Nonparametric Estimation of an Event-Free Survival Distribution Under Cross-Sectional Sampling

2017 ◽  
pp. 57-67
Author(s):  
Jacobo de Uña-Álvarez
Keyword(s):  
Nonparametric Estimation ◽  
Event Free Survival ◽  
Cross Sectional ◽  
Free Survival ◽  
Survival Distribution

scholarly journals Hubungan Pemberian Kortikosteroid terhadap Kenaikan Berat Badan pada Anak Penderita Leukemia Limfoblastik Akut Fase Induksi di RSUP Haji Adam Malik Medan

2021 ◽  
Vol 2 (2) ◽  
pp. 76-83
Author(s):  
Isni Dhiyah Almira ◽  
Selvi Nafianti
Keyword(s):  
Body Weight ◽  
Weight Gain ◽  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Induction Phase ◽  
Spearman Correlation ◽  
Event Free Survival ◽  
Cross Sectional ◽  
Corticosteroid Administration ◽  
Free Survival

Background: Glucocorticoid corticosteroids have vasoconstrictive, anti-proliferation, anti-inflammatory, and immunosuppressant effects through interactions with glucocorticoid receptors which have also been found in one type of leukemia, acute lymphoblastic leukemia (ALL). The most common side effect long-term use of high dose corticosteroids is increase in body weight resulting in obesity. It is one of the main problems in ALL patients, because it leads to persistent leukemia, increase of the risk of recurrence, and poor event-free survival. This has been associated with the use of glucocorticoids namely dexamethasone and prednisone in the induction phase chemotherapy process. Objectives: This study was intended to determine the association of corticosteroid administration to weight gain in children with ALL induction phase. Methods: The study was analytic-cross sectional. A total of 62 medical records of pediatric patients with ALL in Haji Adam Malik General Hospital Medan in 2015-2018. The data obtained were processed using the Wilcoxon statistical test, the Mann-Whitney test, and the Spearman-Correlation Rank test. Results: Wilcoxon test showed the effect of corticosteroid administration on body weight in the sample (p = 0.001). The Mann-Whitney test showed a difference in the influence of the use of prednisone and dexamethasone on sample body weight (p = 0.001), but it was not found regarding the nutritional status of the sample (p = 0.149). The Spearman-correlation test showed that there was no association of weight gain with the total corticosteroid dose given (p = 0.251). Conclusion: There is an association of corticosteroid administration to body weight in children with ALL induction phase. There are differences in the influence of the use of prednisone and dexamethasone on body weight, while there is no such difference on nutritional status in children with ALL induction phase. There is no association of weight gain based on the total corticosteroid dose given during the induction phase in children with ALL. Keywords: acute lymphoblastic leukemia, corticosteroid, induction phase chemotherapy, weight gain   Latar Belakang: Kortikosteroid golongan glukokortikoid memiliki efek vasokontriksi, anti-proliferasi, anti-inflamasi, dan imunosupresan melalui interaksinya dengan glucocorticoid receptor yang juga telah ditemukan pada salah satu jenis leukemia yaitu leukemia limfoblastik akut (LLA). Efek samping paling sering dari penggunaan kortikosteroid jangka panjang dengan dosis tinggi adalah peningkatan berat badan berlebih yang berakibat pada obesitas. Hal ini menjadi salah satu masalah utama pada pasien LLA, karena dapat menyebabkan leukemia persisten, meningkatkan risiko kekambuhan, dan event-free survival yang buruk. Hal tersebut telah dikaitkan dengan penggunaan glukokortikoid deksametason dan prednisone dalam proses kemoterapi LLA fase induksi. Tujuan: Penelitian ini dimaksudkan untuk mengetahui hubungan pemberian kortikosteroid terhadap kenaikan berat badan pada anak penderita leukemia limfoblastik akut fase induksi. Metode: Penelitian yang dilakukan bersifat analitik-cross sectional. Dikumpulkan sebanyak 62 rekam medis pasien anak penderita LLA di RSUP Haji Adam Malik Medan tahun 2015-2018. Data yang diperoleh diolah menggunakan uji statistik Wilcoxon, uji Mann-Whitney, dan uji Rank Spearman-Correlation. Hasil: Uji Wilcoxon menunjukkan adanya pengaruh pemberian kortikosteroid terhadap berat badan pada sampel (p = 0,001). Uji Mann-Whitney menunjukkan adanya perbedaan pengaruh penggunaan prednison dan deksametason terhadap berat badan sampel (p = 0,001), tetapi tidak terhadap status gizi sampel (p = 0,149). Uji Rank Spearman-Correlation menunjukkan tidak terdapat hubungan kenaikan berat badan terhadap total dosis kortikosteroid yang diberikan (p = 0,251). Kesimpulan: Terdapat hubungan pemberian kortikosteroid terhadap berat badan anak penderita LLA fase induksi. Terdapat perbedaan pengaruh penggunaan prednison dan deksametason terhadap berat badan anak penderita LLA fase induksi, tetapi tidak terhadap status gizi. Tidak terdapat hubungan kenaikan berat badan berdasarkan total dosis kortikosteroid yang diberikan selama fase induksi pada anak penderita LLA. Kata kunci: kemoterapi fase induksi, kenaikan berat badan, kortikosteroid, leukemia limfoblastik akut

Sex Differences in Perioperative and Long-term Cardiac Event–Free Survival in Vascular Surgery Patients

Circulation ◽  
1995 ◽  
Vol 91 (4) ◽  
pp. 1044-1051 ◽  
Author(s):  
Robert C. Hendel ◽  
Ming Hui Chen ◽  
Gilbert J. L’Italien ◽  
John B. Newell ◽  
Sumita D. Paul ◽  
...  
Keyword(s):  
Sex Differences ◽  
Vascular Surgery ◽  
Cardiac Event ◽  
Event Free Survival ◽  
Free Survival

scholarly journals OP0146 LONG TERM OUTCOME AND PROGNOSIS FACTORS OF ISOLATED AORTITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 93.1-93
Author(s):  
Y. Ferfar ◽  
S. Morinet ◽  
O. Espitia ◽  
C. Agard ◽  
M. Vautier ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Giant Cell Arteritis ◽  
Takayasu Arteritis ◽  
Vascular Complications ◽  
Event Free Survival ◽  
Prognosis Factors ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Free Survival

Background:Aortitis is a group of disorders characterized by the inflammation of the aorta. The most common causes of aortitis are the large-vessel vasculitis i.e. giant cell arteritis (GCA) and Takayasu arteritis (TA). However, aortitis may be isolated. Because of the wide variation in the course of aortitis, predicting outcome is challenging. The optimal management strategy of isolated aortitis (IA) is still unclear as IA is poorly defined, with data consisting of small retrospective and case control studies.Objectives:To assess the long-term outcome and prognosis factors for vascular complications in patients with isolated aortitis.Methods:Retrospective multicenter study of 353 patients with non-infectious aortitis including 136 giant cell arteritis (GCA), 96 Takayasu arteritis (TA) and 73 isolated aortitis (IA). Factors associated with event-free survival, vascular event-free survival and revascularization-free survival were assessed. Risk factors for vascular complications were identified in multivariate analysis.Results:After a median follow up of 52 months, vascular complications were observed in 32.3 %, revascularization in 30 % and death in 7.6%. The 5-year cumulative incidence of vascular complications was 58% (41; 71), 20% (13; 29), and 19 % (11; 28) in IA, GCA and TA, respectively. In multivariate analysis, IA [HR, 1.85 (1.19 to 2.88), p=0.017] and male gender [1.77 (1.26 to 2.49), p<0.0001] were independently associated with vascular events. The 5-year surgery-free survival was 45% (31; 65), 71% (62; 81) and 76% (68; 86) in IA, TA and GCA, respectively.Conclusion:IA has a worse vascular prognosis than GCA and TA. Sixty percent of IA patients will experience a vascular complication within 5 years from diagnosis.Disclosure of Interests:None declared

scholarly journals Oral Metronomic Maintenance Therapy Can Improve Survival in High-Risk Neuroblastoma Patients Not Treated with ASCT or Anti-GD2 Antibodies

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3494
Author(s):  
Xiaofei Sun ◽  
Zijun Zhen ◽  
Ying Guo ◽  
Yuanhong Gao ◽  
Juan Wang ◽  
...  
Keyword(s):  
High Risk ◽  
Conventional Treatment ◽  
Maintenance Treatment ◽  
Antibody Therapy ◽  
Aggressive Treatment ◽  
Newly Diagnosed ◽  
Event Free Survival ◽  
Free Survival ◽  
Stage 4 ◽  
Risk Patients

Despite aggressive treatment, the prognosis of high-risk NB patients is still poor. This retrospective study investigated the benefits of metronomic maintenance treatment (MT) in high-risk NB patients without ASCT or GD2 antibody therapy. Patients aged ≤ 21 years with newly diagnosed high-risk NB were included. Patients with complete/very good partial remission (CR/VGPR/PR) to conventional treatment received, or not, oral metronomic MT for 1 year. Two hundred and seventeen high-risk NB patients were enrolled. One hundred and eighty-five (85%) had a CR/VGPR/PR to conventional treatment, of the patients with stage 4, 106 receiving and 61 not receiving oral metronomic MT, and the 3-year event-free survival (EFS) rate was 42.5 ± 5.1% and 29.6 ± 6%, respectively (p = 0.017), and overall survival (OS) rate was 71.1 ± 4.7% and 59.4 ± 6.4%, respectively (p = 0.022). A total of 117 high-risk patients with oral metronomic MT had EFS rate of 42.7 ± 4.8%. The toxicity of MT was mild. For high-risk NB patients without ASCT or anti-GD2 antibody therapy, stage 4, MYCN amplication and patients with stage 4 not receiving oral metronomic MT after CR/VGPR/PR were independent adverse prognostic factors. Oral metronomic MT can improve survival in high-risk NB patients in CR/VGPR/PR without ASCT or anti-GD2 antibodies therapy.

scholarly journals Genetic program activity delineates risk, relapse, and therapy responsiveness in multiple myeloma

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Matthew A. Wall ◽  
Serdar Turkarslan ◽  
Wei-Ju Wu ◽  
Samuel A. Danziger ◽  
David J. Reiss ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Chromosomal Abnormalities ◽  
Transcriptional Regulatory Network ◽  
Progression Free Survival ◽  
Cross Sectional ◽  
Free Survival ◽  
Extreme Risk ◽  
Transcriptional Regulatory ◽  
Transcription Regulators ◽  
Immunosuppressive Microenvironment

AbstractDespite recent advancements in the treatment of multiple myeloma (MM), nearly all patients ultimately relapse and many become refractory to multiple lines of therapies. Therefore, we not only need the ability to predict which patients are at high risk for disease progression but also a means to understand the mechanisms underlying their risk. Here, we report a transcriptional regulatory network (TRN) for MM inferred from cross-sectional multi-omics data from 881 patients that predicts how 124 chromosomal abnormalities and somatic mutations causally perturb 392 transcription regulators of 8549 genes to manifest in distinct clinical phenotypes and outcomes. We identified 141 genetic programs whose activity profiles stratify patients into 25 distinct transcriptional states and proved to be more predictive of outcomes than did mutations. The coherence of these programs and accuracy of our network-based risk prediction was validated in two independent datasets. We observed subtype-specific vulnerabilities to interventions with existing drugs and revealed plausible mechanisms for relapse, including the establishment of an immunosuppressive microenvironment. Investigation of the t(4;14) clinical subtype using the TRN revealed that 16% of these patients exhibit an extreme-risk combination of genetic programs (median progression-free survival of 5 months) that create a distinct phenotype with targetable genes and pathways.

scholarly journals MBCL-37. CHEMOTHERAPY STRATEGIES FOR YOUNG CHILDREN NEWLY DIAGNOSED WITH CLASSIC (CLMB) OR ANAPLASTIC/LARGE CELL (A/LCMB) MEDULLOBLASTOMA UP TO THE ERA OF MOLECULAR PROFILING – A COMPARATIVE OUTCOMES ANALYSIS

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii396-iii397
Author(s):  
Jonathan Finlay ◽  
Martin Mynarek ◽  
Girish Dhall ◽  
Claire Mazewski ◽  
Richard Grundy ◽  
...  
Keyword(s):  
Head Start ◽  
Young Children ◽  
Induction Chemotherapy ◽  
Treatment Strategies ◽  
Large Cell ◽  
High Dose ◽  
Event Free Survival ◽  
Standard Chemotherapy ◽  
Outcomes Analysis ◽  
Free Survival

Abstract BACKGROUND/OBJECTIVE The introduction of German regimens, supplementing “standard” chemotherapy with both intravenous high-dose (HD-MTX) and intraventricular (IVENT-MTX) methotrexate, and North American regimens incorporating marrow-ablative chemotherapy with autologous hematopoietic cell rescue (HDCx+AuHCR), report encouraging outcomes for young children with medulloblastoma. We performed a comparative outcomes analysis of treatment strategies for young children with ClMB or A/LCMB. DESIGN/ METHODS Data from 12 prospective multi-center trials published between 2005 and 2019 for children &lt;six-years-old with ClMB or A/LCMB were reviewed; survivals were compared. RESULTS COG-9921, UKCCSG-CNS9204, COG-P9934 and SJYCO7 employing standard chemotherapy with either no or risk-based irradiation, reported 3-5-year event-free survival (EFS) of 17+/-5%, 33+/-28% (ClMB), 14+/-7% and 13.8+/-9% (ClMB) respectively, with reported EFS of 0% for A/LCMB in UKCCSG-CNS9204 and SJYCO7. HIT-SKK’87, HIT-SKK’92 and HIT-SKK’00 incorporating HD-MTX and IVENT-MTX reported 2-10-year EFS of 30–34+/-10–11% for ClMB and 33+/-27% (HIT-SSK’00) for A/LCMB. Head Start HS-I-II combined, CCG-99703 and HS-III employing induction chemotherapy, with or without HD-MTX, followed by single or tandem HDCx+AuHCR reported 3-5-year EFS of 42+/-14%, 50+/-11% and 27+/-6% for ClMB, with EFS for A/LCMB of 38+/-13% (HS-III). Finally, 5-year overall survivals for ACNS0334, without or with induction HD-MTX, are 39% and 69% respectively for ClMB and A/LCMB combined. CONCLUSIONS A trend towards better outcomes for young children with ClMB and A/LCMB is observed in trials including either HD-MTX and IVENT-MTX or including HD-MTX-containing induction chemotherapy and HDCx+AuHCR. Trials excluding HD-MTX, IVENT-MTX and HDCx+AuHCR have poorer outcomes.

In vitro all-trans retinoic acid sensitivity of acute promyelocytic leukemia blasts: a novel indicator of poor patient outcome

Blood ◽  
2001 ◽  
Vol 98 (9) ◽  
pp. 2862-2864 ◽  
Author(s):  
Bruno Cassinat ◽  
Sylvie Chevret ◽  
Fabien Zassadowski ◽  
Nicole Balitrand ◽  
Isabelle Guillemot ◽  
...  
Keyword(s):  
Acute Promyelocytic Leukemia ◽  
Promyelocytic Leukemia ◽  
Leukemic Cells ◽  
Event Free Survival ◽  
Free Survival ◽  
Acid Sensitivity ◽  
Trans Retinoic Acid ◽  
All Trans Retinoic Acid

Abstract Acute promyelocytic leukemia (APL) blasts possess a unique sensitivity to the differentiating effects of all-transretinoic acid (ATRA). Multicenter trials confirm that the combination of differentiation and cytotoxic therapy prolongs survival in APL patients. However relapses still occur, and exquisite adaptation of therapy to prognostic factors is essential to aim at a possible cure of the disease. A heterogeneity was previously reported in the differentiation rate of patients' APL blasts, and it was postulated that this may reflect the in vivo heterogeneous outcome. In this study, it is demonstrated that patients of the APL93 trial whose leukemic cells achieved optimal differentiation with ATRA in vitro at diagnosis had a significantly improved event-free survival (P = .01) and lower relapse rate (P = .04). This analysis highlights the importance of the differentiation step in APL therapy and justifies ongoing studies aimed at identifying novel RA-differentiation enhancers.

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