HLA Typing Identifies Pemphigus Risk Factors

2007 ◽  
Vol 38 (11) ◽  
pp. 15
Author(s):  
BRUCE JANCIN
Keyword(s):  
Risk Factors ◽  
Hla Typing

Recent Decrease in Acute GVHD and Increased Relapse in Children with Leukemia Receiving Unrelated Donor Bone Marrow Transplants.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1081-1081
Author(s):  
Stella M. Davies ◽  
D. Wang ◽  
T. Wang ◽  
M. Arora ◽  
O. Ringden ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Gvhd ◽  
Marrow Transplant ◽  
Hla Typing ◽  
Unrelated Donor ◽  
Resistant Disease ◽  
Donor Bone Marrow ◽  
The Impact ◽  
Over Time ◽  
Risk Of Relapse

Abstract Unrelated donor (URD) BMT is an effective treatment for leukemia in children, but significant morbidity and mortality occur as a result of acute graft versus host disease (GVHD). In addition, relapse is a major cause of treatment failure in children with otherwise successful transplants. We used the database of the Center for International Blood & Marrow Transplant Research (CIBMTR) to determine whether improved HLA typing and prophylaxis have changed incidence and risk factors for acute GVHD, and the impact of GVHD on treatment-related mortality and relapse. We analyzed outcomes of 638 myeloablative URD BMT performed between 1990 and 2003 for the treatment of AML, ALL, CML or MDS. Peripheral blood stem cell and cord blood recipients were excluded as risk factors for GVHD might differ. All recipients were <18 years of age, and had available high resolution HLA typing for HLA A, B, C and DRB1. Overall, 45% of children developed aGVHD grades II–IV, and 27% aGVHD grades III–IV. The data showed that risk of aGVHD was significantly higher in recipients of T-replete compared with T-depleted grafts (OR 3.12, 95%CI 2.02–4.83; p< 0.0001). Survival was reduced in children with grades II–IV aGVHD compared to those without (OR 1.96, 95% CI 1.46–2.62; p<0.0001). However, the occurrence of aGVHD reduced risk of relapse in children with ALL (OR 0.36 95% CI 0.17–0.75, p=0.004) but not in children with AML (OR 1.23, 95% CI 0.50–2.98; p=0.65). Outcomes have changed significantly over time. The risk of aGVHD was higher in children transplanted in earlier years (1990–1998, n=365) compared to 1999–2003 (n= 220) (OR 1.93 95%CI 1.27–2.91; p=0.002), suggesting that current prophylactic regimens may be more effective. In contrast to this recent improvement in risk of GVHD, risk of relapse was lower in children transplanted 1990–1998 compared with 1999–2003 (OR 0.47, 95% CI 0.28–0.78; p=0.004), possibly reflecting changes in the patient population currently referred for transplant, or perhaps a reduced graft versus leukemia effect with better control of GVHD. As more intense risk adapted chemotherapy has improved outcomes of upfront treatment of leukemia, children who are referred for transplant may have more resistant disease, increasing the difficulty of controlling disease with standard irradiation and chemotherapy preparative regimens. Overall survival of children with URD BMT has not changed over time, although it is possible that current results reflect treatment of children with more resistant disease compared with 10 years ago.

scholarly journals Human Leukocyte Antigen (HLA) Typing Study Identifies Maternal DQ2 Susceptibility Alleles among Infertile Women: Potential Associations with Autoimmunity and Micronutrients

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3270
Author(s):  
Paola Triggianese ◽  
Carlo Perricone ◽  
Erica De Martino ◽  
Arianna D’Antonio ◽  
Maria Sole Chimenti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Human Leukocyte ◽  
Hla Typing ◽  
Leukocyte Antigen ◽  
Infertile Women ◽  
Micronutrient Status ◽  
Independent Risk Factors ◽  
Hla Haplotypes ◽  
First Time ◽  
Hla Dq2

Background. The interplay between female fertility and autoimmune diseases (AIDs) can involve HLA haplotypes and micronutrients. We analyzed the distribution of HLA-DQ2/-DQ8 in women with infertility or recurrent spontaneous abortion (RSA) and possible associations with AIDs and micronutrient status. Methods. Consecutive women (n = 187) with infertility and RSA, and controls (n = 350) were included. All women were genotyped for HLA-DQ2 (DQA1*0201, A1*05, and B1*02) and -DQ8 (DQA1*03 and DQB1*0302) alleles. Serum 25(OH)D, VB12, folate, and ferritin were evaluated. Results. DQA1*05/B1*02 and the occurrence of at least one DQ2 allele were more prevalent among RSA and infertile women than controls. Infertile women showed lower 25(OH)D and higher prevalence of AIDs than RSA women. In the multivariate analysis, DQA1*05/B1*02 was associated with a significantly higher risk of AIDs in infertile women, and DQA1*05 was independently associated with both 25(OH)D deficiency and AIDs. In RSA women, the presence of AIDs was associated with a significantly higher risk of 25(OH)D deficiency. Conclusion. Our findings showed, for the first time, a higher proportion of DQ2 alleles in infertile and RSA women as compared to controls. Predisposing DQ2 alleles are independent risk factors for AIDs and 25(OH)D deficiency in infertile women and could represent biomarkers for performing early detection of women requiring individually tailored management.

Graft-Versus-Host Disease (GVHD) in Cord Blood Transplantation (CBT): Risk Factors, Clinical Manifestations and Outcomes.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2977-2977
Author(s):  
Daniel Couriel ◽  
Poliana Patah ◽  
Rima Saliba ◽  
Lawrence Cooper ◽  
Laura Worth ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cord Blood ◽  
Proportional Hazards ◽  
Cord Blood Transplantation ◽  
Chronic Gvhd ◽  
Clinical Manifestations ◽  
Significant Risk ◽  
Cox Proportional Hazards ◽  
Hla Typing ◽  
Significant Difference

Abstract Introduction: Umbilical CBT from mismatched donors can restore hematopoiesis both in children and adults with acceptable rates of severe acute (aGVHD) and chronic GVHD (cGVHD). Acute and chronic GVHD, including risk factors, clinical manifestations and its specific impact on outcomes has not been systematically evaluated in this particular patient population. Objective: To analyze the manifestations of GVHD in CBT, with emphasis on risk factors and impact on overall survival. Methods: Prospective evaluation of aGVHD and cGVHD in 138 adult and pediatric patients undergoing single or double CBT for hematological disorders and solid tumors from 3/96 and 6/07. cord blood units were selected on the basis of a maximum of 2 MM (HLA-A, B, DRB1) and the minimum of 1x107TNC/Kg. Risk factors for aGVHD after CBT were assessed using the Cox proportional hazards method. The estimates of aGVHD and cGVHD were performed accounting for competing risks such as death and engraftment using the cumulative incidence (CI) method. Results: A total of 138 adult (n=78) and pediatric (n=60) CBT were performed in the time period. Median age was 21 (1-64), 58 females and 80 males. The majority received a transplant for hematological malignancies (n= 132), mostly MDS/AML and ALL (n= 98, 71%). The remainder had AA (n= 3) and one a solid tumor (n=1). Seventy-seven patients (56%) were in remission of their disease at the time of transplant. Most patients received a myeloablative regimen (n= 125, 91%), and single cord grafts (n= 81, 59%). Of 100 CBT where HLA typing is available, 39%, 45 and 9% have 1, 2 and 3 mismatched loci respectively. Twenty-four patients (17%) did not engraft. At 3 months post transplant, the CI of grade II-IV aGVHD was 36% (adult 38%, pediatric 34%, p= 0.9), and that of grade III-IV was 12% (adult 14%, pediatric 10%, p= 0.9). Skin was the organ most often involved (84%, adult 71%, pediatric 100%, p= 0.017). In adults skin was the only organ involved in 80% of patients with skin GVHD. Lower GI, upper GI and liver involvement were observed in 24, 18, and 21% of patients respectively, without significant difference between adults and children. The total nucleated cell count (TNC) of the graft was the strongest predictor of aGVHD. In children, active disease at the time of transplant was also significantly associated with higher incidence aGVHD. Other factors analyzed, including number and type of mismatched HLA loci were not significant risk factors for aGVHD. CI of cGVHD was 20%, and significantly lower in children compared to adults (8 vs 31%, p= 0.002). Nonrelapse mortality (NRM) at 2 years was 30%, and significantly lower in children (18 vs 41%, p= 0.007). Only 7/43 (16%) deaths were attributed to aGVHD or cGVHD. Conclusions: CBT can be performed in children and adults with acceptable rates of GVHD, even in the presence of multiple HLA mismatched loci. Most cases of acute GVHD involved the skin, often as the only organ. Chronic GVHD and NRM are significantly higher in adults. GVHD accounts for a relatively small proportion of nonrelapse deaths.

Donor Cell Derived Leukemia: Description Of 38 Cases and a Case Control Study

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 914-914
Author(s):  
Nicole Engel ◽  
Rafael F. Duarte ◽  
Myriam Labopin ◽  
Thomas Schroeder ◽  
Johanna Tischer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Growth Factor ◽  
Case Series ◽  
Allogeneic Transplantation ◽  
Hla Typing ◽  
Matched Pair ◽  
Donor Age ◽  
Unrelated Donors

Abstract Introduction The development of leukemia in donor cells (DCL) in the recipient after an allogeneic hematopoietic transplantation is a rare but severe complication and has been suggested as a model for leukemogenesis. Due to a low incidence, very little is known about the pathogenesis and management, although different pathogenetic factors e.g. immunoregulatory dysfunction, replicative stress and damaged host environment have already been postulated. Apart from a few small case series most of the patients have been reported in single case reports. Therefore we aim to evaluate the incidence and outcome of DCL within the EBMT centers and to identify potential risk factors for DCL. Methods Identification of cases and controls was done using a survey sent to all EBMT centers. An additional questionnaire was sent in order to get complete specific information for DCL cases. Prognostic factors were studied with a matched pair analysis comparing cases and controls confirmed not having developed DCL. Matching factors were age, gender, diagnosis, disease status at transplantation, year of transplantation, donor, stem cell source and length of follow-up (control’s follow-up was equivalent to, or exceeded that, of time to DCL in cases). Results Incidence of DCL Out of 47,186 allogeneic transplantations performed from 1985 to 2013 in fifty-nine participating EBMT centers, thirty-eight DCL cases were identified. The cumulative incidence of DCL was 0.127 % at 10 years and 0.270 % at 25 years after transplantation. Case description Donor origin of leukemia was confirmed by STR/VNTR analysis (21), by FISH/conventional cytogenetics (14) and by HLA-typing (3). Patients were transplanted for AML/MDS (13), ALL (5), CML (8), CLL (3), lymphoma (3), multiple myeloma (1), granulocytic sarcoma (1) and non-malignant diseases (4). Graft source was bone marrow (14), G-CSF mobilized peripheral blood stem cells (20) and cord blood units (4). Donors were HLA-identical siblings in most cases (22), matched unrelated donors in 12 and mismatched related and unrelated donors in 2 cases each. Donor age was a median of 37 years [0-72]. DCL was diagnosed as AML (22), MDS (7), ALL (2), CML (2) and CLL (5). Interestingly, apart from monosomy 7 (5/38), trisomy 8 (3/38), RUNX1 mutation (2/38) and BCR-ABL translocation (2/38) no cytogenetic or molecular aberrations were detected repeatedly. Median time from allogeneic transplantation to DCL diagnosis was 44.13 months [1.57-279.15]. Most of the patients were treated intensively prior to allogeneic transplantation including previous allogeneic (4) and autologous (4) transplantation. Conditioning regimen tended to be myeloablative in 26 out of 38 cases, 20 patients received growth factor within the first 100 days after transplantation. Acute GvHD has been observed in 20/38 patients and 17/38 suffered from chronic GvHD. Viral complications have been reported for CMV (26/38), VZV (6/38), HBV (3/38), Parvovirus (3/38), HSV (2/38), BKV (2/38), HHV6 (2/38), and HCV, Parainfluenza, RSV, EBV and Adenovirus in 1 patient each. Donor follow-up was available for 25/38 donors: 7 donors developed the same disease as DCL (4 CLL, 2 MDS, 1 CML) suggesting the transfer of (pre-) malignant clones by transplantation. For DCL treatment 12 patients received chemotherapy only, 17 patients were transplanted subsequently (HSCT), 1 patient is planned for subsequent HSCT, 2 patients were treated but not with chemotherapy, 4 patients were not treated and for 2 patients DCL treatment is unknown. After a median follow up of 32 months 12 patients are alive (5 chemotherapy only, 4 HSCT, 3 no treatment). Prognostic factors for DCL We were able to match 34 DCL cases with 67 controls. Three factors were significantly associated with an increased risk for DCL development: the use of growth factor within the first 100 days after transplantation (p .02; HR 2.43), in vivo T-cell depletion by either alemtuzumab or anti-thymocyte globulin (p .014; HR 2.59) and previous allograft (p .012; HR 4.08). Donor age, type of conditioning, CMV status, immunosuppression, and GVHD were not identified as risk factors for DCL development. Conclusion This study for the first time characterizes a case series of 38 patients with DCL and provides data for further discussion of pathogenesis and management of DCL. Disclosures: No relevant conflicts of interest to declare.

Relevance of the Hematopoietic Cell Transplantation-Specific Comorbidity Index (HCT-CI) On Non-Relapse Related Mortality (NRM) in Patients with Acute Lymphoblastic Leukemia (ALL) Receiving Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) in First Complete Remission: Results From the GMALL Study Group.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3352-3352
Author(s):  
Matthias Stelljes ◽  
Mareike David ◽  
Renate Arnold ◽  
Dietrich W Beelen ◽  
Wolfgang A Bethge ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Complete Remission ◽  
Cell Transplantation ◽  
Cumulative Incidence ◽  
Hla Typing ◽  
Study Group ◽  
Allogeneic Hsct ◽  
Related Risk ◽  
First Complete Remission

Abstract Abstract 3352 Poster Board III-240 Allogeneic HSCT is established as a potent curative therapy in adult patients with high risk ALL. However, due to transplant-related morbidity and lethality the gains in relapse prevention do not necessarily translate into survival advantages in the overall patient population. Defining the role of allogeneic HSCT in ALL patients in first complete remission (CR1) according to leukemia related risk factors, to transplant related risk factors (e.g. HLA matching, conditioning therapy and immunosuppressive treatment), and to comorbidity related risks, remains a major task for upcoming clinical trials. Several retrospective studies suggest that the HCT-CI is suitable in capturing patients with comorbidities, in distributing them into risk groups and in prediction of NRM and overall survival (OS) during the first 2 years after allogeneic HSCT. The aim of this study was to evaluate if the HCT-CI might be predictive in patients with ALL receiving allogeneic HSCT in CR1. The prospective studies of the German multicenter study group for adult ALL (GMALL 06/99 and 07/2003) include indication for HSCT from HLA-matched related donor (MRD) or HLA-matched unrelated donor (MUD) in CR1 in patients with high risk features after uniform induction and first consolidation therapy. Between December 1999 and April 2008, 541 patients with high risk or very high risk ALL in CR1 underwent HSCT as part of their treatment according to the GMALL protocols. Of this patient cohort full data sets allowing the definition of individual HCT-CI were available for 251 patients. Median age of all evaluable patients was 35 years. Seventy-six of these patients (30%) received an allograft from MRD and 175 patients (70%) were transplanted from MUD. Most patients (86%) received conditioning consisting of total body irradiation (8-14 Gy) in combination with cyclophosphamide, fludarabine and/or etoposide. Seventy-seven (30%, median age 34 years) patients had a HCT-CI of 0, 78 patients (31%, median age 32 years) of 1, 45 (18%, median age 38 years) of 2, 27 (11%, median age 40 years) of 3, 15 (6%, median age 34 years) of 4, and 9 patients (4%, median age of 52 years) had an index ≥5. Cumulative incidence of NRM two years after transplantation for patients with a HCT-CI of 0, 1-2, 3-4 and ≥5 were 18%, 25%, 15% and 48%, respectively, and differed not significantly (p=.21). Corresponding estimated OS rates at 2 years were 64% (95% C.I., 58-70%), 64% (95% C.I., 59-69%), 66% (95% C.I., 58-74%) and 52% (95% C.I., 34-70%), respectively. Single organ comorbidities included in the HCT-CI (e.g. pre-transplant existing cardio-vascular, pulmonary or hepatic diseases) showed no significant association with higher risks of NRM. In addition, neither donor origin (MUD versus MRD), nor the combination male patients / female donor versus other sex combinations, nor high risk for cytomegalovirus (CMV) reactivation (patient CMV positive/donor CMV negative versus other combinations) were associated with higher risk for NRM. Only age (e.g. <40 years versus ≥40 years) remained a patient related significant risk factor for NRM with cumulative incidence of 17% and 40%, respectively (p=.028). In conclusion, our preliminary data suggest that the HCT-CI or other transplant related risk factors are insufficient to predict NRM in ALL patients of younger age compared to studies with HCT-CI in other diseases such as acute myeloid leukemia. In addition, the majority (65%) of our patients were transplanted after December 2003 and showed a significantly decreasing risk for NRM at two years after transplantation (17% versus 31%, p=.005). With improving survival rates, probably associated with the optimizations of transplantation procedures, introduction of reduced intensity conditioning, high resolution HLA-typing and better supportive care, stratifications according to scores established retrospectively from historic patient populations should not be used for clinical decisions. Therefore, at least in elderly patients future transplant studies should include prospective evaluations of comorbidities and other transplant related risk factors to identify factors that could be helpful in the decision which patient might benefit from allogeneic HSCT. Supported by Dt.Krebshilfe 702657Ho2 Disclosures: No relevant conflicts of interest to declare.

scholarly journals P1651HLA CW12 IN KIDNEY TRANSPLANT RECIPIENTS IS A NOVEL RISK FACTOR FOR THE DEVELOPMENT OF POST-TRANSPLANTATION DIABETES: A SINGLE-CENTRE RETROSPECTIVE STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Nuvreen Phagura ◽  
Alice Culliford ◽  
Felicity Evison ◽  
Suzy Gallier ◽  
Jay Nath ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Kidney Transplant ◽  
Hla Typing ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Single Centre ◽  
Post Transplantation ◽  
Hla Alleles ◽  
Hla Dq

Abstract Background and Aims Counselling kidney transplant candidates for their personalised risk of developing post-transplantation diabetes mellitus (PTDM) requires an understanding of risk factors. While some risk factors are well defined (e.g. age, ethnicity, body mass index), others like HLA typing are heterogeneously reported and lack consistency. The aim of this study was to investigate the association between HLA alleles and PTDM risk. Method Data was retrospectively extracted from hospital informatics systems for all kidney transplant recipients at a single-centre between 2007 and 2018, with patients excluded if they had pre-existing diabetes. Electronic patient records were then manually searched and records linked to various sources (e.g. NHS Blood and Transplant tissue typing, Hospital Episode Statistics, national death registry) to create a well-phenotyped cohort. Standard immunosuppression for all kidney transplant recipients during this study period was basiliximab induction with maintenance immunosuppression consisting tacrolimus, mycophenolate mofetil and low-dose corticosteroids. PTDM classification was aligned with International Consensus recommendations. Results Data was extracted for 1,560 kidney allograft recipients, with median follow up 5.4 years (IQR 2.7-8.7 years) up to October 2018. PTDM developed in 243 kidney transplant recipients (incidence 15.6%). A range of HLA alleles were examined (e.g. HLA-A, HLA-B, HLA-Cw, HLA-Bw, HLA-DR and HLA-DQ) but only the presence of HLA-Cw12 allele was associated with risk for PTDM (27.4% versus 14.3%, p&lt;0.001) along with a selection of predominately recipient- and transplant related variables. In a logistic regression model, adjusted for all variables with a p-value &lt;0.15 on univariate analysis, recipient HLA-Cw12 was found to be an independent risk factor associated with development of PTDM (Odds Ratio 1.793 [95% confidence interval 1.070-3.002], p=0.027) along with recipient female sex, recipient age, recipient BMI and recipient non-white ethnicity. Conclusion HLA-Cw12 allele in the kidney transplant recipient is independently associated with development of PTDM, although it is important to acknowledge association does not imply causality. This association has not been previously reported and requires validation and further investigation to understand any possible underlying biological mechanisms.

Elevated level of circulatory sTLT1 induces inflammation through SYK/MEK/ERK signalling in coronary artery disease

2019 ◽  
Vol 133 (22) ◽  
pp. 2283-2299
Author(s):  
Apabrita Ayan Das ◽  
Devasmita Chakravarty ◽  
Debmalya Bhunia ◽  
Surajit Ghosh ◽  
Prakash C. Mandal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Chronic Inflammation ◽  
Ex Vivo ◽  
Human Subjects ◽  
Critical Role ◽  
Atherosclerotic Cardiovascular Disease ◽  
Tnf Α ◽  
Artery Disease

Abstract The role of inflammation in all phases of atherosclerotic process is well established and soluble TREM-like transcript 1 (sTLT1) is reported to be associated with chronic inflammation. Yet, no information is available about the involvement of sTLT1 in atherosclerotic cardiovascular disease. Present study was undertaken to determine the pathophysiological significance of sTLT1 in atherosclerosis by employing an observational study on human subjects (n=117) followed by experiments in human macrophages and atherosclerotic apolipoprotein E (apoE)−/− mice. Plasma level of sTLT1 was found to be significantly (P<0.05) higher in clinical (2342 ± 184 pg/ml) and subclinical cases (1773 ± 118 pg/ml) than healthy controls (461 ± 57 pg/ml). Moreover, statistical analyses further indicated that sTLT1 was not only associated with common risk factors for Coronary Artery Disease (CAD) in both clinical and subclinical groups but also strongly correlated with disease severity. Ex vivo studies on macrophages showed that sTLT1 interacts with Fcɣ receptor I (FcɣRI) to activate spleen tyrosine kinase (SYK)-mediated downstream MAP kinase signalling cascade to activate nuclear factor-κ B (NF-kB). Activation of NF-kB induces secretion of tumour necrosis factor-α (TNF-α) from macrophage cells that plays pivotal role in governing the persistence of chronic inflammation. Atherosclerotic apoE−/− mice also showed high levels of sTLT1 and TNF-α in nearly occluded aortic stage indicating the contribution of sTLT1 in inflammation. Our results clearly demonstrate that sTLT1 is clinically related to the risk factors of CAD. We also showed that binding of sTLT1 with macrophage membrane receptor, FcɣR1 initiates inflammatory signals in macrophages suggesting its critical role in thrombus development and atherosclerosis.

The Preschool Stuttering Screen for Health Care Professionals

2011 ◽  
Vol 21 (2) ◽  
pp. 59-62
Author(s):  
Joseph Donaher ◽  
Christina Deery ◽  
Sarah Vogel
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Differential Diagnosis ◽  
Preschool Children ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Evidence Based ◽  
Developmental Profile

Healthcare professionals require a thorough understanding of stuttering since they frequently play an important role in the identification and differential diagnosis of stuttering for preschool children. This paper introduces The Preschool Stuttering Screen for Healthcare Professionals (PSSHP) which highlights risk factors identified in the literature as being associated with persistent stuttering. By integrating the results of the checklist with a child’s developmental profile, healthcare professionals can make better-informed, evidence-based decisions for their patients.

Clinical Response to Questions Regarding Outcomes and Therapy Efficacy

2010 ◽  
Vol 20 (3) ◽  
pp. 76-83 ◽  
Author(s):  
Joseph Donaher ◽  
Tom Gurrister ◽  
Irving Wollman ◽  
Tim Mackesey ◽  
Michelle L. Burnett
Keyword(s):  
Risk Factors ◽  
Clinical Response ◽  
Speech Language Pathologists ◽  
Specific Therapy ◽  
Therapy Efficacy ◽  
Therapy Program ◽  
Adults Who Stutter ◽  
Cure Rates

Parents of children who stutter and adults who stutter frequently ask speech-language pathologists to predict whether or not therapy will work. Even though research has explored risk-factors related to persistent stuttering, there remains no way to determine how an individual will react to a specific therapy program. This paper presents various clinicians’answers to the question, “What do you tell parents or adults who stutter when they ask about cure rates, outcomes, and therapy efficacy?”

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