 2014 Apr;69(2):98-100.
    PMID: 25241822
    Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a group of uncommon diseases. Given its rarity and multisystem clinical presentation which are usually serious and potentially fatal, prompt recognition and early treatment are of utmost importance. We report a case of AAV that presented with digital infarcts, cutaneous vasculitis, rapidly progressive glomerulonephritis, mononeuritis multiplex, eosinophilia and positive myeloperoxidase (MPO)-ANCA antibody. Apart from renal damage, there was complete recovery in other systems following intravenous cyclophosphamide and high-dose glucocorticoids albeit the response was delayed. This response obviates the need for second-line therapy with newer agent such as rituximab (anti-CD20 monoclonal antibody). We would also like to highlight that this is the first case of AAV that is associated with autoimmune thyroid disease to be reported from Malaysia.
    Matched MeSH terms: Cyclophosphamide
  11. Kuan JW, Su AT, Wong SP, Sim XY, Toh SG, Ong TC, et al.
    Transfus Apher Sci, 2015 Oct;53(2):196-204.
    PMID: 25910537 DOI: 10.1016/j.transci.2015.03.017
    There are few randomized trials comparing filgrastim and pegfilgrastim in peripheral blood stem cell mobilization (PBSCM). None of the trials studied the effects of the timing of pegfilgrastim administration on the outcomes of mobilization. We conducted a randomized triple blind control trial comparing the outcomes of filgrastim 5 µg/kg daily from day 3 onwards, 'early' pegfilgrastim 6 mg on day 3 and 'delayed' pegfilgrastim 6 mg on day 7 in cyclophosphamide PBSCM in patients with no previous history of mobilization. Peripheral blood (PB) CD34+ cell count was checked on day 8 and day 11 onward. Apheresis was started when PB CD34+ ≥ 10/µl from day 11 onward. The primary outcome was the successful mobilization rate, defined as cumulative collection of ≥2 × 10(6)/kg CD34+ cells in three or less apheresis. The secondary outcomes were the day of neutrophil and platelet engraftment post transplantation. There were 156 patients randomized and 134 patients' data analyzed. Pegfilgrastim 6 mg day 7 produced highest percentage of successful mobilization, 34 out of 48 (70.8%) analyzed patients, followed by daily filgrastim, 28 out of 44 (63.6%) and day 3 pegfilgrastim, 20 out of 42 (47.6%) (p = 0.075). Pegfilgrastim day 7 and daily filgrastim reported 1.48 (p = 0.014) and 1.49 (p = 0.013) times higher successful mobilization rate respectively as compared to pegfilgrastim day 3 after adjusting for disease, gender and exposure to myelotoxic agent. Multiple myeloma patients were three times more likely to achieve successful mobilization as compared to acute leukemia or lymphoma patients. Pegfilgrastim avoided the overshoot of white cells compared to filgrastim. There was no difference in the duration of both white cells and platelet recovery post transplantation between the three interventional arms.
    Matched MeSH terms: Cyclophosphamide
  12. Wan SA, Teh CL, Jobli AT
    Lupus, 2016 Apr 28.
    PMID: 27125293 DOI: 10.1177/0961203316646461
    Objective. The aim of this study was to examine the clinical features, treatment and outcome of systemic lupus erythematosus (SLE) patients in our centre who presented with lupus pneumonitis as the initial manifestation.
    Methods. We performed a retrospective review of all patients who presented with lupus pneumonitis during the initial SLE manifestation from March 2006 to March 2015.
    Results. There were a total of five patients in our study who presented with fever and cough as the main clinical features. All patients had pulmonary infiltrates on chest radiographs. High-resolution computed tomography, which was performed in two patients, showed ground glass opacities with patchy consolidations bilaterally. All patients received high-dose steroids, 80% received intravenous cyclophosphamide and 60% received intravenous immunoglobulin. Two patients died from severe lupus pneumonitis within 2 weeks of admission despite treatment with ventilation, steroids, cyclophosphamide and intravenous immunoglobulin.
    Conclusions. Acute lupus pneumonitis is an uncommon presentation of SLE. Mortality in this case series is 40%.
    KEYWORDS: Lupus pneumonitis; systemic lupus erythematosus
    Matched MeSH terms: Cyclophosphamide
  13. Ghazali WSW, Daud SMM, Mohammad N, Wong KK
    Medicine (Baltimore), 2018 Oct;97(42):e12787.
    PMID: 30334968 DOI: 10.1097/MD.0000000000012787
    The aims of this study were to determine damage index in systemic lupus erythematosus (SLE) patients based on Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (SDI) and to determine the laboratory and clinico-demographic factors affecting SDI.This is a retrospective cohort study of 94 SLE patients attending rheumatology clinics in 2 local hospitals in Kelantan, Malaysia. The patients were divided into 2 groups based on SDI score assigned by the attending physician, 0 (without damage) or ≥1 (with damage). Newly diagnosed SLE patients with disease duration less than 6 months were excluded.A total of 45 (47.9%) SLE patients showed damage by SDI score. Majority of the subjects had neuropsychiatric damages (21/94; 22.3%) followed by skin (12/94; 12.8%) and musculoskeletal (6/94; 6.4%) damage. SDI score was significantly associated with higher disease duration (6.2 ± 6.57 years vs 4.5 ± 3.7 years; P = .018), lower prednisolone dose (8.74 ± 10.89 mg vs 4.89 ± 3.81 mg; P 
    Matched MeSH terms: Cyclophosphamide/administration & dosage
  14. Abdul Rashid AM, Abd Ghani F, Inche Mat LN, Lim CTS
    BMC Complement Med Ther, 2020 Jun 02;20(1):163.
    PMID: 32487242 DOI: 10.1186/s12906-020-02971-y
    BACKGROUND: Herbal medication is widely used in our region as a mode of alternative medicine. Its contents and combinations are often modified to suit the needs of different populations. These products are said to boost the immune system and may serve as a protective measure against many diseases including Systemic Lupus Erythematosus (SLE). Some even lay claims to be able to cure SLE. Although they are not without side effects, these medications are still preferred due to their widespread availability and affordability, compared to modern medications. However, to date, there have been no reported cases in which these traditional medications can trigger a lupus-like reaction, moreover one involving the kidneys.

    CASE PRESENTATION: We report a patient who developed overt lupus nephritis after consuming a course of herbal supplement. Her renal status did not improve upon cessation of the offending drug, and she required immunosuppressive therapy. After one cycle of IV cyclophosphamide, we managed to get the patient into remission - she is now on tapering doses of steroids.

    CONCLUSION: We wish to highlight the possibility of consumption of herbal medication and the emergence of drug-induced lupus nephritis. A thorough anamnesis and high index of suspicion of drug-induced lupus nephritis is warranted when a patient on supplements presents with urinary abnormalities.

    Matched MeSH terms: Cyclophosphamide/therapeutic use*
  15. Go KW, Teo SM
    Med J Malaysia, 2006 Oct;61(4):447-50.
    PMID: 17243522
    Systemic Lupus Erythematosus (SLE) is a multisystemic autoimmune disease with renal involvement being one of the most frequent and serious manifestations of the disease. The aim of the study is to analyze the treatment and renal outcome of patients with lupus nephritis (LN) WHO class III and IV on cyclophosphamide (CYC). We retrospectively identified 41 patients with biopsy proven LN who was given either oral or intravenous CYC. The male: female ratio was 4:37; with a mean age of 31.7 +/- 9.8 years at presentation. 36 patients (87.8%) had LN class IV and only five patients (12.2%) with LN class III. The mean serum creatinine at presentation was 87.4 +/- 37.2 micromol/L with mean follow-up of 84 +/- 78 months. A total of 30 patients (73.2%) completed 12 courses of IV CYC and one patient (2.4%) completed three months of oral CYC. 71.0% (n = 22) had complete response (CR), 25.8% (n = 8) had partial response and 3.2% (n = 1) had no response (NR). Of the remaining 11 patients, two patients (4.9%) died during the treatment, three patients (7.3%) defaulted treatment and five patients (12.2%) are still receiving ongoing treatment. Presence of hypertension (p < 0.003) and evidence of chronicity on renal biopsy (p < 0.016) were significantly correlated with the progressive deterioration of renal function in our population. In conclusion, hypertension and evidence of chronicity on renal biopsy, proved to be risk factors for progressive renal impairment in our study population. The achieved global outcome can be considered good.
    Study site: Hospital Ipoh, Ipoh, Perak, Malaysia
    Matched MeSH terms: Cyclophosphamide/therapeutic use*
  16. Wong KW
    BMJ Case Rep, 2015 Jan 16;2015.
    PMID: 25596289 DOI: 10.1136/bcr-2014-208060
    We report a case of renal cell carcinoma diagnosed after a patient was treated successfully with intravenous cyclophosphamide for her active proliferative lupus nephritis (classes III and V). After the intravenous cyclophosphamide regimen, the patient was asymptomatic with persistent microscopic haematuria, and no proteinuria. The renal cell carcinoma was located on the left kidney; incidentally, this was where the initial renal biopsy was done to diagnose lupus nephritis.
    Matched MeSH terms: Cyclophosphamide/therapeutic use
  17. Tiash S, Othman I, Rosli R, Chowdhury EH
    Curr Drug Deliv, 2014;11(2):214-22.
    PMID: 24328684
    Most of the classical drugs used today to destroy cancer cells lead to the development of acquired resistance in those cells by limiting cellular entry of the drugs or exporting them out by efflux pumps. As a result, higher doses of drugs are usually required to kill the cancer cells affecting normal cells and causing numerous side effects. Accumulation of the therapeutic level of drugs inside the cancer cells is thus required for an adequate period of time to get drugs' complete therapeutic efficacy minimizing the side effects on normal cells. In order to improve the efficacy of chemotherapeutic drugs, nanoparticles of carbonate apatite and its strontium (Sr(2+))-substituted derivative were used in this study to make complexes with three classical anticancer drugs, methotrexate, cyclophosphamide and 5-flurouracil. The binding affinities of these drugs to apatite were evaluated by absorbance and HPLC analysis and the therapeutic efficacy of drug-apatite complexes was determined by cell viability assay. Carbonate apatite demonstrated significant binding affinity towards methotrexate and cyclophosphamide leading to more cellular toxicity than free drugs in MCF-7 and 4T1 breast cancer cells. Moreover, Sr(2+) substitution in carbonate apatite with resulting tiny particles less than 100 nm in diameter further promoted binding of methotrexate to the nanocarriers indicating that Sr(2+)-substituted apatite nanoparticles have the high potential for loading substantial amount of anti-cancer drugs with eventual more therapeutic effectiveness.
    Matched MeSH terms: Cyclophosphamide/administration & dosage*
  18. Ong CS, Cheah TE, Jasmin R, Yahya F, Sockalingam S, Ng CT
    Lupus, 2013 Oct;22(11):1174-7.
    PMID: 23886639 DOI: 10.1177/0961203313498792
    Lupus associated protein loosing enteropathy (LUPLE) is a rare gastrointestinal manifestation of SLE. We presented a case of painless ascites from serve hypoalbuminaemia secondary to LUPLE. The patient responded to a course of intravenous cyclophosphamide. The remission was maintained by azathioprine and low dose prednisolone.
    Matched MeSH terms: Cyclophosphamide/therapeutic use
  19. Chasen M, Urban L, Schnadig I, Rapoport B, Powers D, Arora S, et al.
    Support Care Cancer, 2017 01;25(1):85-92.
    PMID: 27557833
    PURPOSE: Addition of rolapitant to standard antiemetic therapy improved protection against chemotherapy-induced nausea and vomiting (CINV) in phase 3 trials of patients receiving highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC). Here, we assessed the impact of CINV on the daily lives of patients receiving HEC or MEC using the Functional Living Index-Emesis (FLIE).

    METHODS: In three double-blind phase 3 studies, patients receiving HEC or MEC were randomized 1:1 to receive oral rolapitant 180 mg or placebo prior to chemotherapy plus 5-hydroxytryptamine type 3 receptor antagonist and dexamethasone therapy. Patients completed the FLIE questionnaire on day 6 of cycle 1. Endpoints included FLIE total score, nausea and vomiting domain scores, and the proportion of patients with no impact on daily life (total score >108 [range 18-126]). We performed a prespecified analysis of the MEC/anthracycline-cyclophosphamide (AC) study and a post hoc analysis of two pooled cisplatin-based HEC studies.

    RESULTS: In the pooled HEC studies, rolapitant significantly improved the FLIE total score (114.5 vs 109.3, p 

    Matched MeSH terms: Cyclophosphamide/administration & dosage; Cyclophosphamide/adverse effects
  20. Kamal WSA, Affandi AM, Bhullar A, Kamal WSZ
    Med J Malaysia, 2018 08;73(4):253-254.
    PMID: 30121690 MyJurnal
    Lymphoma presenting with ulceration is not typical. We report a case of relapsed DLBCL in a 73-year-old man presenting with a chronic non-healing leg ulcer. He has underlying varicose veins with recurrent venous ulcers. This patient was diagnosed to have DLBCL six years earlier when he presented with recurrent epistaxis originating from a left nasal cavity nodule. Complete resolution was achieved after eight cycles of R-CHOP and intrathecal methotrexate. For this current problem, this patient was treated with rituximab combined with chemotherapy which resulted in healing of the ulcer.
    Matched MeSH terms: Cyclophosphamide/administration & dosage; Cyclophosphamide/therapeutic use
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