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We performed a randomized, double-blind, placebo-controlled trial in Vietnam in patients over 14 years of age who had tuberculous meningitis, with or without HIV infection, to determine whether adjunctive treatment with dexamethasone reduced the risk of death or severe disability after nine months of follow-up.
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As the trial progressed, however, this dosing was reduced to 20 mg (first four cycles) and 10 mg (cycles 5-8).
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After stem cell collection, participants will have the second four treatment cycles.
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This regimen was intended for all patients with previously untreated multiple myeloma who were considered candidates for systemic treatment.
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Animal Cancer Centre, Ontario Veterinary College Health Sciences Centre (Parsons-Doherty, Poirier), and Department of Clinical Studies, Ontario Veterinary College, (Monteith), University of Guelph, Guelph, Ontario N1G 2W1.
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We reasoned that we might focus steroid treatment on an atopic population, enriched for possible asthma and presenting with bronchiolitis, if we targeted infants and young children with eczema or first-degree relatives (a parent or sibling) with asthma and that for them, dexamethasone could be safe and effective, alleviating severe symptoms and decreasing the length of hospitalization or infirmary confinement.
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Combinations of cytogenetics and international scoring system can predict poor prognosis in multiple myeloma after high-dose chemotherapy and autologous stem cell transplantation.
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The secondary objectives are: (1) to compare complete protection from delayed vomiting and severity of nausea; (2) to compare differences in the impact of nausea and vomiting on QOL, and (3) to compare differences in symptoms that have been associated with dexamethasone (insomnia, anxiety, agitation, mood, etc.
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This is in line with in vitro studies which show that dexamethasone reduces cell proliferation of rodent neural stem cells, supporting a role specifically for the GR in the effects of glucocorticoids on neurogenesis ().
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The effect of dexamethasone on the combined end point of death or disability and on death alone was homogeneous across the HIV subgroups, although the stratified subgroup analyses failed to confirm a significant association between dexamethasone and improvement in either outcome ().
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Given the unexpected synergy we found between epinephrine and dexamethasone and the lack of any apparent benefit when either drug is used alone, our results should be considered exploratory.
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Several baseline variables and prognostic factors including age, time from diagnosis, number of prior therapies, prior stem cell transplantation, prior thalidomide therapy, β2-microglobulin levels, hemoglobin, platelet, albumin levels, lymphocytes, creatinine clearance and disease stage were evaluated in univariate logistic regression analyses to identify the prognostic factors associated with long-term benefit of therapy.
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