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Gallium Nitrate


Presentation

  • Gallium has unique mechanisms of action that include its binding to transferrin in the circulation and targeting transferrin receptors present on lymphoma cells.[ncbi.nlm.nih.gov]
Sepsis
  • The cause of death was attributed to amonafide in one patients (from sepsis) and to teniposide in two patients (due to infection and leukopenia). There was no objective response in all the patients entered.[ncbi.nlm.nih.gov]
Weight Loss
  • All patients had one or more clinical features predicting a low likelihood of durable complete response to standard chemotherapy, ie, weight loss, visceral metastases, and low performance status.[ncbi.nlm.nih.gov]
Hypoxemia
  • Two patients (25%) developed grade 4 toxicity: 1 patient developed complete blindness with partial reversal over 12 months, and another patient had pulmonary infiltrates, hypoxemia, and fever.[ncbi.nlm.nih.gov]
Dysgeusia
  • Diverse low-grade toxicities were observed, including nausea and vomiting in 11 patients, anorexia in 11, diarrhea in eight, stomatitis in five, dysgeusia in six, musculoskeletal pain in five, skin rash in seven, partially reversible tinnitus and/or mild[ncbi.nlm.nih.gov]
Central Scotoma
  • After receiving intravenous gallium nitrate, a 77-year-old man developed bilateral visual loss and optic neuropathy with central scotomas on visual field testing and diminished P2-wave amplitude on visual evoked potential examination.[ncbi.nlm.nih.gov]
Scotoma
  • After receiving intravenous gallium nitrate, a 77-year-old man developed bilateral visual loss and optic neuropathy with central scotomas on visual field testing and diminished P2-wave amplitude on visual evoked potential examination.[ncbi.nlm.nih.gov]
Tinnitus
  • Diverse low-grade toxicities were observed, including nausea and vomiting in 11 patients, anorexia in 11, diarrhea in eight, stomatitis in five, dysgeusia in six, musculoskeletal pain in five, skin rash in seven, partially reversible tinnitus and/or mild[ncbi.nlm.nih.gov]
Musculoskeletal Pain
  • Diverse low-grade toxicities were observed, including nausea and vomiting in 11 patients, anorexia in 11, diarrhea in eight, stomatitis in five, dysgeusia in six, musculoskeletal pain in five, skin rash in seven, partially reversible tinnitus and/or mild[ncbi.nlm.nih.gov]
Polyuria
  • Symptoms of hypercalcemia include nausea, vomiting, bone pain, polyuria, renal insufficiency, bradycardia, and arrhythmia. The goals of medical therapy are to inhibit bone resorption and promote renal calcium excretion.[ncbi.nlm.nih.gov]

Workup

Central Scotoma
  • After receiving intravenous gallium nitrate, a 77-year-old man developed bilateral visual loss and optic neuropathy with central scotomas on visual field testing and diminished P2-wave amplitude on visual evoked potential examination.[ncbi.nlm.nih.gov]

Treatment

  • RESULTS: Fifteen courses of treatment were administered to ten patients. Reductions in serum alkaline phosphatase and urinary hydroxyproline excretion were observed after treatment with each dose schedule.[ncbi.nlm.nih.gov]

Prognosis

  • Abstract Patients with advanced lymphoma who relapse from intensive first-line combination chemotherapy generally have a very poor prognosis.[ncbi.nlm.nih.gov]

Epidemiology

  • Blind E, Raue F, Zisterer A et al (1990) Epidemiology of hypercalcemia. Significance of the determination of intact parathyroid hormone for differential diagnosis. Dtsch Med Wochenschr 115:1739–1745 PubMed CrossRef Google Scholar 2.[link.springer.com]
Sex distribution
Age distribution

Pathophysiology

  • Its pathophysiology includes enhanced osteoclastic bone resorption and decreased renal excretion of extracellular calcium. Symptoms of hypercalcemia include nausea, vomiting, bone pain, polyuria, renal insufficiency, bradycardia, and arrhythmia.[ncbi.nlm.nih.gov]
  • Mundy GR (1990) Pathophysiology of cancer-associated hypercalcemia. Semin Oncol 17:10–15 PubMed Google Scholar 4. Mundy GR (2002) Metastasis to bone: causes, consequences and therapeutic opportunities.[link.springer.com]

Prevention

  • Explosive mixtures of Gallium Nitrate with reducing agents often persist unchanged for long periods if initiation is prevented.[en.wikipedia.org]
  • Abstract The goal of adjuvant chemotherapy is to treat postoperative microscopic disease in the hope of preventing tumor recurrence and/or metastasis.[ncbi.nlm.nih.gov]
  • Alendronate slows bone loss while increasing bone mass, which may prevent bone fractures. Alendronate is used to treat or prevent postmenopausal osteoporosis and steroid-induced osteoporosis.[emedicinehealth.com]

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