Deficiency In Cancer Patients Research Articles

Is it necessary to diagnose and correct vitamin D deficiency in malignant neoplasms? Analytical review

BACKGROUND: Although the critical role of vitamin D in mineral homeostasis regulation is widely recognized, the global prevalence of vitamin D deficiency is exceedingly high. The substantial number of population-based studies that examine the correlation between the concentration of circulating vitamin D levels and the risk of developing cancer may be attributed to the growing interest of researchers in this vitamin as a suppressor of proliferating epithelial cells. However, the data collected are contradictory. AIM: To ascertain the necessity of diagnosing and rectifying vitamin D deficiency in cancer patients. MATERIALS AND METHODS: The keywords “vitamin D,” “vitamin D deficiency,” “cancer,” and “survival” were employed to identify publications in the e-Library, PubMed, and ScienceDirect databases from January 2014 to January 2024. Based on the data obtained, an analytical review of the literature was conducted. RESULTS: The global prevalence of vitamin D deficiency, including among cancer patients, is exceedingly high and does not vary by sex, age, or ethnicity. Decreased serum vitamin D levels are linked to an elevated incidence of colorectal cancer, breast cancer, melanoma, prostate, and pancreatic cancer. Addressing vitamin D deficiency helped mitigate the risk of developing breast cancer. Data on the effect of vitamin D deficiency and its correction on patient survival are inconsistent. CONCLUSION: Currently, there is no consensus regarding the impact of vitamin D supplementation on the incidence of diverse malignancies, as well as tumor-specific and overall survival. Additional research is required to address the necessity of diagnosing and correcting vitamin D deficiency.

Integrating Network Pharmacology and In vivo Experimental Validation to Reveal the Mechanism of FuZheng YiLiu Formula on Estrogen Receptor Positive Breast Cancer.

FuZheng YiLiu Formula (FZYL) is a commonly used formula for postoperative estrogen receptor-positive (ER+) breast cancer and post-radiotherapy deficiency of both Qi and Yin. FZYL has been used in clinical practice for decades because of its ability to effectively improve the symptoms of deficiency in cancer patients. However, its mechanism needs to be further clarified. In this paper, we will observe the effect of FZYL on mice with ER+ breast cancer and explore the mechanism by which it improves the symptoms of ER+ breast cancer. A tumor xenograft mouse model was established to detect tumor growth in vivo in order to evaluate the pharmacological effects of FZYL on ER+ breast cancer. The main targets of FZYL were identified by extracting the FZYL components and the corresponding potential target genes of breast cancer from the established database and constructing a protein-protein interaction network of shared genes using the string database. GO functional annotation and KEGG pathway enrichment analysis were performed, and molecular docking, molecular dynamics simulations, western blotting analysis, and RT-qPCR were performed to confirm the validity of targets in the relevant pathways. FZYL was able to significantly reduce the size of tumors in vivo and had a significant therapeutic effect on tumor xenograft mice. GO and KEGG pathway enrichment analyses indicated that the effects of FZYL may be mediated by oxidative stress levels, apoptotic signaling pathways, and cell cycle proliferation. By RT-qPCR and protein blotting assays, FZYL targeted the key targets of TP53, JUN, ESR1, RELA, MYC, and MAPK1 to exert its effects. The key active components of FZYL are quercetin, luteolin, stigmasterol, and glycitein. Molecular docking and molecular dynamics simulation results further demonstrated that the key active components of FZYL are stably bound to the core targets. In this study, the potential active ingredients, potential core targets, key biological pathways, and signaling pathways involved in the treatment of breast cancer with FZYL were identified, providing a theoretical basis for further anti ER+ breast cancer research.

Anemia and iron deficiency in cancer patients: the role of intravenous iron supplements (a literature review)

Anemia in patients with malignancies is a common disorder that has a markedly negative impact on quality of life and overall prognosis. The pathogenesis of anemia is complex and multifactorial, depending on the type and stage of malignancy, nutritional status, renal function, age and gender, cytostatic drug, dose, and chemotherapeutic regimen, with iron deficiency often being the main and potentially treatable factor for anemia. In cancer patients, it can be caused by various concomitant mechanisms, including bleeding (e.g., in malignant gastrointestinal tumors or after surgery), malnutrition, medication, and hepcidin-induced iron sequestration in macrophages, with subsequent iron-deficient erythropoiesis. The variety of clinical manifestations of anemia makes it challenging to establish universal criteria to develop optimal treatments. Current therapy for anemia in malignant tumors includes replacement therapy with an iron supplement, erythropoiesis-stimulating agents (erythropoietins), and blood transfusions. However, blood transfusions should be minimized due to the high risks and costs. Therapy with an iron supplement is an effective approach to correcting the iron deficiency. It can increase the efficacy of erythropoiesis-stimulating drugs and reduce the need for blood transfusions. Published guidelines suggest the wide use of intravenous iron supplements. This article discusses possible approaches to treating iron deficiency in cancer patients in various clinical settings. We build on current guidelines and emphasize the need for further research in this area.

CT-058 Outcome of Chemotherapy in G6PD-Deficient Patients

G6PD deficiency is an inherited condition characterized by a lack of glucose-6-phosphate dehydrogenase, leading to hemolytic anemia after any oxidative stress. Many therapeutic agents have been implicated in hemolysis in G6PD-deficient patients, but little is known about the prevalence of G6PD deficiency in cancer patients. Data regarding the use and safety of chemotherapy in this population is extremely rare. We report the case of a 20-year-old male patient known to have G6PD deficiency who was diagnosed with a stage I non-seminomatous germ cell tumor (NSGCT). He underwent a left orchiectomy, revealing the presence of NSGCT with embryonal carcinoma predominance and lymphovascular invasion. Postoperative tumor markers (lactate dehydrogenase [LDH], αFP, βHCG) and a chest-abdomen-pelvis CT scan were within normal limits. Thus, he was a candidate to receive one cycle of BEP protocol (bleomycin, etoposide, and cisplatin). An extensive review of the literature regarding the premedications (aprepitant, palonosetron, metoclopramide, omeprazole, desloratadine, dexamethasone) and chemotherapeutic agents did not reveal any associated or reported hemolysis in patients with G6PD deficiency. A baseline hemolytic panel was tested, and hemoglobin, LDH, haptoglobin, bilirubin, and the reticulocyte count fell within normal limits. The patient received one cycle of BEP with serial hemolytic panel testing during the treatment administration, which did not reveal any induced hemolysis. He is currently in complete remission of his disease. Excluding case reports of rasburicase and one case of anthracycline-induced hemolysis in G6PD-deficient patients, descriptions of chemotherapy uses and outcomes in this population are extremely limited in the literature. Clinicians must consider the potential benefit of treatment to decide on cytotoxic therapies in G6PD-deficient patients. As medical oncologists, we believe that more information is required to support the safety of chemotherapy in this population.

The use of vitamin B12 in cancer patients

Based on the data of foreign and domestic literature, the question of the possible carcinogenesis of vitamin B12 and the expediency of its administration to patients with cancer who have neurological complications due to chemotherapy is analyzed. The absence of convincing direct evidence of the carcinogenic effect of cyanocobalamin has been demonstrated, as well as the reasonableness of drug correction of vitamin B12 deficiency in cancer patients in order to prevent the development of characteristic deficient neurological disorders. The question of the effectiveness of oral administration of cyanocobalamin at a dose of 1 mg per day is considered.

69P Transferrin saturation shows high prevalence of iron deficiency in cancer patients under adjuvant and neo-adjuvant treatment

While iron deficiency (ID) in cancer patients is frequent, it is likely under-diagnosed and under-treated, in particular in patients without anaemia or at an early stage of the disease. Also, ID diagnosis is rarely based on the transferrin coefficient saturation (TSAT) which is very sensitive in patients with inflammatory diseases. We previously showed that ID was frequent in patients under metastatic treatment. Here, we aimed to assess the prevalence of ID based on TSAT index in cancer patients treated at an early stage of the disease.

Prevalence of iron deficiency in cancer patients: The French prospective CARENFER study.

e15617 Background: Despite the potential deleterious consequences of iron deficiency (ID) in patients with cancer, under-diagnosis is frequent and existence of ID based on both serum ferritin concentration and transferrin coefficient saturation (TSAT) index is rarely determined. The CARENFER Study aimed to assess prospectively the prevalence of ID, anemia and iron deficiency anemia (IDA) in cancer patients. Methods: The study was conducted in France from May to July 2019, as a prospective cross-sectional survey carried out in 15 oncology units. The analysis focused on 1221 patients with different types of solid malignant tumors. Serum ferritin and iron concentrations, TSAT index and hemoglobin (Hb) level were determined. Based on ESMO 2018 Guidelines, ID was defined as ferritin < 100 μg/L or TSAT < 20%, and then categorized as either absolute ID (ferritin < 100 μg/L) or functional ID (ferritin ≥ 100μg/L and TSAT < 20%). Anemia was defined as Hb level ≤ 11 g/dL. Iron deficiency anemia (IDA) was defined according to ESMO 2018 Guidelines. The prevalence of ID, anemia and IDA was estimated using Agresti-Coull 95% confidence interval. Results: Patient’s median age was 63 years (55% women and 45% men). 89.4% of patients were currently under treatment for their cancer, mainly by chemotherapy (75.4%). The proportion of cancer patients with ferritin level < 100 μg/L was 20.5% [18.3-22.9] and 50.6% [47.8-53.4] of patients had a TSAT index < 20%. Overall, ID was found in 57.9% [55.1-60.6] of patients, with absolute ID accounting for 36% of all ID cases. 36.0% of patients were anemic and among them, IDA was reported in 21.8% [19.6-24.2] of patients. The type of cancer treatment did not influence the ID status as ID was also present in 57.4% of untreated cancer patient. Conclusions: This study highlights the high prevalence of ID in cancer patients, whether or not concomitantly associated with anemia or treatment. These results emphasize the need to better management of ID in cancer thereby optimizing overall patient care. Clinical trial information: NCT03924271.

Association of serum iron and response to immune checkpoint inhibitors (ICIs) in metastatic clear cell renal cell carcinoma (mccRCC).

723 Background: ICIs have improved survival in mRCC patients (pts), yet response rates (RR) to these treatments are variable. Biomarkers predictive of response to ICIs may improve outcomes for mccRCC pts. Genes that promote tumor-specific iron accumulation such as hepcidin (HAMP) or transferrin (TF) are significantly correlated with decreased overall survival in clear cell RCC (TCGA-KIRC). Iron deficiency in cancer patients is positively correlated with tumor stage and inversely proportional to treatment response (PMID: 23567147). Here, we investigate whether serum iron profile may be associated with response to ICIs in mccRCC pts. Methods: Clinical data was obtained from an mRCC registry at the Huntsman Cancer Institute, University of Utah. Analyses were limited to mccRCC pts who had serum iron studies within 6 months before initiating an ICI and had been assessed for RR. ICIs included nivolumab + ipilimumab, atezolizumab, or nivolumab alone. Responses were defined as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD) by RECIST criteria. Clinical benefit (CB) was defined as CR + PR + SD. Descriptive statistics were used to assess associations between iron stores and response to ICIs and IMDC criteria. Results: 36 pts met all aforementioned eligibility criteria (29 were of IMDC intermediate risk, 7 were of IMDC poor risk). 5 pts received a first-line ICI, and the remaining 31 pts received ICIs as salvage therapy. Pts with CB had a significantly higher median serum iron level compared to those with no CB (59 vs 38.5 ug/dL; p=0.024). Furthermore, pts with normal transferrin saturation (TSAT %) were more likely to derive CB from ICIs (p=0.048). No association was found between serum ferritin (a marker of inflammation and tissue iron) and response to ICIs. Conclusions: In this hypothesis-generating study, increased serum iron, and TSAT levels within the normal range are associated with an increased likelihood of response to ICIs in pts with mccRCC. Once validated, these results may establish serum iron profile as a predictive marker of response to ICIs, in addition to providing the rationale for ruling out iron deficiency before starting ICIs.

Effectiveness and safety of ferric carboxymaltose to treat iron deficiency anemia in cancer patients.

e23153 Background: Most cancer patients are faced with anemia during the disease course. Iron deficiency (ID) is one of the major causes of anemia in cancer patients.Bleeding, malabsorption and organ dysfunction may cause iron deficiency in cancer patients. Anemia may result in a decrease in the patient's performance and delayed chemotherapy. Administration of intravenous (IV) iron is a therapeutic option in cancer patients with iron-deficiency related anemia. In this study we analyzed effectiveness and tolerability of ferric carboxymaltose in cancer patients with iron deficiency anemia Methods: This is a retrospective analysis of 603 cancer patients who were treated with ferric carboxymaltose for anemia and iron-deficiency between October 2014 and April 2017 in a tertiary cancer clinic. Demographic data, cancer diagnoses, pre- and post-treatment hemoglobin levels, pre-treatment ferritin, serum iron, and transferrin saturation (TSA) levels were recorded. Results: The median age of the population was 55 (22-90) years, and 52% were male. Of 603 patients, 47.9% (n = 289) had gastrointestinal malignancies and 17% (n = 103) had breast cancer. A total of 331 patients (55%) received cytotoxic chemotherapy and 272 patients (45%) were not on anti-cancer treatment. Median dose of the ferric carboxymaltose is 1000 mg (500-2000). The median baseline hemoglobin, ferritin and TSA were 10.7 (7-13) g/dl, 28 (2.9-2200) ng/ml and 9.3 (1-19) %, respectively. The median hemoglobin level at the 12th week of treatment was 12.7 g/dl. The median increase in hemoglobin was 2.9 (-0.10-6.9) g/dl in patients whom received cytotoxic chemotherapy. Only 2 patients had allergic reaction during IV ferric carboxymaltose administration and treatment was discontinued. Conclusions: Intravenous-iron improved hemoglobin levels both in actively treated and not-actively treated cancer patients. The effect has been shown in the first 3 months after injection. This approach is safe and tolerable. However, the impact of tumor progression on IV iron replacement is unclear, further studies are required.

Vitamin D deficiency in cancer patients and predictors for screening (D-ONC study)

Vitamin D is a prohormone that is vital for calcium/phosphate balance, bone structure, and physiological functioning. Vitamin D deficiency (VDD) is an important clinical problem worldwide. However, there are no standardized protocols for screening of patients with a diagnosis of cancer. The purpose of this study is to define the prevalence of VDD in cancer patients and establish the predictors of VDD to address a specific group of patient for screening. The study was designed as a retrospective case-control study. The patients cared in the outpatient clinic between December 2016 and May 2018 with a diagnosis of cancer were evaluated. The clinical properties and the 25(OH) D levels were evaluated. Logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for the association between VDD and clinical parameters. In 2 cancer centers, 706 patients with a diagnosis of cancer were evaluated. Median 25(OH) D level was 12.2 ng/mL (2.1-96.4). VDD was present in 509 (72.0%) of patients. The multivariate analysis of factors associated with VDD showed that female gender (OR: 1.5 [95% CI: 1.05-2.4], P = 0.026), low sun light exposure (OR: 1.4 [95% CI: 1.009-2.1], P = 0.045), being under palliative (OR: 1.5, [95% CI: 1.008-2.4] P = 0.04) or adjuvant setting (OR: 2.6 [95% CI: 1.3-5.1], P = 0.006), and history of gastrointestinal surgery (OR: 1.8, [95% CI: 1.03-3.2] P = 0.03) were associated with VDD. The female patients with headscarf had lower 25(OH) D levels than without group (10.5 ng/mL vs 23.4 ng/mL, P < 0.001) and they had more VDD (77.2% vs 29.4%, P < 0.001). Our study concluded that prevalence of VDD is high in cancer patients and female gender, low sun light exposure, being under palliative or adjuvant setting, and history of gastrointestinal surgery are associated with VDD. These parameters should be used for selecting patients for screening.

Iron deficiency and cancer – clinical implications

Anemia is a frequent complication in oncologic patients, being encountered both at the moment of cancer diagnosis and during different oncologic therapies. The presence of anemia, regardless of the cause or mechanism, in oncologic patients adversely affects the quality of life, the outcome of the neoplastic disease and the adherence to treatment. The mechanisms involved in the appearance of anemia in oncologic patients are intricated. Iron deficiency is a frequent cause of anemia in oncologic patients. This de­fi­cien­cy is noticed in approximately 50% of patients with solid and hematological tumors. In oncologic patients, the pre­va­lent mechanism for iron deficiency is the functional mechanism. In this case, the iron stores are reduced due to the underlying oncologic condition or due to inflammatory processes associated to cancer treatments. Iron deficiency in cancer patients is often underestimated, mainly due to the difficulty of defining iron deficiency on the basis of usual laboratory markers. The current therapeutic options of cancer anemia include blood transfusions, iron substitution and erythropoietin-stimulating agents.

The rate and treatment outcome of thiamine deficiency in cancer patients diagnosed with delirium: A preliminary study.

205 Background: Vitamin B1 is essential for life, but cannot be synthesized in vivo and must be ingested from outside the body. Retention in the body is as short as 18 days, so that long-term appetite loss can easily lead to vitamin B1 deficiency, resulting in a condition known as Wernicke's encephalopathy (WE), which is characterized by disturbed consciousness, ataxia, and ocular movement disorders. Early detection and treatment with intravenous vitamin B1 usually results in recovery without sequelae, while a delay in detection can lead to severe brain damage (Korsakoff syndrome). The mortality rate is approximately 20%. Recent studies have shown that cancer patients may also experience thiamine deficiency and WE. WE is often overlooked as the typical symptoms are nonspecific, and some cases do not exhibit the disturbed consciousness characteristic of WE. Clinical awareness can be improved by confirming the actual rate and clarifying the associated symptoms, leading to more accurate WE diagnosis. Methods: We retrospectively examined the medical records for patients admitted to Saitama Medical University International Medical Center between 1 October 2014 and 31 May 2018 with cancer as the main disease who consulted the Psycho-oncology Department and were diagnosed with delirium by a psychiatrist. Patient background, medical treatment, neurological symptoms, blood biochemical findings, and disease course after vitamin B1 administration were examined. This study was approved by the IRB of this institution (Approval No. 18-080). Results: Eligibility criteria were met by 76 of 126 patients who received consultations during the study period, with 32 (43%) having a vitamin B1 deficiency. Vitamin B1 treatment led to a full recovery in 19 (59%) of these 32 patients. Conclusions: Our results show that the rate vitamin B1 deficiency in patients in this study was high, although &gt;50% of the affected patients recovered with treatment. This indicated that it is necessary to pay close attention to vitamin B1 deficiency in cancer patients with psychiatric symptoms, and future study is planned to clarify the factors involved in the onset of vitamin B1 deficiency.

Anemia and Iron Deficiency in Cancer Patients: Role of Iron Replacement Therapy.

Anemia in cancer patients is quite common, with remarkable negative impacts on quality of life and overall prognosis. The pathogenesis is complex and typically multifactorial, with iron deficiency (ID) often being a major and potentially treatable contributor. In turn, ID in cancer patients can be due to multiple concurring mechanisms, including bleeding (e.g., in gastrointestinal cancers or after surgery), malnutrition, medications, and hepcidin-driven iron sequestration into macrophages with subsequent iron-restricted erythropoiesis. Indeed, either absolute or functional iron deficiency (AID or FID) can occur. While for absolute ID there is a general consensus regarding the laboratory definition (that is ferritin levels <100 ng/mL ± transferrin saturation (TSAT) <20%), a shared definition of functional ID is still lacking. Current therapeutic options in cancer anemia include iron replacement, erythropoietic stimulating agents (ESAs), and blood transfusions. The latter should be kept to a minimum, because of concerns regarding risks, costs, and limited resources. Iron therapy has proved to be a valid approach to enhance efficacy of ESAs and to reduce transfusion need. Available guidelines focus mainly on patients with chemotherapy-associated anemia, and generally suggest intravenous (IV) iron when AID or FID is present. However, in the case of FID, the upper limit of ferritin in association with TSAT <20% at which iron should be prescribed is a matter of controversy, ranging up to 800 ng/mL. An increasingly recognized indication to IV iron in cancer patients is represented by preoperative anemia in elective oncologic surgery. In this setting, the primary goal of treatment is to decrease the need of blood transfusions in the perioperative period, rather than improving anemia-related symptoms as in chemotherapy-associated anemia. Protocols are mainly based on experiences of Patient Blood Management (PBM) in non-oncologic surgery, but no specific guidelines are available for oncologic surgery. Here we discuss some possible approaches to the management of ID in cancer patients in different clinical settings, based on current guidelines and recommendations, emphasizing the need for further research in the field.

Antioxidant and antimicrobial activity of bacteriocin-producing strains of lactic acid bacteria isolated from the human gastrointestinal tract

Background: cancer patients require special attention to maintenance therapy of their organism vital activity. Distribution of nutritional deficiency in cancer patients not only limits the possibilities of application of modern treatment methods, but can also be the direct cause of life-threatening complications and premature death. Objective: to study the use of bioactive peptide complexes with low molecular weight and probiotic strains isolated from the human gastrointestinal tract in food products intended for patients with cancer during their treatment and rehabilitation. Material and Methods: 14 strains of lactic acid bacteria were pre-selected and identified for this study. They were allocated from the gastrointestinal tract of 500 healthy people and people with cancer, who presented different age groups. The study of antagonistic activity of lactic acid bacteria was carried out by using the MRS medium and Lysogeny broth (LB). Biocompatibility study was performed through the co-culture method on solid MRS medium. Results: Research results proved that the isolated metabolites belonged to bacteriocins, as the studied microorganisms were resistant both to their inhibitors and mutually resistant to the single-type synthesized substances. Conclusions. Probiotics have a positive effect on the immune system, as the gastro-intestinal flora they reduce the impact of mutagens and carcinogens.

Iron deficiency in cancer patients.

Anemia is a frequent complication in cancer patients, both at diagnosis and during treatment, with a multifactorial etiology in most cases. Iron deficiency is among the most common causes of anemia in this setting and can develop in nearly half of patients with solid tumors and hematologic malignancies. Surprisingly, this fact is usually neglected by the attending physician in a way that proper and prompt investigation of the iron status is either not performed or postponed. In cancer patients, functional iron deficiency is the predominant mechanism, in which iron availability is reduced due to disease or the therapy-related inflammatory process. Hence, serum ferritin is not reliable in detecting iron deficiency in this setting, whereas transferrin saturation seems more appropriate for this purpose. Besides, lack of bioavailable iron can be further worsened by the use of erythropoiesis stimulating agents that increase iron utilization in the bone marrow. Iron deficiency can cause anemia or worsen pre-existing anemia, leading to a decline in performance status and adherence to treatment, with possible implications in clinical outcome. Due to its frequency and importance, treatment of this condition is already recommended in many specialty guidelines and should be performed preferably with intravenous iron. The evidences regarding the efficacy of this treatment are solid, with response gain when combined with erythropoiesis stimulating agents and significant increments in hemoglobin as monotherapy. Among intravenous iron formulations, slow release preparations present more favorable pharmacological characteristics and efficacy in cancer patients.

Iron metabolism and iron supplementation in cancer patients.

SummaryIron deficiency and iron deficiency-associated anemia are common complications in cancer patients. Most iron deficient cancer patients present with functional iron deficiency (FID), a status with adequate storage iron, but insufficient iron supply for erythroblasts and other iron dependent tissues. FID is the consequence of the cancer-associated cytokine release, while in absolute iron deficiency iron stores are depleted resulting in similar but often more severe symptoms of insufficient iron supply. Here we present a short review on the epidemiology, pathophysiology, diagnosis, clinical symptoms, and treatment of iron deficiency in cancer patients. Special emphasis is given to intravenous iron supplementation and on the benefits and limitations of different formulations. Based on these considerations and recommendations from current international guidelines we developed recommendations for clinical practice and classified the level of evidence and grade of recommendation according to the principles of evidence-based medicine.

Prevalent factor XII deficiency in cancer patients with isolated aPTT prolongation

Prevalent factor XII deficiency in cancer patients with isolated aPTT prolongation

Acquired factor VII deficiency associated with synovial sarcoma

Abstract Background: Acquired factor VII (FVII) deficiency mostly results from liver disease or vitamin K antagonists. Isolated acquired FVII deficiency is a rare event, and only a few cases have been reported. To our knowledge, this is the first reported case of synovial sarcoma associated with FVII deficiency. Objective: To describe our findings in a 20-year-old man, who presented with hemoptysis, weight loss, and later developed a suprascapular mass. Methods: A review of the medical record of the patient plus a comparison with the literature was conducted. Results: A biopsy from a suprascapular mass was made and the histopathological diagnosis of the tumor was confirmed as synovial sarcoma. Initial studies indicated a normal activated partial thromboplastin time and a prolonged prothrombin time. The FVII level was 31%. No evidence of a FVII inhibitor or inactivator was demonstrated. Prothrombin time normalized during tumor regression and FVII level was elevated to 103%. Conclusion: Clinicians should be alert to the possible association of acquired FVII deficiency in cancer patients.

Role of conjunctival imprint cytology in detecting vitamin A deficiency in cancer patients: A case-control study

Context: Conjunctival Imprint cytology is widely used to detect vitamin A deficiency in field studies. Vitamin A deficiency is known to be associated with malignancies. Aims: To assess the vitamin-A status in cancer patients using conjunctival impression cytology technique (CICT) and to correlate the results with serum levels of the vitamin. Settings and Design: To study CICT in freshly detected cancer patients. To compare with normal controls, and to correlate the results obtained by the cytology technique with a serum retinol by HPLC method. Materials and Methods: Patients and their family members accompanying the patients were taken as subjects for the study and after an informed consent. Conjunctival imprint cytology samples and venous blood for serum retinol were collected from both groups. Statistical Analysis Used: Odds ratio, Pearson Chi-square test, Fisher exact test, analysis of variable, independent and dependent sample t test, mean and standard deviation. Data: Of 1551 subjects analyzed, vitamin A level Conclusions: CICT is a reliable technique to detect vitamin A deficiency in cancer patients.

VitaminKdeficiency in cancer patients referred to a hospital palliative care team with bleeding and the impact of vitaminKreplacement on laboratory indicators of vitaminKstatus

International Journal of Laboratory HematologyVolume 35, Issue 4 p. 457-459 Letter to the Editor Vitamin K deficiency in cancer patients referred to a hospital palliative care team with bleeding and the impact of vitamin K replacement on laboratory indicators of vitamin K status D. J. Harrington, D. J. Harrington dominic.harrngton@gstt.nhs.uk Nutristasis Department, St. Thomas' Hospital, London, UKSearch for more papers by this authorL. Booth, L. Booth Eastern Health, Wantirna, Vic., AustraliaSearch for more papers by this authorN. Dando, N. Dando Phyllis Tuckwell Hospice and Frimley Park Hospital, Frimley, UKSearch for more papers by this authorL. Cottingham, L. Cottingham Department of Palliative Care, St. George's Hospital, London, UKSearch for more papers by this authorT. Beynon, T. Beynon Department of Palliative Care, St. Thomas' Hospital, London, UKSearch for more papers by this author D. J. Harrington, D. J. Harrington dominic.harrngton@gstt.nhs.uk Nutristasis Department, St. Thomas' Hospital, London, UKSearch for more papers by this authorL. Booth, L. Booth Eastern Health, Wantirna, Vic., AustraliaSearch for more papers by this authorN. Dando, N. Dando Phyllis Tuckwell Hospice and Frimley Park Hospital, Frimley, UKSearch for more papers by this authorL. Cottingham, L. Cottingham Department of Palliative Care, St. George's Hospital, London, UKSearch for more papers by this authorT. Beynon, T. Beynon Department of Palliative Care, St. Thomas' Hospital, London, UKSearch for more papers by this author First published: 07 December 2012 https://doi.org/10.1111/ijlh.12035Citations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume35, Issue4August 2013Pages 457-459 RelatedInformation