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BACKGROUND AND OBJECTIVES: Cyclophosphamide plus total body irradiation (CYTBI) and oral busulfan plus cyclophosphamide (BUCY) are commonly used conditioning regimens prior to allogeneic hematopoietic stem cell transplantation (HSCT) in patients with leukemia. However, there is conflicting data on the superiority of one regimen over the other. Our aim was to critically appraise and synthesize available evidence regarding the efficacy and safety of CYTBI compared to BUCY as a conditioning regimen.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

The review found that outcomes after allogeneic stem cell transplantation for patients with leukaemia differed according to the conditioning regimen used and the type of leukaemia. Although the review was limited by the small amount of data, variation between studies, lack of randomised evidence and poor reporting of study characteristics, the authors’ cautious conclusion appears likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

The aim of this review is to assess the evidence for the accuracy and safety of tests to diagnose gout in patients with no prior diagnosis of gout. The review also assesses factors that affect accuracy of diagnostic tests. Tests include algorithms that combine clinical signs and symptoms, dual-energy computed tomography (DECT), ultrasound, and plain x ray, with particular emphasis on tests that can be conducted in primary and acute (urgent and emergent) care settings.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: February 2016

Nausea and vomiting are major concerns for patients undergoing chemotherapy, radiation therapy and surgery with general anesthesia. Risk factors associated with chemotherapy-induced nausea and vomiting include emetogenicity of the chemotherapy regimen, dose, speed of intravenous infusion, female gender, age under 50 years, history of ethanol consumption, and history of prior chemotherapy. Factors predictive of radiation therapy-induced nausea and vomiting include site of irradiation (in particular, total body irradiation and radiation fields that include the abdomen), total field size, dose per fraction, age, and predisposition for emesis (history of sickness during pregnancy or motion sickness). Female gender, a history of motion sickness or prior postoperative nausea and vomiting, nonsmoking status, and use of postoperative opioids have been suggested as factors predictive of postoperative nausea and vomiting. The objective of this review was to evaluate the comparative effectiveness and harms of newer antiemetic drugs including the 5-HT3 and NK-1 antagonists.

Drug Class Reviews - Oregon Health & Science University.

Version: January 2009

Epithelial ovarian cancer (EOC) arises from the cells covering the surface of the ovary. The majority of women with this type of cancer present with advanced stage disease at diagnosis. The initial treatment involves surgery (removal of as much disease as possible) followed by chemotherapy. In some cases chemotherapy is given to shrink the cancer before surgery is undertaken. Irrespective of the type of treatment received, cancer will return at some point in some women. Treatment following relapse, usually involves chemotherapy. The choice of chemotherapy depends on the cancer‐free period from the initial chemotherapy (platinum drugs). If relapse occurs after six months from finishing initial treatment with chemotherapy, women are treated with platinum drugs. However if the cancer recurs within six months, women are treated with non‐platinum drugs, since platinum drugs would be unlikely to work again. Eventually, the majority of women develop resistance to any chemotherapeutic drug. Some women also suffer from drug‐related side effects and poor quality of life (QoL) as a result of treatment. Therefore, there is a need for newer drug treatments with fewer side effects. In this context, hormone therapy have been tried. Luteinising hormone releasing hormone (LHRH) agonist are hormones that work by telling the pituitary gland located in the brain to stop producing this hormone and as a result the tumour cells in the ovary, which may be dependent on this hormone, cannot be stimulated. LHRH agonists have been used in relapsed EOC and some studies have shown low toxicity with these hormones.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: June 29, 2016

The management of myeloma is complex and challenging. It increasingly involves the use of expensive drugs. The guideline will aim to raise standards nationally while allowing clinical flexibility and defining a common pathway for patients at various stages of their illness, and of different ages and levels of fitness. Although a consistent approach to management is desirable, it needs to reflect the very different groups of patients with myeloma from the fit and suitable for transplant, fairly fit but not suitable for transplant to patients who are extremely frail and/or unwell.

NICE Guideline - National Collaborating Centre for Cancer (UK).

Version: February 2016

Cutaneous melanoma is increasing in incidence in many of the developed countries as this form of cancer occurs predominantly in pale skinned people who expose themselves to intense sunlight, especially when taking holidays in sunny places. The increased work-load for melanoma services resulting from this increase is furthermore complicated by the fact that the individuals with the most rapid rate of increase in incidence are those over the age of 60 and especially men. Male sex and age are two poor prognostic factors for melanoma and therefore the likelihood is that despite efforts to promote primary and secondary melanoma prevention, melanoma mortality is likely to increase rather than decrease. Although the incidence trends described above are of concern, for the first time in very recent years, the advent of therapies targeted to driver mutations (such as inhibitors of BRAF) and of T cell checkpoint inhibitors which both have efficacy in melanoma is in the process of rapidly changing management of this disease. Use of both classes of drugs has been the subject of NICE technology appraisals in recent years and these have been cross referenced in the text.

NICE Guideline - National Collaborating Centre for Cancer (UK).

Version: July 2015

Chronic myeloid leukaemia (CML) is a form of cancer affecting the blood, characterised by excessive proliferation of white blood cells in the bone marrow and circulating blood. In the UK, an estimated 560 new cases of CML are diagnosed each year.

Health Technology Assessment - NIHR Journals Library.

Version: April 2012

The incidences of life-threatening toxicities such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are inconsistently reported. The potential association of anticancer agents with SJS or TEN has not been systematically investigated. We searched the literature (Ovid: 1950 to June 2013 and PubMed: 1948 to June 2013) using terms for SJS/TEN and anticancer therapies. Primary case reports, case series, and clinical trials were included. In addition, MedWatch, the Food and Drug Administration Adverse Event Reporting System (FAERS), was searched (1968 to August 2012) for SJS/TEN reports associated with anticancer therapies. Proportional reporting ratios (PRR>2, N>3), empirical Bayes geometric mean (EBGM>2, N>3), and lower 95% confidence interval (EBGM0.05>2) were used as thresholds to constitute a signal of association between SJS/TEN and anticancer drugs. There were 46 SJS and 37 TEN cases associated with 18 and 22 anticancer drugs in the literature, respectively. Among cases in the FAERS, significant signals were associated with SJS for bendamustine and with TEN for bendamustine, busulfan, chlorambucil, fludarabine, lomustine, and procarbazine. Several drugs reported in the published literature to be associated with SJS/TEN were not found to have significant signals in FAERS. Proactive pharmacovigilance to detect and define safety signals serves to aid oncology practitioners in the recognition of possible, yet uncommon, serious, and/or life-threatening skin reactions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

This well-conducted review assessed concurrent antioxidant supplementation in chemotherapy for cancer patients. The authors concluded that there was no evidence of a detriment to chemotherapy efficacy. Indications of improved outcomes were found with supplementation, but further adequately powered trials were required. These cautious conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

The review concluded that compared with interferon alpha alone, combined interferon alpha plus cytarabine significantly improved complete haematologic response and cytogenic response rates and improved three-year and five-year survival, but was more likely to cause serious adverse events. The reviewers’ conclusions should be considered tentative due to potential for bias and the poor quality evidence base.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

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