Clonal Hematopoiesis: Molecular and Clinical Implications

While clonal hematopoiesis (CH) can precede the development of acute myeloid leukemia (AML), it can also persist after achieving remission. Long-term clonal dynamics and clinical implications of persistent CH are not well understood. Here, we studied the prevalence, dynamics and clinical implications of post-remission CH in 164 AML patients who attained complete remission after induction chemotherapies. Post-remission CH was identified in 79 (49%) patients. Post-remission CH persisted long-term in 91% of the trackable patients despite treatment with various types of consolidation and maintenance therapies. Post-remission CH was eradicated in 20 out of 21 (95%) patients who underwent allogeneic stem cell transplant. While patients with post-remission CH as a group had comparable hematopoiesis with those without it, patients with persistent TET2 mutations showed significant neutropenia long-term. Post-remission CH had little impact on relapse risk, non-relapse mortality, and incidence of atherosclerotic cardiovascular disease, although the clinical impact of post-CR CH was heterogeneous among different mutations. These data suggest that while residual clonal hematopoietic stem cells (HSCs) are generally resistant to consolidation and maintenance therapies, they retain the ability to maintain normal hematopoiesis and have little impact on clinical outcomes, although larger study is needed to dissect the gene-specific heterogeneity.

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83TiP Clinical implications of clonal hematopoiesis mutations in patients with solid tumors

Annals of Oncology ◽

10.1016/j.annonc.2021.08.2079 ◽

2021 ◽

Vol 32 ◽

pp. S1370-S1371

Author(s):

V.M. Croitoru ◽

I.M. Cazacu ◽

D. Paul ◽

A. Colita ◽

C.V. Lungulescu ◽

...

Keyword(s):

Solid Tumors ◽

Clinical Implications ◽

Clonal Hematopoiesis

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Clonal hematopoiesis and preleukemia—Genetics, biology, and clinical implications

Genes Chromosomes and Cancer ◽

10.1002/gcc.22756 ◽

2019 ◽

Vol 58 (12) ◽

pp. 828-838 ◽

Cited By ~ 5

Author(s):

Luise Hartmann ◽

Klaus H. Metzeler

Keyword(s):

Clinical Implications ◽

Clonal Hematopoiesis

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Effects of Selected Rhinologic Disorders on the Perception of Nasal Resonance in Children

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.1501.44 ◽

1984 ◽

Vol 15 (1) ◽

pp. 44-50 ◽

Cited By ~ 2

Author(s):

Michael P. Rastatter ◽

Melvin Hyman

Keyword(s):

Allergic Rhinitis ◽

Clinical Implications ◽

Normal Children ◽

Nasal Resonance

A group of sophisticated listeners judged the nasal resonance characteristics of normal children versus children evidencing selected rhinologic disorders under three speaking conditions. Results showed that perceptions of denasality are influenced by both speakers and speaking tasks. That is, children with allergic rhinitis and edemic adenoids were perceived as being denasal when they produced VCV utterances and recited sentences. However, their resonance characteristics were deemed normal for vowel productions. Interestingly, children with severely deviated septums were judged to have normal nasal resonance under all speaking conditions. Clinical implications are discussed.

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Perceptions of Stuttering of Different Age Groups

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig4-2018-0007 ◽

2019 ◽

Vol 4 (6) ◽

pp. 1311-1315

Author(s):

Sergey M. Kondrashov ◽

John A. Tetnowski

Keyword(s):

Age Groups ◽

School Age Children ◽

Clinical Implications ◽

School Age ◽

Fourth Edition ◽

Self Perception ◽

Behavioral Measures ◽

Self Rating ◽

Comparison Results ◽

Subject Pool

Purpose The purpose of this study was to assess the perceptions of stuttering of school-age children who stutter and those of adults who stutter through the use of the same tools that could be commonly used by clinicians. Method Twenty-three participants across various ages and stuttering severity were administered both the Stuttering Severity Instrument–Fourth Edition (SSI-4; Riley, 2009 ) and the Wright & Ayre Stuttering Self-Rating Profile ( Wright & Ayre, 2000 ). Comparisons were made between severity of behavioral measures of stuttering made by the SSI-4 and by age (child/adult). Results Significant differences were obtained for the age comparison but not for the severity comparison. Results are explained in terms of the correlation between severity equivalents of the SSI-4 and the Wright & Ayre Stuttering Self-Rating Profile scores, with clinical implications justifying multi-aspect assessment. Conclusions Clinical implications indicate that self-perception and impact of stuttering must not be assumed and should be evaluated for individual participants. Research implications include further study with a larger subject pool and various levels of stuttering severity.

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Treatment Considerations for Adolescents Who Exhibit Cognitive/Communication Problems: A Neuroscience Perspective

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-20-00071 ◽

2020 ◽

Vol 5 (6) ◽

pp. 1767-1775

Author(s):

Martha S. Burns

Keyword(s):

Social Communication ◽

Transition Period ◽

Clinical Intervention ◽

Review Article ◽

Sensitive Period ◽

Clinical Implications ◽

Evidence Based ◽

Communication Problems ◽

Treatment Considerations ◽

Behavioral Growth

Purpose Adolescence is a period of substantial neurophysiological and behavioral growth, representing a second sensitive period of brain development. It is a psychological and social transition period between childhood and adulthood with many beneficial changes occurring, especially with respect to potential responsiveness to clinical intervention. However, adolescent behavioral complexities introduce clinical challenges as well. The purpose of this review article is to review the current neuroimaging research on neurophysiological changes observed during adolescence and the cognitive and social behavioral counterparts, with specific attention to the clinical implications. The review article will then summarize currently available intervention tools that can be utilized by speech-language pathologists working with this population. It will conclude with available evidence-based social-communication approaches that may be applicable as well as available evidence-based supplemental technological cognitive interventions that may be useful in working with adolescents who exhibit language and communication issues. Conclusion As a transition period between childhood and adulthood, adolescence represents a second sensitive period during which there is opportunity for clinically derived beneficial cognitive and communication growth.

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Laryngeal Manifestations of Autoimmune Diseases

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-19-00168 ◽

2020 ◽

Vol 5 (2) ◽

pp. 439-456

Author(s):

Jenny L. Pierce

Keyword(s):

Autoimmune Disease ◽

Autoimmune Diseases ◽

Patient Outcomes ◽

Correct Diagnosis ◽

Upper Airway ◽

Clinical Implications ◽

Laryngeal Function ◽

The Past ◽

Referral Practices ◽

Timely Referral

Purpose This review article provides an overview of autoimmune diseases and their effects on voice and laryngeal function. Method A literature review was conducted in PubMed. Combinations of the following keywords were used: “autoimmune disease and upper airway,” “larynx,” “cough,” “voice,” “dysphonia,” and “dyspnea.” Precedence was given to articles published in the past 10 years due to recent advances in this area and to review articles. Ultimately, 115 articles were included for review. Results Approximately 81 autoimmune diseases exist, with 18 of those highlighted in the literature as having laryngeal involvement. The general and laryngeal manifestations of these 18 are discussed in detail, in addition to the clinical implications for a laryngeal expert. Conclusions Voice, breathing, and cough symptoms may be an indication of underlying autoimmune disease. However, these symptoms are often similar to those in the general population. Appropriate differential diagnosis and timely referral practices maximize patient outcomes. Guidelines are provided to facilitate correct diagnosis when an autoimmune disease is suspected.

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The Nature of Deviant Articulation

Journal of Speech and Hearing Disorders ◽

10.1044/jshd.3802.156 ◽

1973 ◽

Vol 38 (2) ◽

pp. 156-161 ◽

Cited By ~ 24

Author(s):

Laurence B. Leonard

Keyword(s):

Clinical Implications ◽

Phonological System

This paper examines the credibility of deviant articulation as a less mature phonological system and as an individual phonological system with its own rules. Evidence is presented suggesting that both types of deviant phonological systems may occur in the articulatory defective population. The clinical implications of each type of deviant system are presented.

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