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Clinical usefulness of cell-free and concentrated ascites reinfusion therapy (CART) in combination with chemotherapy for malignant ascites: a post-marketing surveillance study

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Abstract

Background

Cell-free and concentrated ascites reinfusion therapy (CART) has been suggested to be able to treat malignant ascites more safely and effectively with chemotherapy because of its ability to retain serum protein and albumin. Although the characteristics of cancer types and CART and the clinical implications of combination therapy with antitumor agents are becoming widespread, there are limited reports on its efficacy and complications.

Methods

In this prospective observational national post-marketing study, 128 patients with malignancies received 300 CART sessions at 22 centers. After excluding other malignancies, the patients were divided into four groups: gynecological malignancies with chemotherapy (GYC+; 18 cases and 36 times) and without chemotherapy (GYC−; 35 cases and 52 times), and gastrointestinal malignancies with chemotherapy (GIC+; 8 cases and 16 times) and without chemotherapy (20 cases and 58 times).

Results

There were significant reductions in the body weight in all groups and significant reductions in abdominal circumference and significant improvements in the diet and Eastern Cooperative Oncology Group performance status only in the GYC+ group. The total serum protein and albumin increased significantly in all groups, except for the GIC+ group, before and after CART. There was no significant difference in the presence or absence of antitumor medication.

Conclusion

With CART, there were differences in the improvement of the clinical symptoms between malignancy groups. The combination of CART and antineoplastic agents may be as safe as CART alone in cases of exudative malignant ascites.

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Acknowledgements

We would like to thank the staff of all of the centers that participated in this study.

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Authors and Affiliations

  1. Department of Gynecology, Kitasato University Kitasato Institute Hospital, 5-9-1, Shirokane, Minato-ku, Tokyo, 108-8642, Japan

    Ken Ishitani

  2. Department of Obstetrics and Gynecology, Tokyo Women’s Medical University, Tokyo, Japan

    Ken Ishitani

  3. Blood Purification Division, Asahi Kasei Medical Co., Ltd, Tokyo, Japan

    Ayako Isoai, Hirokazu Onodera, Ryosuke Kobayashi, Naoko Torii, Noriko Soneda & Yoshihiro Matsuno

  4. Department of Palliative Care, Japanese Red Cross Medical Center, Tokyo, Japan

    Tetsuya Ito

  5. Department of Gastroenterology, Kizawa Memorial Hospital, Gifu, Japan

    Hiroshi Sugiyama

  6. Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

    Atsushi Arakawa

  7. Division of Nephrology, Shinshu University Hospital, Nagano, Japan

    Yosuke Yamada

  8. Department of Transfusion Medicine and Cell Processing, Tokyo Women’s Medical University, Tokyo, Japan

    Taiju Utsugisawa

  9. Kato Michio Clinic of Liver Diseases, Hyogo, Japan

    Michio Kato

  10. Department of Blood Purification, Tokyo Women’s Medical University, Tokyo, Japan

    Norio Hanafusa

Authors
  1. Ken Ishitani
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  2. Ayako Isoai
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  11. Yoshihiro Matsuno
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  13. Michio Kato
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  14. Norio Hanafusa
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Corresponding author

Correspondence to Ken Ishitani.

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Ishitani, K., Isoai, A., Ito, T. et al. Clinical usefulness of cell-free and concentrated ascites reinfusion therapy (CART) in combination with chemotherapy for malignant ascites: a post-marketing surveillance study. Int J Clin Oncol 26, 1130–1138 (2021). https://doi.org/10.1007/s10147-021-01883-2

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  • DOI: https://doi.org/10.1007/s10147-021-01883-2

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