scholarly journals MBCL-41. LYMPHOHEMATOPOIETIC TOXICITY IDENTIFIED IN PATIENTS WITH MEDULLOBLASTOMA RECEIVING CRANIOSPINAL IRRADIATION

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii397-iii397
Author(s):  
Atsuko Watanabe ◽  
Yuuki Shimizu ◽  
Atsuhiko Ohta ◽  
Takashi Fukushima ◽  
Tomonari Suzuki ◽  
...  
Keyword(s):  
Medical Records ◽  
Vertebral Column ◽  
Disease Risk ◽  
Newly Diagnosed ◽  
Infectious Episode ◽  
Irradiation Treatment ◽  
High Risk Disease ◽  
Hematopoietic Organs ◽  
Standard Risk ◽  
Craniospinal Axis

Abstract BACKGROUND Medulloblastoma (MB) is the most common malignant brain tumor of childhood. MB easily disseminates through the spinal fluid. Surgery followed by radiotherapy, applied to the entire craniospinal axis (CSI), and adjuvant chemotherapy, represent the treatment of choice for patients aged ≥3 years. Since the bone marrow of the skull and vertebral column are the major hematopoietic organs, we investigated the myelosuppressive effect of irradiation treatment in patients with MB retrospectively. METHODS Medical records of newly diagnosed MB patients treated at our hospital from 2007–2019 were analyzed. Children <3 years old were excluded because they did not receive CSI to avoid potential neurotoxicity. RESULTS Medical records of 18 patients (11 males and 7 females, aged 6–26, median 11 years) were reviewed. Eight patients were stratified as high-risk disease and 10 patients with standard risk. All patients received CSI (dosage range 23.4–39.6 Gy based on disease risk) and posterior fossa boost. All patients developed lymphocytopenia (<0.5×109/L) during irradiation, and for 11 of 18 patients, lymphocytopenia (<0.2×109/L) was severe. Although 13 patients recovered from the lymphocytopenia before the initiation of chemotherapy, five patients underwent chemotherapy without recovery. Conversely, only six patients developed neutropenia (<1.0×109/L), and five of the six patients were <10 years old. CONCLUSION Although infectious episode associated with lymphocytopenia was not observed in this study, CSI treatment in children and adolescents may induce immunodeficient condition particularly in the lymphocytic system. Pediatric oncologists should pay attention to the impaired immunity of patients with MB who receive CSI.

scholarly journals Direct Versus Calculated LDL Cholesterol and C-Reactive Protein in Cardiovascular Disease Risk Assessment in the Framingham Offspring Study

2019 ◽  
Vol 65 (9) ◽  
pp. 1102-1114 ◽  
Author(s):  
Hiroaki Ikezaki ◽  
Virginia A Fisher ◽  
Elise Lim ◽  
Masumi Ai ◽  
Ching-Ti Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Ldl Cholesterol ◽  
Disease Risk ◽  
Univariate Analysis ◽  
Significant Risk ◽  
C Reactive Protein ◽  
Cox Regression Analysis ◽  
Reactive Protein ◽  
Standard Risk

AbstractBACKGROUNDIncreases in circulating LDL cholesterol (LDL-C) and high-sensitivity C-reactive protein (hsCRP) concentrations are significant risk factors for cardiovascular disease (CVD). We assessed direct LDL-C and hsCRP concentrations compared to standard risk factors in the Framingham Offspring Study.METHODSWe used stored frozen plasma samples (−80 °C) obtained after an overnight fast from 3147 male and female participants (mean age, 58 years) free of CVD at cycle 6 of the Framingham Offspring Study. Overall, 677 participants (21.5%) had a CVD end point over a median of 16.0 years of follow-up. Total cholesterol (TC), triglyceride (TG), HDL cholesterol (HDL-C), direct LDL-C (Denka Seiken and Kyowa Medex methods), and hsCRP (Dade Behring method) concentrations were measured by automated analysis. LDL-C was also calculated by both the Friedewald and Martin methods.RESULTSConsidering all CVD outcomes on univariate analysis, significant factors included standard risk factors (age, hypertension, HDL-C, hypertension treatment, sex, diabetes, smoking, and TC concentration) and nonstandard risk factors (non-HDL-C, direct LDL-C and calculated LDL-C, TG, and hsCRP concentrations). On multivariate analysis, only the Denka Seiken direct LDL-C and the Dade Behring hsCRP were still significant on Cox regression analysis and improved the net risk reclassification index, but with modest effects. Discordance analysis confirmed the benefit of the Denka Seiken direct LDL-C method for prospective hard CVD endpoints (new-onset myocardial infarction, stroke, and/or CVD death).CONCLUSIONSOur data indicate that the Denka Seiken direct LDL-C and Dade Behring hsCRP measurements add significant, but modest, information about CVD risk, compared to standard risk factors and/or calculated LDL-C.

Thirty-year cardiovascular risk score in patients with newly diagnosed bipolar disorder and their unaffected first-degree relatives

2018 ◽  
Vol 53 (7) ◽  
pp. 651-662 ◽  
Author(s):  
Klara Coello ◽  
Hanne L Kjærstad ◽  
Sharleny Stanislaus ◽  
Sigurd Melbye ◽  
Maria Faurholt-Jepsen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Bipolar Disorder ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Newly Diagnosed ◽  
Healthy Individuals ◽  
First Degree Relatives ◽  
Age And Sex

Objectives: Bipolar disorder is associated with a decreased life expectancy of 8–12 years. Cardiovascular disease is the leading cause of excess mortality. For the first time, we investigated the Framingham 30-year risk score of cardiovascular disease in patients with newly diagnosed/first-episode bipolar disorder, their unaffected first-degree relatives and healthy individuals. Methods: In a cross-sectional study, we compared the Framingham 30-year risk score of cardiovascular disease in 221 patients with newly diagnosed/first-episode bipolar disorder, 50 of their unaffected first-degree relatives and 119 healthy age- and sex-matched individuals with no personal or first-degree family history of affective disorder. Among patients with bipolar disorder, we further investigated medication- and illness-related variables associated with cardiovascular risk. Results: The 30-year risk of cardiovascular disease was 98.5% higher in patients with bipolar disorder ( p = 0.017) and 85.4% higher in unaffected first-degree relatives ( p = 0.042) compared with healthy individuals in models adjusted for age and sex. When categorizing participants in low cardiovascular risk without considering age and sex distribution among participants, 81% of patients were at low risk, versus 92% of unaffected relatives and 89% of healthy individuals. Of the patients 209 (94.6%) were diagnosed within the preceding 2 years. Smoking was more prevalent among patients with bipolar disorder (45.2%) and their unaffected first-degree relatives (20.4%) compared with healthy individuals (12.8%). Similarly, dyslipidemia was more common among patients with bipolar disorder compared with healthy individuals. Treatment with psychotropic medication with metabolic adverse effects was associated with higher 30-year cardiovascular disease risk score, whereas we did not find illness-related variables associated with cardiovascular risk among patients with bipolar disorder. Conclusion: We found an enhanced cardiovascular disease risk score in patients with newly diagnosed bipolar disorder and their unaffected first-degree relatives, which points to a need for specific primary preventive interventions against smoking and dyslipidemia in these populations.

Early Engagement in Exercise Improves Coronary Artery Disease Risk in Newly Diagnosed Transient Ischemic Attack Patients

2013 ◽  
Vol 8 (6) ◽  
pp. E29-E29 ◽  
Author(s):  
James Faulkner ◽  
Danielle Lambrick ◽  
Brandon Woolley ◽  
Lee Stoner ◽  
Laikin Wong ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Transient Ischemic Attack ◽  
Disease Risk ◽  
Coronary Artery Disease Risk ◽  
Newly Diagnosed ◽  
Artery Disease ◽  
Ischemic Attack

scholarly journals Substratification of patients with newly diagnosed standard‐risk multiple myeloma

2019 ◽  
Vol 185 (2) ◽  
pp. 254-260 ◽  
Author(s):  
Moritz Binder ◽  
S. Vincent Rajkumar ◽  
Rhett P. Ketterling ◽  
Angela Dispenzieri ◽  
Martha Q. Lacy ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Newly Diagnosed ◽  
Standard Risk

scholarly journals Circulating plasma cells in newly diagnosed symptomatic multiple myeloma as a possible prognostic marker for patients with standard-risk cytogenetics

2015 ◽  
Vol 170 (4) ◽  
pp. 523-531 ◽  
Author(s):  
Davide Vagnoni ◽  
Fosco Travaglini ◽  
Valerio Pezzoni ◽  
Miriana Ruggieri ◽  
Catia Bigazzi ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Prognostic Marker ◽  
Plasma Cells ◽  
Newly Diagnosed ◽  
Standard Risk

scholarly journals The influence of age on the GH–IGF1 axis in patients with acromegaly

2008 ◽  
Vol 159 (4) ◽  
pp. 375-379 ◽  
Author(s):  
Keiji Tanimoto ◽  
Naomi Hizuka ◽  
Izumi Fukuda ◽  
Kazue Takano ◽  
Toshiaki Hanafusa
Keyword(s):  
Medical Records ◽  
The Elderly ◽  
Young Group ◽  
Elderly Group ◽  
Age Difference ◽  
Newly Diagnosed ◽  
Middle Aged ◽  
Clinical Complications ◽  
Medical University ◽  
Serum Gh

ObjectiveThe purpose of this study was to investigate the influence of age on GH and IGF1 axis, and complications in patients with acromegaly.Subjects and methodsFrom the medical records, we retrospectively analyzed clinical features and complications in 87 newly diagnosed patients with active acromegaly (34 males, 53 females; aged 18–82 years) who were admitted to Tokyo Women's Medical University between 1999 and 2006. We divided the patients into three groups according to age: ≤30 years old (young group), 31–60 years old (middle-aged group), and ≥61 years old (elderly group).ResultsThe median GH levels in young, middle-aged, and elderly groups were 18.5, 8.8, and 6.7 μg/l respectively, and the IGF1 levels were 810, 717, and 740 μg/l respectively. The values were not significantly different among the groups. However, the serum IGF1 SDS were significantly higher in the elderly group (10.2) than those in young and middle-aged groups (6.6 and 6.2 respectively, P<0.001). The age difference in the higher IGF1 SDS was remarkable in female patients. In the elderly group, glucose intolerance and hypertension were found in 94 and 53% of the patients respectively and the incidences were higher than those in the other groups.ConclusionThis study suggests that the relatively high IGF1 secretions in elderly patients might be involved in the progression of clinical complications in acromegalic patients. Therefore, awareness of the early symptoms and examination of serum GH and IGF1 are important for patients with acromegaly.

Wilms Tumor 1 Gene Mutations in Adult Acute T-Lymphoblastic Leukemia

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2516-2516
Author(s):  
Sandra Heesch ◽  
Nicola Goekbuget ◽  
Jutta Ortiz Tanchez ◽  
Cornelia Schlee ◽  
Stefan Schwartz ◽  
...  
Keyword(s):  
Mrna Expression ◽  
Wilms Tumor ◽  
Lymphoblastic Leukemia ◽  
Single Amino Acid ◽  
Newly Diagnosed ◽  
Expression Levels ◽  
Wilms Tumor 1 ◽  
Standard Risk ◽  
Wt1 Protein ◽  
Mrna Expression Levels

Abstract The wilms tumor 1 gene (WT1) encodes a transcriptional regulator involved in normal hematopoietic development. The role of WT1 in acute leukemia has been underscored by the finding of WT1 overexpression in subsets of patients (pts) associated with an increased relapse risk. In addition mutations of WT1 have been found in about 10–15% of acute myeloid leukemia (AML) pts and have recently shown to predict inferior survival. Thus far, larger studies have not yet determined the frequency and impact of WT1 mutations in acute T-lymphoblastic leukemia (T-ALL). Herein, we have analyzed WT1 mutations and WT1 mRNA expression levels in a large cohort of T-ALL including 239 newly diagnosed adult pts treated on the GMALL protocols 0699 and 0703. Diagnostic bone marrow specimens were studied for WT1 mutations by DNA sequencing. In addition, samples were immunophenotyped, and mRNA expression of the molecular markers HOX11, HOX11L2, ERG, BAALC, as well as WT1 were determined by real-time RT-PCR. Twenty (8%) of the 239 analyzed T-ALL pts had WT1 mutations (WT1mut) [20 pts had mutations in exon 7 (WT1mut7), with 2 pts having coexisting mutations in exon 9 (WT1mut9)]. WT1mut7 were frameshift or nonsense mutations predicted to result in a truncated WT1 protein, whereas WT1mut9 were missense mutations leading to single amino-acid substitutions. WT1mut and WT1 wildtype (WTwt) pts did not significantly differ with respect to clinical parameters at diagnosis (e. g. age, leukocyte count, and sex). WT1mut cases were characterized by immature features such as an early immunophenotype (45% of WT1mut showed an early T-ALL immunophenotype as compared to only 25% of WT1wt), and WT1mut also showed higher levels of CD34 expression as determined by flow cytometry (WT1mut median: 46% vs. WT1wt median: 2 %; P=0.03). Moreover, WT1mut had significantly higher WT1 mRNA expression levels [WT1mut median: 0.05 (range: 0–0.395) vs. WT1wt median: 0 (range: 0–0.15); P&lt;0.001]. Significant differences were not observed in the complete remission rate nor overall survival or relapse free-survival (RFS) between WT1mut and WT1wt pts. However, in the standard risk group of thymic T-ALL 80% (4/5) of WT1mut relapsed as compared to 28% (25/89) of WT1wt thymic pts [P=0.01; RFS at 18 months: 20% (SE: ±18) for thymic WT1mut vs. 82% (SE: ±4) for thymic WT1wt pts; P=0.008]. In conclusion, in adult T-ALL WT1 mutations are present in 8% of newly diagnosed pts and are located in the same region as reported in AML expected to impair the DNA binding ability of the WT1 protein. Similar to findings in AML, WT1mut cases are characterized by immature features pinpointing to a genetic hit in hematopoietic progenitors likely harboring bilineage potential. The prognostic implications of WT1 mutations in standard risk thymic T-ALL will have to be further validated in independent studies and may in future direct molecularly-based treatment stratification.

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