Preliminary experience with pancreatic sphincterotomy as treatment for intraductal papillary mucinous neoplasm-associated recurrent pancreatitis

Abstract Background and study aims Pancreatic intraductal papillary mucinous neoplasms (IPMN) are cystic tumors of the pancreas characterized by a malignant potential. IPMN have been associated with recurrent pancreatitis (RP). Obstruction of the main pancreatic duct by thick mucus has been postulated to be the cause of pancreatitis. In a few isolated reports, pancreatic sphincterotomy (PS) has been reported to reduce the frequency of pancreatitis. The aim of this study was to assess the efficacy of PS in patients with IPMN-associated RP. Patients and methods We retrospectively identified patients with RP and IPMN who underwent PS from June 2010 to December 2015. Patients were included in two different groups: (a) main duct/mixed type IPMN (MD-IPMN) and (b) branch duct IPMN (BD-IPMN) with or without worrisome features/high risk stigmata. Other causes of RP were excluded. The number of pancreatitis episodes occurring during a comparable time period before and after PS was evaluated. Results In total, 16 patients were analyzed (seven included in the MD-IPMN group and nine in the BD-IPMN group). The numbers of pancreatitis episodes occurring before and after PS were 3.5 ± 2.32 and 0.56 ± 1.03, respectively (P < 0.0001). Mean follow-up was 27.4 months (range 6 – 63 months). Complete, partial (reduction of pancreatitis episodes > 50 %), and no response were obtained in 11 (68.7 %), 3 (18.7 %), and 2 patients (12.5 %), respectively. One (6.25 %) case of mild post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis was observed. No cancer was detected in resected patients. None of the BD-IPMN group patients had or developed worrisome features/high risk stigmata during follow-up. Conclusions PS seems to be effective in reducing the number of episodes of IPMN-associated pancreatitis and should be considered as a treatment option in selected clinical settings. However, active surveillance should be continued considering the malignant potential of IPMN. Further prospective controlled studies are needed to confirm our results.

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The Effect of Q-Switched Nd:YAG 1064 nm/532 nm Laser in the Treatment of Onychomycosis In Vivo

Dermatology Research and Practice ◽

10.1155/2013/379725 ◽

2013 ◽

Vol 2013 ◽

pp. 1-10 ◽

Cited By ~ 23

Author(s):

Kostas Kalokasidis ◽

Meltem Onder ◽

Myrto-Georgia Trakatelli ◽

Bertrand Richert ◽

Klaus Fritz

Keyword(s):

Clinical Study ◽

Treatment Time ◽

Prospective Clinical Study ◽

Self Evaluation ◽

Time Period ◽

Level Of Satisfaction ◽

Before And After ◽

532 Nm

In this prospective clinical study, the Q-Switched Nd:YAG 1064 nm/532 nm laser (Light Age, Inc., Somerset, NJ, USA) was used on 131 onychomycosis subjects (94 females, 37 males; ages 18 to 68 years). Mycotic cultures were taken and fungus types were detected. The laser protocol included two sessions with a one-month interval. Treatment duration was approximately 15 minutes per session and patients were observed over a 3-month time period. Laser fluencies of 14 J/cm2were applied at 9 billionths of a second pulse duration and at 5 Hz frequency. Follow-up was performed at 3 months with mycological cultures. Before and after digital photographs were taken. Adverse effects were recorded and all participants completed “self-evaluation questionnaires” rating their level of satisfaction. All subjects were well satisfied with the treatments, there were no noticeable side effects, and no significant differences were found treating men versus women. At the 3-month follow-up 95.42% of the patients were laboratory mycologically cured of fungal infection. This clinical study demonstrates that fungal nail infections can be effectively and safely treated with Q-Switched Nd:YAG 1064 nm/532 nm laser. It can also be combined with systemic oral antifungals providing more limited treatment time.

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A 16-year prospective cohort study to evaluate effects of long-term fluctuations in obesity indices of prediabetics on the incidence of future diabetes

Scientific Reports ◽

10.1038/s41598-021-91229-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Shahla Safari ◽

Maryam Abdoli ◽

Masoud Amini ◽

Ashraf Aminorroaya ◽

Awat Feizi

Keyword(s):

High Risk ◽

Transition Probabilities ◽

Clinical Settings ◽

High Tendency ◽

Mean Values ◽

Latent Markov Model ◽

Term Evaluation ◽

Obesity Indices

AbstractThis study aimed to evaluate the patterns of changes in obesity indices over time in prediabetic subjects and to classify these subjects as either having a low, moderate, and high risk for developing diabetes in the future. This study was conducted among 1228 prediabetics. The patterns of changes in obesity indices based on three measurements including first, mean values during the follow-up period, and last visit from these indices were evaluated by using the latent Markov model (LMM). The mean (standard deviation) age of subjects was 44.0 (6.8) years and 73.6% of them were female. LMM identified three latent states of subjects in terms of change in all anthropometric indices: a low, moderate, and high tendency to progress diabetes with the state sizes (29%, 45%, and 26%), respectively. LMM showed that the probability of transitioning from a low to a moderate tendency to progress diabetes was higher than the other transition probabilities. Based on a long-term evaluation of patterns of changes in obesity indices, our results reemphasized the values of all five obesity indices in clinical settings for identifying high-risk prediabetic subjects for developing diabetes in future and the need for more effective obesity prevention strategies.

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Cessation from Smoking Improves Innate Host Defense and Clearance of Experimentally Inoculated NasalStaphylococcus aureus

Infection and Immunity ◽

10.1128/iai.00912-17 ◽

2018 ◽

Vol 86 (4) ◽

Cited By ~ 4

Author(s):

Amy L. Cole ◽

Mary Schmidt-Owens ◽

Ashley C. Beavis ◽

Christine F. Chong ◽

Patrick M. Tarwater ◽

...

Keyword(s):

Smoking Cessation ◽

Interleukin 1 ◽

Nasal Carriage ◽

The United States ◽

Content Type ◽

Time Period ◽

Serious Infections ◽

Before And After ◽

Enhanced Expression

ABSTRACTStaphylococcus aureusnasal carriage is transient in most humans and usually benign, but dissemination ofS. aureusto extranasal sites causes the majority of clinical infections, andS. aureusis a major cause of serious infections in the United States. A better understanding of innate nasal decolonization mechanisms is urgently needed, as are relevant models for studyingS. aureusclearance. Here, we screened a population of healthy smokers for nasalS. aureuscarriage and compared the participants' abilities to clear experimentally applied nasalS. aureusbefore and after completion of a smoking cessation program. We determined that cigarette smoking increases the mean nasalS. aureusload (2.6 × 104CFU/swab) compared to the load observed in healthy nonsmokers (1.7 × 103CFU/swab) and might increase the rate ofS. aureusnasal carriage in otherwise-healthy adults: 22 of 99 smokers carriedS. aureusat the screening visit, while only 4 of 30 nonsmokers screened positive during the same time period. Only 6 of 19 experimental inoculation studies in active smokers resulted inS. aureusclearance within the month of follow-up, while in the cessation group, 6 of 9 subjects cleared nasalS. aureusand carriage duration averaged 21 ± 4 days. Smoking cessation associated with enhanced expression ofS. aureus-associated interleukin-1β (IL-1β) and granulocyte colony-stimulating factor (G-CSF) in nasal fluids. Participants who failed to clearS. aureusexhibited a higher nasalS. aureusload and elevated nasal interleukin-1 receptor antagonist (IL-1RA) expression at the preexperiment study visits. We conclude that smokers exhibit higherS. aureusloads than nonsmokers and that innate immune pathways, including G-CSF expression and signaling through the IL-1 axis, are important mediators of nasalS. aureusclearance.

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Results after Laparoscopic Fundoplication: Does Age Matter?

The American Surgeon ◽

10.1177/000313480607200904 ◽

2006 ◽

Vol 72 (9) ◽

pp. 778-784 ◽

Cited By ~ 6

Author(s):

Sarah M. Cowgill ◽

Dean Arnaoutakis ◽

Desiree Villadolid ◽

Sam Al-Saadi ◽

Demetri Arnaoutakis ◽

...

Keyword(s):

Myocardial Infarction ◽

High Risk ◽

Older Patients ◽

Laparoscopic Fundoplication ◽

Nissen Fundoplication ◽

Younger Patients ◽

Before And After ◽

Laparoscopic Nissen ◽

Age Range

Antireflux fundoplications are undertaken with hesitation in older patients because of presumed higher morbidity and poorer outcomes. This study was undertaken to determine if symptoms of gastroesophageal reflux disease (GERD) could be safely abrogated in a high-risk/reward population of older patients. One hundred eight patients more than 70 years of age (range, 70–90 years) underwent laparoscopic Nissen fundoplications undertaken between 1992 and 2005 and were compared with 108 concurrent patients less than 60 years of age (range, 18–59 years) to determine relative outcomes. Before and after fundoplication, patients scored the severity of reflux and dysphagia on a Likert Scale (0 = minor, 10 = severe). Before fundoplication, older patients had lower reflux scores ( P < 0.01), but not lower dysphagia scores or DeMeester scores. One patient (86 years old) died from myocardial infarction; otherwise, complications occurred infrequently, inconsequentially, and regardless of age. At similar durations of follow-up, reflux and dysphagia scores significantly improved ( P < 0.01) for older and younger patients. After fundoplication, older patients had lower dysphagia scores ( P < 0.01) and lower reflux scores ( P < 0.01). At the most recent follow-up, 82 per cent of older patients rated their relief of symptoms as good or excellent. Similarly, 81 per cent of the younger patients reported good or excellent results. Ninety-one per cent of patients 70 years of age or more versus 85 per cent of patients less than 60 years would undergo laparoscopic Nissen fundoplication again, if necessary. With fundoplication, symptoms of GERD improve for older and younger patients, with less symptomatic dysphagia and reflux in older patients after fundoplication. Laparoscopic fundoplication safely ameliorates symptoms of GERD in elderly patients with symptomatic outcomes superior to those seen in younger patients.

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Long-term Results after Stereotactic Radiosurgery for Patients with Cavernous Malformations

Neurosurgery ◽

10.1097/00006123-200206000-00003 ◽

2002 ◽

Vol 50 (6) ◽

pp. 1190-1198 ◽

Cited By ~ 23

Author(s):

Toshinori Hasegawa ◽

James McInerney ◽

Douglas Kondziolka ◽

John Y.K. Lee ◽

John C. Flickinger ◽

...

Keyword(s):

High Risk ◽

Stereotactic Radiosurgery ◽

Gamma Knife Radiosurgery ◽

Long Term Results ◽

Major Hemorrhage ◽

Cavernous Malformations ◽

Before And After ◽

Risk Of Hemorrhage

Abstract OBJECTIVE Stereotactic radiosurgery has been used for patients with high-risk cavernous malformations of the brain. We performed radiosurgery for patients with symptomatic, imaging-confirmed hemorrhages for which resection was believed to be associated with high risk. This study examines the long-term hemorrhage rate after radiosurgery. METHODS We reviewed data obtained before and after gamma knife radiosurgery on 82 patients treated between 1987 and 2000. Most patients had multiple hemorrhages from brainstem or diencephalic cavernous malformations. Follow-up data were examined to identify hemorrhages, and an overall hemorrhage rate was calculated. RESULTS Observation before treatment averaged 4.33 years (range, 0.17–18 yr) for a total of 354 patient-years. During this period, 202 hemorrhages were observed, for an annual hemorrhage rate of 33.9%, excluding the first hemorrhage. Temporal clustering of hemorrhages was not significant. After radiosurgery, patient follow-up averaged 5 years (range, 0.42–12.08 yr), for a total of 401 patient-years. During this period, 19 hemorrhages were identified, 17 in the first 2 years posttreatment and 2 after 2 years. The annual hemorrhage rate was 12.3% per year for the first 2 years after radiosurgery, followed by 0.76% per year from Years 2 to 12. Eleven patients had new neurological symptoms without hemorrhage after radiosurgery (13.4%). The symptoms were minor in six of these patients and temporary in five. CONCLUSION Radiosurgery confers a reduction in the risk of hemorrhage for high-risk cavernous malformations. Risk reduction, although in evidence during initial follow-up, is most pronounced after 2 years. Given the difficulty of identifying high-risk patients, treatment after one major hemorrhage should be considered in selected younger patients. Such a strategy warrants further investigation.

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Levothyroxine Therapy Adequacy, Dose Estimation and Vitamin D Effect Assessment in a Sample of Iraqi Female Patients with Different Causes of Hypothyroidism

Iraqi Journal of Pharmaceutical Sciences ( P-ISSN 1683 - 3597 E-ISSN 2521 - 3512) ◽

10.31351/vol29iss2pp245-252 ◽

2020 ◽

Vol 29 (2) ◽

pp. 245-252

Author(s):

Ban A. Al-Shimmran ◽

Zinah M. Anwer ◽

Bassam H. Al-Jarrah

Keyword(s):

Vitamin D ◽

Vitamin D Supplementation ◽

Clinical Settings ◽

Dose Estimation ◽

Thyroid Status ◽

Female Patients ◽

Before And After ◽

Secondary Objective ◽

Dose Modulation

Exogenous levothyroxine dose modulation and euthyroidism achievement is a persistent challenge in clinical settings. This study strives to assess the adequacy of treatment and identify the patients’ factors that can be used to estimate the euthyroid levothyroxine dose. A secondary objective was to assess vitamin D supplementation impact on thyroid status. A review of a prospectively collected information from 142 female patients from Baghdad Center of Nuclear Medicine from June 2019 until March 2020 who were receiving levothyroxine for different causes was done. After a follow-up period, the patients’ thyroid tests were assessed and the euthyroid doses for each cause category were statistically analyzed. Thyroid function was assessed before and after three months of vitamin D supplementation for 29 out of 50 patients who measured its level. Sixty-six patients (47%) of the sample were inadequately replaced

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Risk Factors for Development of High-Risk Stigmata in Branch-Duct Intraductal Papillary Mucinous Neoplasms

10.21203/rs.3.rs-100654/v1 ◽

2020 ◽

Author(s):

Tatasuhiro Yamazaki ◽

Takeshi Tomoda ◽

Hironari Kato ◽

Kazuyuki Miyamoto ◽

Akihiro Matsumi ◽

...

Keyword(s):

Risk Factors ◽

Growth Rate ◽

High Risk ◽

Odds Ratio ◽

Imaging Studies ◽

Intraductal Papillary Mucinous Neoplasms ◽

Branch Duct ◽

Mucinous Neoplasms ◽

Cyst Growth

Abstract Background: Strict follow-up is recommended for branch-duct intraductal papillary mucinous neoplasms (BD-IPMN) to avoid missing the development of high-risk stigmata (HRS) at a premalignant stage. This study aimed to identify the risk factors associated with the development of HRS during follow-up.Methods: We performed a retrospective analysis of 283 patients with BD-IPMN, treated at the Okayama University Hospital in Japan between January 2009 and December 2016. Only patients with imaging studies indicative of classical features of BD-IPMN without HRS and followed for >1 year were included in the study. We performed radiological follow-up every 6 months and collected patients’ demographic data, cyst characteristics, and clinical outcomes. Cyst size was recorded at the initial and final imaging studies and growth rate was calculated. The primary outcome was to evaluate the risk factors for development of HRS in patients with BD-IPMN without HRS at the initial diagnosis.Results: Patients with BD-IPMN had a median follow-up of 53.3 months. Based on image analyses, a mean cysts size were initially 18.0 mm and their final size was 20.4 mm, and the mean annual cyst growth was 0.57 mm. Among them, 10 patients (3.5%) developed HRS after a median surveillance period of 55.8 months. Main pancreatic duct (MPD) size (5-9 mm) and cyst growth rate (>2.5 mm/year) were, both, independent risk factors for the development of HRS (odds ratio, 14.2; 95% CI, 3.1-65.2, P = .0006, and odds ratio, 6.1; 95% CI 1.5-25.5, P = .014). Considering the number of worrisome features (WFs), the rate of HRS development was not a WF: 2.0% (4/199), a single WF: 1.6% (1/62), multiple WFs: 22.7% (5/22), and significantly higher in multiple WFs (95% CI: 4.0–57.1; p=.0003).Conclusions: MPD dilation, rapid cyst growth, and multiple WFs were significant risk factors for the development of HRS. In the presence of such features, it is necessary to closely follow the development of HRS and avoid missing the best opportunity for surgical intervention.

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Improved Supervision and Safety of Discharges Through Formal Discharge Education

American Journal of Medical Quality ◽

10.1177/1062860618794283 ◽

2018 ◽

Vol 34 (3) ◽

pp. 226-233

Author(s):

Lily L. Ackermann ◽

Emily A. Stewart ◽

Jeffrey M. Riggio

Keyword(s):

High Risk ◽

Current Model ◽

Discharge Process ◽

Discharge Instructions ◽

Post Intervention ◽

Internal Medicine Residents ◽

Before And After ◽

Attending Physicians ◽

Discharge Education

The goal of this study is to evaluate change in residents’ assessment of supervision and safety of the discharge process after formal discharge instruction education. An educational lecture and workshop addressing high-risk medications, medication reconciliation, follow-up, and handoffs were provided to internal medicine residents. Residents were given a longitudinal survey before and after the discharge education session. Significant improvement in perception was demonstrated in review of discharge instructions ( P < .001), review of new medications/side effects with patients ( P < .001), and review of discharge instructions with and receiving feedback from attending physicians ( P < .001). On review of 40 discharge instructions pre and post intervention, there was an improvement in completion of instructions for high-risk medications ( P < .05 [14 insulin, 26 anticoagulation]). This intervention was viewed positively by residents; more than two thirds of all residents favored a process of formal training over the current model of “training by doing.”

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Pancreatic sphincterotomy improves pain symptoms due to branch-duct intrapapillary mucinous neoplasia without worrisome features: a multicenter study

Endoscopy International Open ◽

10.1055/a-0841-3385 ◽

2019 ◽

Vol 07 (09) ◽

pp. E1130-E1134

Author(s):

Jean-Michel Gonzalez ◽

Diane Lorenzo ◽

Jean-Philippe Ratone ◽

Adrian Culetto ◽

Frédérique Maire ◽

...

Keyword(s):

Multicenter Study ◽

Median Number ◽

Low Grade ◽

Branch Duct ◽

Biliary Sphincterotomy ◽

Mucinous Neoplasms ◽

Pain Symptoms ◽

Pancreatic Sphincterotomy ◽

Retrospective Multicenter Study

Abstract Introduction Branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) require follow-up to detect worrisome features (WF). Data are missing about endoscopic pancreatic sphincterotomy (PS) for symptomatic IPMN. Patients and methods This was a retrospective multicenter study in four expert centers. Patients treated with endoscopic PS for symptomatic (painful) BD-IPMN without WF were included. Age, sex, follow-up time, characteristics of IPMNs and endoscopic retrograde cholangiopancreatographies (ERCPs), and indications for surgery were recorded. Results In total, 21 patients were included (median age 68 years, range 45 – 87 years). The median number of cysts was 2 (range 1 – 10), located in the head (59 %), body/tail (17 %), or multifocal (24 %). ERCP including PS was completed in all of the cases, with biliary sphincterotomy in 33 %. Clinical efficacy after one session was 81 % (17/21). Among the failures, one had a second successful PS and three were operated. The final efficacy was 86 % (18/21). Seven patients were operated after a mean of 19 months: four for WF, three for pain. The histopathology showed four low grade dysplasia, one high grade dysplasia, and two no dysplasia. No adenocarcinoma occurred during a follow-up of 99 months (range 14 – 276 months). Conclusions Endoscopic PS for symptomatic IPMN without WF is effective in more than 80 % of cases, without increasing the risk for adenocarcinoma.

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Improved Survival of Patients with Myelofibrosis in the Last Decade

Blood ◽

10.1182/blood-2020-142578 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 50-51

Author(s):

Lucia Masarova ◽

Prithviraj Bose ◽

Naveen Pemmaraju ◽

Lingsha Zhou ◽

Sherry A. Pierce ◽

...

Keyword(s):

Overall Survival ◽

High Risk ◽

Research Funding ◽

Myeloproliferative Neoplasm ◽

Categorical Variables ◽

Rank Test ◽

Fisher Exact Test ◽

Grant Support ◽

Before And After

Introduction: The myeloproliferative neoplasm myelofibrosis (MF) is associated with reduced overall survival (OS) compared to the general population. In 2011, the JAK1/2 inhibitor ruxolitinib, was approved in the USA for the treatment of intermediate and high-risk MF. Long-term follow-up of patients in pivotal phase 3 studies showed survival benefit of ruxolitinib therapy. Objective: We sought to evaluate the outcome of patients with MF diagnosed before and after the year of 2010 to assess whether OS changed in the past decade in the era of ruxolitinib. Methods: We retrospectively reviewed the charts of 1346 patients with MF who presented to our institution in the last 25 years and compared clinical parameters and outcomes between those presented before and after the year of 2010 (before / after y. 2010). Newly diagnosed MF patients and patients within 12 months from diagnosis who were previously only treated with supportive therapy (danazol, growth-factors, steroids) were included. Cytogenetics (≥10 metaphases) was classified according to Gangat, JCO, 2011. Molecular analysis (≥ 28 genes) was performed only after y. 2010 by using next generation sequencing platform. Fisher exact test and χ2 were used for analysis of categorical variables. Overall survival (OS) was estimated using the Kaplan-Meier method and comparison was done by the log-rank test. Results: Among the 1346 patients, 806 (60%) patients were seen after y. 2010. Median age of all patients was 65 years (range, 20-94), 62% were males. Patient characteristics with comparison between groups are shown in Table 1. Patients after y. 2010 were older, with lower WBC and lower lactate dehydrogenase, but had more symptoms. The distribution of IPSS scores between groups were comparable at around 10% for low, 36% for intermediate-1, 20-25% for intermediate-2 and ~30% for high risk. Eighty-five and 80% of patients before and after y. 2010, respectively, received therapy for MF at our institution. Overall, 78 patients (37 after y. 2010) underwent stem cell transplantation. Among treated patients at our institution, 25% (n 117) and 37% (n 241) before and after y. 2010 received ruxolitinib during their follow-up. Ruxolitinib therapy was initiated with a median time of 2 months (range, 0.2-156) from presentation to our institution, longer in those before y. 2010 (11 vs 1 months in patients after y. 2010, respectively, p = 0.001) After a median follow-up of 30.4 months (range, 0.9-266); 659 (49%) of patients died. More deaths were noticed in those before y. 2010 (74% vs 32 %, respectively, p < 0.001); but these patients had also longer follow-up (37.5 months vs 25 months, p < 0.001). Eighty-five patients (10%) developed acute leukemia: 2 cases per 100 person-years per observation for both groups. Patients after y. 2010 had superior OS to those before y. 2010 with HR 0.7 (95% CI: 0.59-0.82), p < 0.001, Figure 1. Superior OS was observed in all patients after y. 2010 (vs before y. 2010) when stratified by IPSS score (higher equals for combination of int -2 and high, Figure 2), or age (cutoff of 65 years, Figure 3). Patients exposed to ruxolitinib had superior OS regardless of being diagnosed before or after y. 2010, with respective medians of 98 (95% CI: 78-118) and 91 (95% CI: 73-109) months (details to be presented at the conference). Conclusion: Our results demonstrate that survival of patients with MF has improved in the last decade. Survival has improved in younger and older patients as well as in those with more advanced disease (per IPSS risks). Many factors may have contributed to the observed improvement in outcome of MF patients, including new therapies, e.g. ruxolitinib, as well as improved supportive management and disease awareness. Disclosures Bose: Blueprint Medicines Corporation: Honoraria, Research Funding; Astellas Pharmaceuticals: Research Funding; Kartos Therapeutics: Honoraria, Research Funding; Celgene Corporation: Honoraria, Research Funding; Incyte Corporation: Consultancy, Honoraria, Research Funding, Speakers Bureau; NS Pharma: Research Funding; Constellation Pharmaceuticals: Research Funding; Pfizer, Inc.: Research Funding; CTI BioPharma: Honoraria, Research Funding; Promedior, Inc.: Research Funding. Pemmaraju:Daiichi Sankyo: Research Funding; DAVA Oncology: Honoraria; Blueprint Medicines: Honoraria; Roche Diagnostics: Honoraria; AbbVie: Honoraria, Research Funding; Celgene: Honoraria; Incyte Corporation: Honoraria; MustangBio: Honoraria; Plexxikon: Research Funding; Samus Therapeutics: Research Funding; SagerStrong Foundation: Other: Grant Support; Novartis: Honoraria, Research Funding; Pacylex Pharmaceuticals: Consultancy; Affymetrix: Other: Grant Support, Research Funding; LFB Biotechnologies: Honoraria; Stemline Therapeutics: Honoraria, Research Funding; Cellectis: Research Funding. Kantarjian:Novartis: Research Funding; Ariad: Research Funding; Jazz Pharma: Research Funding; Actinium: Honoraria, Membership on an entity's Board of Directors or advisory committees; Cyclacel: Research Funding; Pfizer: Honoraria, Research Funding; Daiichi-Sankyo: Research Funding; Amgen: Honoraria, Research Funding; Immunogen: Research Funding; Astex: Research Funding; Takeda: Honoraria; Agios: Honoraria, Research Funding; AbbVie: Honoraria, Research Funding; BMS: Research Funding. Verstovsek:CTI Biopharma Corp: Research Funding; Protagonist Therapeutics: Research Funding; PharmaEssentia: Research Funding; ItalPharma: Research Funding; Gilead: Research Funding; Promedior: Research Funding; Novartis: Consultancy, Research Funding; Sierra Oncology: Consultancy, Research Funding; Incyte Corporation: Consultancy, Research Funding; Roche: Research Funding; NS Pharma: Research Funding; Celgene: Consultancy, Research Funding; Blueprint Medicines Corp: Research Funding; Genentech: Research Funding; AstraZeneca: Research Funding.

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