scholarly journals Fertility preservation and fulfillment of parenthood after treatment of hematological malignancies: results from the ‘Aftercare in Blood Cancer Survivors’ (ABC) study

2020 ◽  
Vol 25 (6) ◽  
pp. 1187-1194 ◽  
Author(s):  
Christine Schmitz ◽  
Julia Baum ◽  
Hildegard Lax ◽  
Nils Lehmann ◽  
Tanja Gromke ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Hematological Malignancies ◽  
Allogeneic Transplantation ◽  
Post Treatment ◽  
Blood Cancer ◽  
Hematological Patients ◽  
History Of ◽  
Pre Treatment ◽  
Treatment Free Remission ◽  
Treatment Wish

Abstract Purpose Treatment of hematological malignancies carries the risk of lasting sterility. We aimed to identify fertility-related unmet needs. Methods The ‘Aftercare in Blood Cancer Survivors’ study is a cohort study of hematological patients who were in treatment-free remission for ≥ 3 years or stable under continuous oral medication. Female patients age 18–45 years and male patients age 18–65 years without a history of pre-treatment infertility were asked to answer a structured questionnaire including questions addressing fertility issues. Multivariable analyses were performed to detect risk factors. Results Of 1562 study participants, 1031 met the inclusion criteria for the fertility sub-study. A high proportion of patients (72.4%) received information about the risk of losing fertility, but only a minority (15%) took steps to preserve it. Female and older patients were less likely to be informed. A post-treatment wish for parenthood was expressed by 19.3% of patients. It was strongly associated with childlessness at time of diagnosis and could be fulfilled by 29.4%. Fulfillment of desired parenthood increased with increasing time from diagnosis and was low after allogeneic transplantation. Conclusions Female and older hematological patients are less likely to be informed about fertility-related issues than other patients. With societal changes towards first parenthood at higher age, the proportion of patients desiring a child after treatment is likely to increase. Fulfillment of desired parenthood remains challenging, especially after allogeneic transplantation. Implications for cancer survivors In patients likely to express a wish for post-treatment parenthood, fertility-related issues should routinely be addressed before gonadotoxic treatment is started.

scholarly journals Body mass index and attitudes towards health behaviors among women with endometrial cancer before and after treatment

2019 ◽  
Vol 30 (2) ◽  
pp. 187-192
Author(s):  
Ross Harrison ◽  
Hui Zhao ◽  
Charlotte C Sun ◽  
Shuangshuang Fu ◽  
Shannon D Armbruster ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Endometrial Cancer ◽  
Health Behavior ◽  
Health Behaviors ◽  
Cancer Survivors ◽  
Body Mass ◽  
Post Treatment ◽  
Treatment Changes ◽  
The Mean ◽  
Pre Treatment

IntroductionSome experts have argued that obesity-related malignancies such as endometrial cancer are a “teachable moment” that lead to meaningful changes in health behaviors. It is unclear if endometrial cancer survivors lose weight following treatment. Our goal with this investigation was to evaluate post-treatment changes in body mass index (BMI) and attitudes towards health behaviors in endometrial cancer survivors.MethodsIncident endometrial cancer cases undergoing surgery between 2009–2015 were identified in the Marketscan Commercial database and linked with BMI data and health behavior questionnaires from the Marketscan Health Risk Assessment database. Patients were excluded for insufficient BMI data. Standard statistical methods, including the two-sample Wilcoxon rank sum test, χ2 test, and McNemar’s test, were used.Results655 patients with a median age of 54 (IQR 49-58) were identified and analyzed. Median duration of follow-up was 595 days (IQR 360–1091). Mean pre- and post-treatment BMI was 35.5 kg/m2 (median 35.0; IQR 27.0–42.3) and 35.6 kg/m2 (median 34.3; IQR 28.0–42.0), respectively. Median BMI change in the entire cohort was 0 kg/m2 (IQR −1.0 to 2.0). Weight gain (n=302; 46.1%) or no change in weight (n=106; 16.2%) was seen in most patients. Among the 302 patients who gained weight, the mean pre-treatment BMI was 34.0 kg/m2 and mean increase was 2.8 kg/m2 (median 2.0; IQR 1.0–3.4). Among the 247 cases who lost weight, the mean pre-treatment BMI was 38.6 kg/m2 and mean decrease was 3.2 kg/m2 (median 2.0; IQR 1.0–4.0). No pre- to post-treatment differences were observed in health behavior questionnaires regarding intention to better manage their diet, exercise more, or lose weight.DiscussionMost endometrial cancer survivors gain weight or maintain the same weight following treatment. No post-treatment changes in attitudes regarding weight-related behaviors were observed. The systematic delivery of evidence-based weight loss interventions should be a priority for survivors of endometrial cancer.

scholarly journals Ivermectin Treatment Response in Onchocerca Volvulus Infected Persons with Epilepsy: A Three-Country Short Cohort Study

Pathogens ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 617
Author(s):  
Alfred Dusabimana ◽  
Dan Bhwana ◽  
Stephen Raimon ◽  
Bruno P. Mmbando ◽  
An Hotterbeekx ◽  
...  
Keyword(s):  
Democratic Republic Of Congo ◽  
Geometric Mean ◽  
Infection Intensity ◽  
Post Treatment ◽  
Onchocerca Volvulus ◽  
Ivermectin Treatment ◽  
Positive Skin ◽  
History Of ◽  
Pre Treatment ◽  
Study Sites

Despite a long history of community-directed treatment with ivermectin (CDTI), a high ongoing Onchocerca volvulus transmission is observed in certain onchocerciasis-endemic regions in Africa with a high prevalence of epilepsy. We investigated factors associated with higher microfilarial (mf) density after ivermectin treatment. Skin snips were obtained from O. volvulus-infected persons with epilepsy before, and 3 to 5 months after ivermectin treatment. Participants were enrolled from 4 study sites: Maridi (South Sudan); Logo and Aketi (Democratic Republic of Congo); and Mahenge (Tanzania). Of the 329 participants, 105 (31.9%) had a post-treatment mf density >20% of the pre-treatment value. The percentage reduction in the geometric mean mf density ranged from 69.0% (5 months after treatment) to 89.4% (3 months after treatment). A higher pre-treatment mf density was associated with increased probability of a positive skin snip after ivermectin treatment (p = 0.016). For participants with persistent microfiladermia during follow-up, a higher number of previous CDTI rounds increased the odds of having a post-treatment mf density >20% of the pre-treatment value (p = 0.006). In conclusion, the high onchocerciasis transmission in the study sites may be due to initially high infection intensity in some individuals. Whether the decreasing effect of ivermectin with increasing years of CDTI results from sub-optimal response mechanisms warrants further research.

Reduced-Intensity Unrelated Cord Blood Transplantation (RICBT) in Adult Patients with High-Risk Hematological Malignancies.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5433-5433 ◽  
Author(s):  
Takeshi Morii ◽  
Itsuto Amano ◽  
Haruyuki Tanaka ◽  
Toshihiro Takahashi ◽  
Hiroshi Kimura
Keyword(s):  
High Risk ◽  
Diabetic Complications ◽  
Hematological Malignancies ◽  
Acute Gvhd ◽  
Past History ◽  
Allogeneic Transplantation ◽  
Organ Damage ◽  
Short Term ◽  
History Of ◽  
One Year

Abstract <Introduction> RICBT using cyclosporine (CSP) and short-term mycophenolate mofetil (MMF) was performed on adult patients with high-risk hematological malignancies, from which data on complication measures and transplantation indications was obtained. <Subjects and Methods> From November 2003 to January 2005, RICBT was performed a total of 16 times on 14 patients. All patients were adults diagnosed with high-risk hematological malignancies, and 12 patients were not in remission. The average age of the patients was 57 years (range: 31–72 years). The average body weight of the patients was 59.1 kg (range: 48–72). The HLA match of two patients was 5/6 and 12 patients was 4/6. The average nucleated cell count was 2.55 x 107 cells/kg (range: 2.12–3.84 x 107 cells/kg). The conditioning regimen consisted of fludarabine and/or busulfan or cyclophosphamide and TBI (total body irradiation), and the intensity of therapy was adjusted based on age, disease, and systemic status. CSP and MMF were administered for GVHD (graft-versus-host disease) prophylaxis. The targeted duration of CSP and MMF administration was set at 100 and 28 days, respectively. <Results> Primary graft failure occurred in two patients. RICBT was repeated, and while the second treatment was successful in one patient, the other patient died of brain hemorrhage. Granulocyte recovery was observed in 13 patients on an average of 21 days, and platelet recovery was noted in 11 patients on an average of 43 days. Acute GVHD was assessed in 13 patients and confirmed in 12 patients, but a condition of grade II or above was seen in only three patients. Chronic GVHD was assessed in 12 patients and confirmed in six patients (limited type in five patients and extensive type in one patient). For the 16 treatments, the 100-day TRM (transplantation related mortality) was 19% (3 patients). Of the 14 patients, five remained alive and the statistically calculated one-year survival rate was 37%. Cause of death was recurrence in three patients, acute GVHD in one patient, viral infection in three patients, cerebral hemorrhage in one patient, and sudden death in one patient. Non-recurrence deaths included four patients with a past history of allogeneic transplantation, two patients with serious organ damage, and two patients with diabetic complications (two patients died of multiple causes). Of eight patients, excluding the six patients with past histories of allogeneic transplantation, serious organ damage, or diabetic complications, the 100-day TRM was 0% and the statistically calculated one-year survival rate was 54.7%. Two patients with VZV (varicella-zoster virus) infections died on days 221 and 228. <Discussion and conclusions> While the risk of graft failure is generally high for RICBT, the success rate for the present RICBT technique was extremely high. This technique also made it possible to induce proper GVHD without steroidal agents. The low recurrence rate appeared to indicate the GVL (graft versus leukemia) effects of RICBT. The high GVL effects and low 100-day TRM observed appeared to be attributable to short-term MMF administration. We believe viral infections must be prevented for a lengthy period after the cessation of immunosuppressant therapy. Our results suggest that a past history of allogeneic transplantation, severe organ damage, or diabetic complications may constitute risk factors.

Cytoprotective Effect of Tocotrienol-Rich Fraction and α-Tocopherol Vitamin E Isoforms Against Glutamate-Induced Cell Death in Neuronal Cells

2014 ◽  
Vol 84 (3-4) ◽  
pp. 0140-0151 ◽  
Author(s):  
Thilaga Rati Selvaraju ◽  
Huzwah Khaza’ai ◽  
Sharmili Vidyadaran ◽  
Mohd Sokhini Abd Mutalib ◽  
Vasudevan Ramachandran ◽  
...  
Keyword(s):  
Vitamin E ◽  
Cell Viability ◽  
Neuronal Cells ◽  
Positive Control ◽  
Post Treatment ◽  
Mitochondrial Activity ◽  
Before And After ◽  
Pre Treatment ◽  
Tocotrienol Rich Fraction ◽  
Major Mediator

Glutamate is the major mediator of excitatory signals in the mammalian central nervous system. Extreme amounts of glutamate in the extracellular spaces can lead to numerous neurodegenerative diseases. We aimed to clarify the potential of the following vitamin E isomers, tocotrienol-rich fraction (TRF) and α-tocopherol (α-TCP), as potent neuroprotective agents against glutamate-induced injury in neuronal SK-N-SH cells. Cells were treated before and after glutamate injury (pre- and post-treatment, respectively) with 100 - 300 ng/ml TRF/α-TCP. Exposure to 120 mM glutamate significantly reduced cell viability to 76 % and 79 % in the pre- and post-treatment studies, respectively; however, pre- and post-treatment with TRF/α-TCP attenuated the cytotoxic effect of glutamate. Compared to the positive control (glutamate-injured cells not treated with TRF/α-TCP), pre-treatment with 100, 200, and 300 ng/ml TRF significantly improved cell viability following glutamate injury to 95.2 %, 95.0 %, and 95.6 %, respectively (p < 0.05).The isomers not only conferred neuroprotection by enhancing mitochondrial activity and depleting free radical production, but also increased cell viability and recovery upon glutamate insult. Our results suggest that vitamin E has potent antioxidant potential for protecting against glutamate injury and recovering glutamate-injured neuronal cells. Our findings also indicate that both TRF and α-TCP could play key roles as anti-apoptotic agents with neuroprotective properties.

CONTRACEPTION BY AN INJECTABLE LONG-ACTING OESTROGEN-PROGESTOGEN AGENT. III

1972 ◽  
Vol 69 (1) ◽  
pp. 67-76
Author(s):  
Rolf Plesner
Keyword(s):  
Treatment Period ◽  
Treatment Cycle ◽  
Post Treatment ◽  
Mixed Phase ◽  
Discontinuation Of Treatment ◽  
Phase Type ◽  
Secretory Type ◽  
Pre Treatment ◽  
Long Acting ◽  
Fertile Women

ABSTRACT Twenty-two fertile women were treated cyclically in from 4–30 cycles (mean 15.5) with a total of 341 injections of Deladroxate®, an injectable, long-acting oestrogen-progestogen. The injections were administered on the 8th (7th–9th) day of each cycle. Before treatment, the last pre-treatment cycle was controlled by means of daily recordings of the basal body temperature (BBT), urinary excretion of pregnanediol and total pituitary gonadotrophins at certain intervals, and by endometrial biopsies obtained late in the cycle. The effects of Deladroxate® on ovulation, on pituitary gonadotrophic function, and on the endometrium were controlled by the above mentioned parameters during cycles 1, 3, and 6, and all assessments were repeated after discontinuation of treatment. During treatment, there was a statistically significant fall in gonadotrophin excretion values (as compared with the pre-treatment values), and the fall was found to be gradually progressive during treatment. After discontinuation of treatment, there seemed to be a tendency towards an increase in the excretion values. Suppression of ovulation as determined by means of the pregnanediol excretion during treatment, was effective in nearly all of the treatment cycles checked. The fall in pregnanediol excretion was also gradually progressive during treatment, while there was a slight increase in excretion values in the post-treatment period. During treatment, 79 BBT curves were recorded. Nearly 50 % were monophasic, indicating anovulatory cycles, 17 curves were biphasic, but with the rise in temperature occurring at non-characteristic times in the cycles, 18 curves were classified as thermogenic because of a rise in temperature occurring within 24 hours after the injection, and 5 curves were not assessable. During the first month after discontinuation of treatment, 8 out of 10 recorded curves were monophasic. Out of 53 endometrial biopsies obtained around the 23rd day of the cycle, 31 were of the mixed phase type, but showing a predominance of proliferative patterns, 15 were of the secretory type, and 7 were purely proliferative. Out of 15 biopsies obtained in the post-treatment period, only two were of the mixed phase type, 12 were proliferative and one was purely secretory.

Pre-treatment and post-treatment visual functions in congenital myopia alone versus congenital myopia complicated by amblyopia

2018 ◽  
Vol 75 (4) ◽  
pp. 44-48
Author(s):  
A. Mukhina ◽  
◽  
I. Boichuk ◽  
L. Zhuravliova ◽  
◽  
...  
Keyword(s):  
Post Treatment ◽  
Visual Functions ◽  
Pre Treatment

scholarly journals Relationship between metamorphopsia and inner retinal microstructure following intravitreal ranibizumab injection for branch retinal vein occlusion

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoshimi Sugiura ◽  
Fumiki Okamoto ◽  
Tomoya Murakami ◽  
Shohei Morikawa ◽  
Takahiro Hiraoka ◽  
...  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Post Treatment ◽  
Intravitreal Ranibizumab ◽  
Vein Occlusion ◽  
Treatment Naïve ◽  
Pre Treatment ◽  
Number Of Injections

AbstractTo evaluate the effects of intravitreal ranibizumab injection (IVR) on metamorphopsia in patients with branch retinal vein occlusion (BRVO), and to assess the relationship between metamorphopsia and inner retinal microstructure and other factors. Thirty-three treatment-naïve eyes of 33 patients with macular edema caused by BRVO with at least 12 months of follow-up were included. The degree of metamorphopsia was quantified using the M-CHARTS. Retinal microstructure was assessed with spectral-domain optical coherence tomography. Disorganization of the retinal inner layers (DRIL) at the first month after resolution of the macular edema (early DRIL) and at 12 months after treatment (after DRIL) was studied. Central retinal thickness (CRT), and status of the external limiting membrane as well as ellipsoid zone were also evaluated. IVR treatment significantly improved best-corrected visual acuity (BCVA) and CRT, but the mean metamorphopsia score did not improve even after 12 months. Post-treatment metamorphopsia scores showed a significant correlation with pre-treatment metamorphopsia scores (P < 0.005), the extent of early DRIL (P < 0.05) and after DRIL (P < 0.05), and the number of injections (P < 0.05). Multivariate analysis revealed that the post-treatment mean metamorphopsia score was significantly correlated with the pre-treatment mean metamorphopsia score (P < 0.05). IVR treatment significantly improved BCVA and CRT, but not metamorphopsia. Post-treatment metamorphopsia scores were significantly associated with pre-treatment metamorphopsia scores, the extent of DRIL, and the number of injections. Prognostic factor of metamorphopsia was the degree of pre-treatment metamorphopsia.

scholarly journals Comparison of Selected Immune and Hematological Parameters and Their Impact on Survival in Patients with HPV-Related and HPV-Unrelated Oropharyngeal Cancer

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3256
Author(s):  
Adam Brewczyński ◽  
Beata Jabłońska ◽  
Agnieszka Maria Mazurek ◽  
Jolanta Mrochem-Kwarciak ◽  
Sławomir Mrowiec ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Oropharyngeal Cancer ◽  
Hematological Parameters ◽  
White Blood Cells ◽  
Post Treatment ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Hpv Status ◽  
Pre Treatment ◽  
The Impact

Several immune and hematological parameters are associated with survival in patients with oropharyngeal cancer (OPC). The aim of the study was to analyze selected immune and hematological parameters of patients with HPV-related (HPV+) and HPV-unrelated (HPV-) OPC, before and after radiotherapy/chemoradiotherapy (RT/CRT) and to assess the impact of these parameters on survival. One hundred twenty seven patients with HPV+ and HPV− OPC, treated with RT alone or concurrent chemoradiotherapy (CRT), were included. Patients were divided according to HPV status. Confirmation of HPV etiology was obtained from FFPE (Formalin-Fixed, Paraffin-Embedded) tissue samples and/or extracellular circulating HPV DNA was determined. The pre-treatment and post-treatment laboratory blood parameters were compared in both groups. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), and systemic immune inflammation (SII) index were calculated. The impact of these parameters on overall (OS) and disease-free (DFS) survival was analyzed. In HPV+ patients, a high pre-treatment white blood cells (WBC) count (>8.33 /mm3), NLR (>2.13), SII (>448.60) significantly correlated with reduced OS, whereas high NLR (>2.29), SII (>462.58) significantly correlated with reduced DFS. A higher pre-treatment NLR and SII were significant poor prognostic factors for both OS and DFS in the HPV+ group. These associations were not apparent in HPV− patients. There are different pre-treatment and post-treatment immune and hematological prognostic factors for OS and DFS in HPV+ and HPV− patients. The immune ratios could be considered valuable biomarkers for risk stratification and differentiation for HPV− and HPV+ OPC patients.

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