MO306IGA NEPHROPATHY: A 20 YEAR RETROSPECTIVE SINGLE CENTRE EXPERIENCE

Abstract Background and Aims IgA nephropathy is the most common glomerulonephritis worldwide. The clinical course is heterogeneous and not always easy to predict. As such, determining which patients to treat with immunosuppression has been the cause of much debate. Over recent years there has been a focus on risk prediction to help with treatment decisions (such as the widely validated International IgA Risk Prediction Tool). Here, we present a 20 year retrospective study from a single centre with the following aims: to describe the epidemiology of our cohort, to assess outcomes (such as progression to ESKD requiring RRT, mortality), and to determine if treatment choices have changed over time. Method We collected all cases of IgA nephropathy from our biopsy database between January 2020 and December 2019. This totalled 525 biopsies. Of these, a number were excluded from analysis, including transplant biopsies and repeat biopsies in the same patient. After exclusion, the original 525 biopsies were narrowed down to 452 patients for analysis. We collected demographic data for each patient, along with creatinine and proteinuria values over time, MEST-C scores, progression to ESKD, mortality, use of RAAS blockade and immunosuppressants. Initial analysis was performed using Excel. We plan to perform further multivariate Cox regression analysis to determine if there are associations with progression to ESKD such as degree of proteinuria, MEST-C scores and immunosuppression treatment. Results We identified 452 patients with biopsy confirmed IgA nephropathy at our centre between January 2000 and December 2019. 138 (30.5%) were female and 314 (69.4%) were male. The average age at time of biopsy was 45.7 years. Mortality over this period was 19.2% (87 patients). 126 (27.9%) progressed to ESKD requiring RRT, 6 (1.3%) required temporary dialysis whilst 313 (69.2%) did not require RRT. With regards to treatment, 329 (72.8%) were treated with RAAS blockade in comparison to 85 (18.8%) who were not (in 38 patients this was unclear). No immunosuppression was used in 349 (77.2%), whilst a combination of prednisolone; IV cyclophosphamide and prednisolone; and MMF and prednisolone was used in 97 (21.5%). Conclusion We present here a large single centre dataset of IgA nephropathy patients over a 20 year period. We show that there remains a significant risk of progression to ESKD over time. It is important to identify those patients most at risk of progression early on in their disease course so that optimal treatment can be initiated. Further analysis of this dataset will allow us to assess whether treatment strategies in recent years has had a beneficial effect on outcomes, and also to assess the correlation between MEST-C scores and treatment decisions.

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A multicenter, prospective, observational study to determine association of mesangial C1q deposition with renal outcomes in IgA nephropathy

Scientific Reports ◽

10.1038/s41598-021-84715-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Li Tan ◽

Yi Tang ◽

Gaiqin Pei ◽

Zhengxia Zhong ◽

Jiaxing Tan ◽

...

Keyword(s):

Risk Factors ◽

Iga Nephropathy ◽

Cox Regression ◽

Renal Outcome ◽

Matched Cohort ◽

Negative Group ◽

Renal Survival ◽

Cox Regression Analysis ◽

Renal Outcomes

AbstractIt was reported that histopathologic lesions are risk factors for the progression of IgA Nephropathy (IgAN). The aim of this study was to investigate the relationships between mesangial deposition of C1q and renal outcomes in IgAN. 1071 patients with primary IgAN diagnosed by renal biopsy were enrolled in multiple study centers form January 2013 to January 2017. Patients were divided into two groups: C1q-positive and C1q-negative. Using a 1: 4 propensity score matching (PSM) method identifying age, gender, and treatment modality to minimize confounding factors, 580 matched (out of 926) C1q-negative patients were compared with 145 C1q-positive patients to evaluate severity of baseline clinicopathological features and renal outcome. Kaplan–Meier and Cox proportional hazards analyses were performed to determine whether mesangial C1q deposition is associated with renal outcomes in IgAN. During the follow-up period (41.89 ± 22.85 months), 54 (9.31%) patients in the C1q negative group and 23 (15.86%) patients in C1q positive group reached the endpoint (50% decline of eGFR and/or ESRD or death) respectively (p = 0.01) in the matched cohort. Significantly more patients in C1q negative group achieved complete or partial remission during the follow up period (P = 0.003) both before and after PSM. Three, 5 and 7-year renal survival rates in C1q-positive patients were significantly lower than C1q-negative patients in either unmatched cohort or matched cohort (all p < 0.05). Furthermore, multivariate Cox regression analysis showed that independent risk factors influencing renal survival included Scr, urinary protein, T1-T2 lesion and C1q deposition. Mesangial C1q deposition is a predictor of poor renal survival in IgA nephropathy.Trial registration TCTR, TCTR20140515001. Registered May 15, 2014, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=1074.

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Cardiovascular Risk Based on ASCVD and KDIGO Categories in Chinese Adults: A Nationwide, Population-Based, Prospective Cohort Study

Journal of the American Society of Nephrology ◽

10.1681/asn.2020060856 ◽

2021 ◽

pp. ASN.2020060856

Author(s):

Yu Xu ◽

Mian Li ◽

Guijun Qin ◽

Jieli Lu ◽

Li Yan ◽

...

Keyword(s):

Cardiovascular Disease ◽

Cohort Study ◽

Risk Prediction ◽

Cox Regression ◽

Rank Test ◽

Atherosclerotic Cardiovascular Disease ◽

Cvd Risk ◽

Cox Regression Analysis ◽

Ascvd Risk ◽

Risk Categories

BackgroundThe Kidney Disease Improving Global Outcomes (KDIGO) clinical practice guideline used eGFR and urinary albumin-creatinine ratio (ACR) to categorize risks for CKD prognosis. The utility of KDIGO’s stratification of major CVD risks and predictive ability beyond traditional CVD risk prediction scores are unknown.MethodsTo evaluate CVD risks on the basis of ACR and eGFR (individually, together, and in combination using the KDIGO risk categories) and with the atherosclerotic cardiovascular disease (ASCVD) score, we studied 115,366 participants in the China Cardiometabolic Disease and Cancer Cohort study. Participants (aged ≥40 years and without a history of cardiovascular disease) were examined prospectively for major CVD events, including nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death.ResultsDuring 415,111 person-years of follow-up, 2866 major CVD events occurred. Incidence rates and multivariable-adjusted hazard ratios of CVD events increased significantly across the KDIGO risk categories in ASCVD risk strata (all P values for log-rank test and most P values for trend in Cox regression analysis <0.01). Increases in c statistic for CVD risk prediction were 0.01 (0.01 to 0.02) in the overall study population and 0.03 (0.01 to 0.04) in participants with diabetes, after adding eGFR and log(ACR) to a model including the ASCVD risk score. In addition, adding eGFR and log(ACR) to a model with the ASCVD score resulted in significantly improved reclassification of CVD risks (net reclassification improvements, 4.78%; 95% confidence interval, 3.03% to 6.41%).ConclusionsUrinary ACR and eGFR (individually, together, and in combination using KDIGO risk categories) may be important nontraditional risk factors in stratifying and predicting major CVD events in the Chinese population.

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The Value of Laboratory Parameters for Anemia, Renal Function, Systemic Inflammation and Nutritional Status as Predictors for Outcome in Elderly Patients with Head-and-Neck Cancers

Cancers ◽

10.3390/cancers12061698 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1698 ◽

Cited By ~ 5

Author(s):

Alexander Rühle ◽

Erik Haehl ◽

Hélène David ◽

Tobias Kalckreuth ◽

Tanja Sprave ◽

...

Keyword(s):

Risk Factors ◽

Renal Function ◽

Head And Neck ◽

Treatment Outcomes ◽

Cox Regression ◽

Significant Risk ◽

Tumor Oxygenation ◽

Nutrition Status ◽

Cox Regression Analysis ◽

Laboratory Parameters

The purpose of this study was to evaluate the value of routine blood markers regarding their predictive potential for treatment outcomes of elderly head-and-neck squamous cell carcinoma (HNSCC) patients. In total, 246 elderly HNSCC patients (≥65 years) undergoing (chemo)radiotherapy from 2010 to 2018 were analyzed for treatment outcomes, depending on their hemoglobin, glomerular filtration rate (GFR), C-reactive protein (CRP) and albumin values, representing anemia, kidney function, inflammation and nutrition status, respectively. Local/locoregional control, progression-free and overall survival (OS) were calculated using the Kaplan–Meier method. Cox analyses were performed to examine the influence of blood parameters on oncological outcomes. In the univariate Cox regression analysis, hemoglobin ≤ 12 g/dL (HR = 1.536, p < 0.05), a GFR ≤ 60 mL/min/1.73 m2 (HR = 1.537, p < 0.05), a CRP concentration > 5 mg/L (HR = 1.991, p < 0.001) and albumin levels ≤ 4.2 g/dL (HR = 2.916, p < 0.001) were significant risk factors for OS. In the multivariate analysis including clinical risk factors, only performance status (HR = 2.460, p < 0.05) and baseline albumin (HR = 2.305, p < 0.05) remained significant prognosticators. Additionally, baseline anemia correlated with the prevalence of higher-grade chronic toxicities. We could show for the first time that laboratory parameters for anemia (and at least partly, tumor oxygenation), decreased renal function, inflammation and reduced nutrition status are associated with impaired survival in elderly HNSCC patients undergoing (chemo)radiotherapy.

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It Is Easix to Predict Non-Relapse Mortality (NRM) of Allogeneic Stem Cell Transplantation (alloSCT)

Blood ◽

10.1182/blood.v128.22.519.519 ◽

2016 ◽

Vol 128 (22) ◽

pp. 519-519 ◽

Cited By ~ 2

Author(s):

Thomas Luft ◽

Axel Benner ◽

Sonata Jodele ◽

Christopher E. Dandoy ◽

Rainer F. Storb ◽

...

Keyword(s):

Endothelial Dysfunction ◽

Cox Regression ◽

Pearson Correlation ◽

Significant Risk ◽

Serum Levels ◽

Adult Patients ◽

Stress Index ◽

Brier Score ◽

Training Cohort ◽

Cox Regression Analysis

Abstract Endothelial dysfunction has been shown to be associated with severe complications and increased NRM after alloSCT. Endothelial risk markers, such as angiopoetin-2 (ANG2) serum levels and thrombomodulin single nucleotide polymorphisms can be used for pre-transplant prediction of endothelium-related complications after alloSCT (Blood 2011;118:1685; J Clin Oncol. The aim of the present study was to develop a tool for prediction of endothelial dysfunction prior to alloSCT that can be easily used in clinical practice. For this purpose, we focused on routine parameters which are used to diagnose transplant-associated thrombotic microangiopathy (TMA), which is an endothelial complication associated with high NRM. Based on the fact that TMA is defined by high creatinine, high lactate dehydrogenase (LDH), low thrombocyte counts, schistocytes, and loss of haptoglobin, we hypothesized that the simplified formula termed 'Endothelial Activation and Stress Index (EASIX)' might be valuable for predicting TMA, NRM and overall survival (OS) after alloSCT. Design: The capacity of pre-transplant EASIX ("EASIX-pre") obtained directly prior to conditioning for alloSCT for predicting TMA was tested retrospectively in 771 consecutive adult patients undergoing alloSCT in Heidelberg between 2001 and 2013 (training cohort) using cause-specific Cox regression analysis. The correlation of EASIX-pre with pre-transplant ANG2 and suppressor of tumorigenicity-2 (ST2) serum levels was assessed by Kruskal-Wallis test / Pearson correlation. The prognostic strength of EASIX-pre for NRM, time to relapse (TTR) and OS was calculated in the training cohort and in three independent validation cohorts (Berlin adults n=386, Seattle adults n=450 and Cincinnati children n=247) by calculating the prediction error (integrated Brier score), concordance index, and calibration index. Different intensities of conditioning (MAC+RIC+non-MAC) as well as all donor types and all degrees of HLA-matching were included. Hazard ratios (HR) were estimated to illustrate the effect of a two-fold change in EASIX-pre. Results: In the training cohort, EASIX-pre was a significant risk factor for TMA in univariable (HR=1.24, p=0.03) and in multivariable models including age, disease score, ATG, donor sex, recipient sex, graft source, diagnosis and statin intake as covariates (HR 1.28, p=0.02). EASIX-pre correlated with pre-transplant serum levels of the endothelium-related markers ANG2 and ST2. Increasing EASIX-pre was significantly associated with increasing NRM (uni: HR 1.22, p<0.001, multi: HR 1.22, p=0.001) and decreasing OS (univariable: HR 1.13, p=0.002, multivariable: HR 1.11, p=0.01), but not TTR (uni: HR 1.01, p=0.77, multi: HR 1.00, p=0.95) following allo-SCT. Model validation for prediction of NRM and OS by EASIX-pre was successfully done in two independent cohorts of adult patients. In contrast, the adult model for EASIX-pre failed to predict outcome in pediatric patients, which might be explained by the different diseases and comorbidities of adults and children. In order to visualize the clinical value of assessing EASIX-pre, Figure 1 showsKaplan-Meier estimates of OS after alloSCT according to the EASIX-pre derived cutoff in Heidelberg for each cohort separately. Conclusions: The novel and easy to assess EASIX-pre score is a powerful predictor of NRM and overall mortality in adult alloSCT recipients which might be helpful for pre-transplant definition of the individual transplant risk. Disclosures Dreger: Novartis: Consultancy; Janssen: Consultancy; Roche: Consultancy; Novartis: Speakers Bureau; Gilead: Speakers Bureau; Gilead: Consultancy.

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National trends in local excision and esophagectomy for cT1N0 esophageal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.62 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 62-62 ◽

Cited By ~ 1

Author(s):

Emily C. Sturm ◽

Whitney Zahnd ◽

John D. Mellinger ◽

Sabha Ganai

Keyword(s):

Esophageal Cancer ◽

Regression Analysis ◽

Local Excision ◽

Clinical Characteristics ◽

Cox Regression ◽

Chi Square ◽

Cox Regression Analysis ◽

Significant Difference ◽

Chi Square Analysis ◽

Over Time

62 Background: Esophageal cancer management has evolved due to improvements in staging and treatment strategies. Endoscopic local excision presents an attractive option for definitive management of T1 cancers, avoiding the morbidity of esophagectomy. We hypothesized that for cT1N0 cancers, patients who underwent local excision would have lower survival compared to esophagectomy due to potential discordant staging. Methods: The National Cancer Database was queried for esophageal squamous cell carcinoma (SCC) and adenocarcinoma (AC) with AJCC T1N0 clinical stage who underwent local excision (n = 1625) or esophagectomy (n = 3255) between 1998 and 2012. Chi-square analysis was used to compare demographic and clinical characteristics by procedure. Chi-square trend analysis was performed to assess trends in procedure type over time. Cox Regression analysis was performed to assess survival by procedure controlling for demographic and clinical characteristics. Results: Between 1998 and 2012, the proportion of patients who underwent local excision increased from 12% to 50% for all patients (p < 0.001); from 17% to 40% for SCC patients (p < 0.001); and from 9% to 51% for AC patients (p < 0.001). Surgical procedure varied significantly by demographic, socioeconomic status, facility, and tumor-related factors. 65% of cT1N0 cancers had concordant clinical and pathological staging after esophagectomy, with 11% having positive nodal disease; 44% were concordant after local excision. While no significant difference was seen in unadjusted survival, adjusted Cox Regression analysis indicated worse survival after esophagectomy compared to local excision for all cases (HR 1.67; 95% CI, 1.40-2.00) and for ACs with concordant staging (HR 1.54; 95% CI, 1.11-2.14). Conclusions: Local excision for cT1N0 esophageal cancer has increased over time. Staging concordance for esophagectomy is seen in two-thirds of cases. Contrary to our hypothesis, patients undergoing local excision for T1N0 cancers have better overall survival than those undergoing esophagectomy, which may reflect early differences in mortality and/or selection bias. As this study was unable to distinguish T1a from T1b, further analysis is warranted.

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Dental Health Behaviors, Dentition, and Mortality in the Elderly: The Leisure World Cohort Study

Journal of Aging Research ◽

10.4061/2011/156061 ◽

2011 ◽

Vol 2011 ◽

pp. 1-10 ◽

Cited By ~ 22

Author(s):

Annlia Paganini-Hill ◽

Stuart C. White ◽

Kathryn A. Atchison

Keyword(s):

Older Adults ◽

Oral Health ◽

Health Behaviors ◽

Cox Regression ◽

Dental Health ◽

Significant Risk ◽

Dental Floss ◽

Cox Regression Analysis ◽

Risk Of Death ◽

Increased Risk

In the last decade the effect of oral health on the general health and mortality of elderly people has attracted attention. We explored the association of dental health behaviors and dentition on all-cause mortality in 5611 older adults followed from 1992 to 2009 (median=9years) and calculated risk estimates using Cox regression analysis in men and women separately. Toothbrushing at night before bed, using dental floss everyday, and visiting the dentist were significant risk factors for longevity. Never brushing at night increased risk 20–35% compared with brushing everyday. Never flossing increased risk 30% compared with flossing everyday. Not seeing a dentist within the last 12 months increased risk 30–50% compared with seeing a dentist two or more times. Mortality also increased with increasing number of missing teeth. Edentulous individuals (even with dentures) had a 30% higher risk of death compared with those with 20+ teeth. Oral health behaviors help maintain natural, healthy and functional teeth but also appear to promote survival in older adults.

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Identification and validation of AKR1C1/2/3 as hepatocellular carcinoma risk modules via an integrated strategy

10.21203/rs.2.24543/v1 ◽

2020 ◽

Author(s):

Mingxing Xu ◽

Yuesi Zhong ◽

Fangji Yang ◽

Kai Liu ◽

Baoding Zhuang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Cox Regression ◽

Significant Risk ◽

Reduction Process ◽

Progression Free Survival ◽

Tumor Stage ◽

Genetic Alterations ◽

Metabolic Process ◽

Free Survival ◽

Cox Regression Analysis

Abstract Background The human aldo-keto reductase 1 (AKR1) C family comprises four enzymes, AKR1C1–AKR1C4. Lots of studies have investigated the function of AKR1Cs in tumors, however little is known in hepatocellular carcinoma (HCC). Methods Public databases were used to explore expression and role of AKR1Cs in HCC. Meanwhile, data of 134 HCC patients from Firebrowse website was used for validation. Results The results revealed that AKR1Cs expression was negatively correlated with the infiltration level of CD4+ T cells. Overexpression of AKR1C1/2/3 was significantly associated with tumor stage and pathological grade. Moreover, higher mRNA expression of AKR1C1/2/3 was related with shorter overall survival (OS), progression-free survival (PFS) and relapse-free survival (RFS). Multivariate Cox regression analysis showed that AKR1C1/2/3 could be significant risk factors for HCC patients. Additionally, genetic alterations of AKR1Cs can significantly affect patient OS and PFS, and expression of AKR1Cs was linked to functional networks involving oxidation-reduction process, cellular hormone metabolic process and organic hydroxy compound metabolic process, as well as retinol metabolism, steroid hormone biosynthesis, metabolic pathway and fatty acid degradation pathways. Conclusions In conclusion, we successfully elaborated the relationship between AKR1Cs expression and immune infiltrations, and identified AKR1C1/2/3 could be novel prognostic biomarkers for HCC patients.

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Identification of a Ferroptosis-Related LncRNA Signature as a Novel Prognosis Model for Lung Adenocarcinoma

Frontiers in Oncology ◽

10.3389/fonc.2021.675545 ◽

2021 ◽

Vol 11 ◽

Author(s):

Lu Lu ◽

Le-Ping Liu ◽

Qiang-Qiang Zhao ◽

Rong Gui ◽

Qin-Yu Zhao

Keyword(s):

Regression Analysis ◽

Prediction Model ◽

Lung Adenocarcinoma ◽

Tumor Cells ◽

Risk Prediction ◽

Prognostic Value ◽

Cox Regression ◽

Risk Prediction Model ◽

Functional Enrichment ◽

Cox Regression Analysis

Lung adenocarcinoma (LUAD) is a highly heterogeneous malignancy, which makes prognosis prediction of LUAD very challenging. Ferroptosis is an iron-dependent cell death mechanism that is important in the survival of tumor cells. Long non-coding RNAs (lncRNAs) are considered to be key regulators of LUAD development and are involved in ferroptosis of tumor cells, and ferroptosis-related lncRNAs have gradually emerged as new targets for LUAD treatment and prognosis. It is essential to determine the prognostic value of ferroptosis-related lncRNAs in LUAD. In this study, we obtained RNA sequencing (RNA-seq) data and corresponding clinical information of LUAD patients from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database and ferroptosis-related lncRNAs by co-expression analysis. The best predictors associated with LUAD prognosis, including C5orf64, LINC01800, LINC00968, LINC01352, PGM5-AS1, LINC02097, DEPDC1-AS1, WWC2-AS2, SATB2-AS1, LINC00628, LINC01537, LMO7DN, were identified by Least Absolute Shrinkage and Selection Operator (LASSO) Cox regression analysis, and the LUAD risk prediction model was successfully constructed. Kaplan-Meier analysis, receiver operating characteristic (ROC) time curve analysis and univariate and multivariate Cox regression analysis and further demonstrated that the model has excellent robustness and predictive ability. Further, based on the risk prediction model, functional enrichment analysis revealed that 12 prognostic indicators involved a variety of cellular functions and signaling pathways, and the immune status was different in the high-risk and low-risk groups. In conclusion, a risk model of 12 ferroptosis related lncRNAs has important prognostic value for LUAD and may be ferroptosis-related therapeutic targets in the clinic.

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Cardiotoxicity and related risk factors in long-term trastuzumab (T) administration for metastatic breast cancer (MBC): A retrospective analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e11616 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e11616-e11616

Author(s):

Barbara Pistilli ◽

Andrea Marcellusi ◽

Michele Valeri ◽

Umberto Torresi ◽

Dania Nacciarriti ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Cardiac Disease ◽

Cox Regression ◽

Significant Risk ◽

Concomitant Chemotherapy ◽

Cox Regression Analysis ◽

Significant Difference ◽

History Of

e11616 Background: Continuing T beyond progression has become a common strategy in the treatment of human epidermal growth receptor 2- overexpressing (HER2) MBC. However, T administered for several years with concomitant chemotherapy elicits concern about cardiac safety especially in patients (pts) with risk factors. Methods: Cardiac events (CEs) and survival of HER2 MBC pts treated with T +/- chemotherapy at our institution from Dec 2003 to Jun 2012 were evaluated. CEs were graded by NCI-CTCAE v 3.0. Risk factors assessed for cardiotoxicity were: age, body mass index, antihypertensive therapy, history of cardiac disease, diabetes, hypothyroidism, smoking, prior radiotherapy on the chest wall, prior cumulative dose of anthracycline(A), interval between last A dose and first T dose, baseline LVEF, continued/interrupted T exposure, concomitant chemotherapy. Chi-square test was used to compare distribution of CEs over different times of T exposure (p≤ 0.05). Univariate and multivariate Cox regression analysis were used to assess the effect of risk predictors. Results: Sixty-two pts assessable. Median age 52 years (range, 29 to 76), median cumulative time receiving T 29.5 months (range, 3 to 99 months); 40 pts (64.5%) received T without interruption and 19 pts (30.6%) were treated for more than 36 months. CEs occurred in 11 out of all pts (17.7%): grade 1 in 3 pts (4.8%), grade 2 in 5 (8.1%) and grade 3 in 3 (4.8%). The rate of CEs showed no statistically significant difference in pts receiving T for up to 36 months and over: 7/43 (16.3%) and 4/19 (21%), respectively, (p =0.724). In univariate Cox regression analysis significant risk factors were: history of cardiac disease (HR 6,814, 95% CI: 1,384-33,542) and smoking (HR 5,228, 95% CI: 1,403-19,491). In multivariate analysis smoking was the only independent predictor (HR 5,886, 95% CI: 1,479-23,247). Median survival from MBC diagnosis was 50 months (range, 6 to 101 months). Conclusions: Despite the limited sample size, our analysis suggests that cardiotoxicity does not hamper a long-term use of T, since the rate of CEs did not increase in pts treated over 36 months. Moreover, smoking appears to be a predictive factor of T cardiotoxicity.

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High Soluble P-Selectin and Low Platelet Count as Thrombosis Risk Markers in Glioma Patients.

Blood ◽

10.1182/blood.v114.22.2985.2985 ◽

2009 ◽

Vol 114 (22) ◽

pp. 2985-2985

Author(s):

Rainer Vormittag ◽

Christine Marosi ◽

Cihan Ay ◽

Ralph Simanek ◽

Ilse Schwarzinger ◽

...

Keyword(s):

Regression Analysis ◽

Platelet Count ◽

Cox Regression ◽

Significant Risk ◽

Cumulative Probability ◽

Risk Markers ◽

Cox Regression Analysis ◽

Thrombosis Risk ◽

Increased Risk ◽

Soluble P

Abstract Abstract 2985 Poster Board II-961 Background Glioma patients are at high risk for venous thromboembolism (VTE). However, predictive laboratory parameters have not been identified. High platelet count (PLC) and increased soluble P-selectin (sP-selectin) have been reported as risk factors in cancer patients, so we investigated sP-selectin and PLC as risk markers in glioma patients. Methods The Cancer and Thrombosis Study (CATS) is a prospective observational study, whose endpoint is the occurrence of objectively confirmed VTE. sP-selectin was measured in the third week after neurosurgical intervention using a human sP-selectin Immunoassay (R&D Systems®, Minneapolis, USA). Multivariable Cox regression analysis was applied to calculate hazard ratios (HR) for VTE, including PLC, sP-selectin, age, sex and type of surgery. Results 140 patients with newly diagnosed high grade glioma were analysed (52 women; median age 54.5 years [interquartile range (IQR): 42.8-5.1]) during a median observation time of 309 (range: 3-1664) days. Twenty patients developed VTE (6 women, 14 men), of which 2 events were fatal pulmonary embolisms. The cumulative probability of VTE was 10% at six and 15% at twelve months. sP-selectin levels (ng/mL) were higher in patients with VTE compared to those without (median=51.8, IQR: 36.9–66.0 versus median=38.8, IQR: 30.7–52.1, p=0.011). Interestingly, PLC (G/l) was significantly lower in patients with (median=214, IQR: 166-248) than in those without VTE (median=255, IQR: 200-327; p=0.011). In multivariable regression analysis high sP-selectin (75th percentile: 55.1ng/mL) and low PLC (25th percentile: 198G/L) were significant risk markers of VTE (HR=3.4, 95% CI 1.3-9.0, and HR=3.3, 95% CI 1.2-8.8, respectively). Conclusion Our study revealed two strong predictive markers for VTE in glioma patients. Elevated sP-selectin is associated with a three-fold increased risk of thrombosis. In contrast to patients with other solid tumours, in glioma patients low PLC is associated with increased thrombosis risk. Disclosures: Pabinger: Amgen Inc.: Honoraria, Membership on an entity's Board of Directors or advisory committees.

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