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Initial treatment is usually with oral prednisone (50–150 mg/day) or high-dose intravenous methylprednisolone (1 g/day) for 3–7 days. Thyroid hormone treatment is also included if required. Thyroid hormone treatment is also included if required.
Prednisone is a glucocorticoid medication mostly used to suppress the immune system and decrease inflammation in conditions such as asthma, COPD, and rheumatologic diseases. [3] It is also used to treat high blood calcium due to cancer and adrenal insufficiency along with other steroids . [ 3 ]
The neuropsychiatric effects are partly mediated by sensitization of the body to the actions of adrenaline. Therapeutically, the bulk of corticosteroid dose is given in the morning to mimic the body's diurnal rhythm; if given at night, the feeling of being energized will interfere with sleep. An extensive review is provided by Flores and Gumina ...
Psychosocial behavioral and emotional disturbances [41] with aggression being one of the most common cognitive symptoms, especially with oral use. [42] Nasal septum perforation and bowel perforation (in some pathologic conditions). [43] [44] Discontinuing prednisolone after long-term or high-dose use can lead to adrenal insufficiency. [41]
R-miniCHOP is indicated in elderly patients (>80 years) with diffuse large B-cell lymphoma due to less toxicity from the reduced dose in comparison to R-CHOP. R-Maxi-CHOP is used in mantle cell lymphoma and is given in 21-day intervals, alternating with R-HDAC (rituximab + high-dose cytarabine).
The Mayo Clinic Cancer Center is one of the oldest NCI-designated cancer centers in the United States, having first been designated in 1973. [3] The main location of the Mayo Clinic is in Rochester, MN. Campuses in Arizona and Florida opened later and became part of the Mayo Clinic Cancer Center in 2003. [4] [5]
It was developed at the National Cancer Institute in the 1960s by a team that included Vincent DeVita, Jr. Although no longer the most effective combination, MOPP is still used after relapse or where the patient has certain allergies or lung or heart problems which prevents the use of another regimen.
Cognitive symptoms from steroids appear within the first few weeks of treatment, appear to be dose dependent, and may or may not be accompanied by steroid psychosis or other Cushing's-type symptoms. [4] The symptoms include deficits in verbal and non-verbal memory; working memory; attention; sustained concentration; executive function ...