Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5932_Библиотеки_им_академика_М_И_Перельмана

Despite Doxil®’s general tolerability advantage over DOX, there have been two adverse events that were not characteristic of the free drug standard of care therapy. The very rst, more severe case, known as palmar plantar erythrodysthesia (PPE) or “foot and hand syndrome,” causes underestimating dermatitis in grades 2 or 3. The PPE manifests as skin that is red, sensitive, and peeling, as was earlier shown ininitial FIM research [18] and published by Solomon and Gabizon [25]. In comparison to DOXin the same treatment protocol, the Doxil® dose that may be administered is constrained by the frequency of this adverse effect. In addition to the aforementioned extension in treatment intervals, there is currently no comprehensive cure for this effect [25]. The second consequence is an unfavorable immunological phenomenon that Doxil®, along with numerous other nano-systems, can cause; it is an infusion-related response that manifests as ushing and breathlessness. It is, in fact, a complement activation-related pseudo-allergy (CARPA). CARPA is an abrupt hypersensitivity, or infusion response, and is so named due to the causative involvement of complement activation in its patho-mechanism in place of IgE binding [28]. Sluggish infusion rates and premed­ication can also help to lower CARPA. There is a strong likelihood that minimizing these two side effects and, in particular, minimizing or overcoming the negative PPE