Comparison of Different Ldl-Apheresis Techniques

1998 ◽  
Vol 21 (6_suppl) ◽  
pp. 66-71 ◽  
Author(s):  
C. Stefanutti ◽  
S. Di Giacomo ◽  
A. Vivenzio
Keyword(s):  
High Risk ◽  
Plasma Exchange ◽  
Whole Blood ◽  
Pediatric Patients ◽  
Early Age ◽  
Efficacy And Safety ◽  
Ldl Apheresis ◽  
Cell Plasma ◽  
Risk Patients ◽  
Direct Adsorption

LDL-apheresis is an extracorporeal technique which removes all apo B100-containing lipoproteins (VLDL, LDL, Lp(a)) from plasma, in patients whith homozygous, and double heterozygous, familial hypercholesterolemia (FH). One of the most significant technical characteristics of LDL-apheresis is the selectivity in the removal of atherogenic lipoproteins, namely LDLs, which has been improved in the most recently developed techniques. The oldest system for therapeutic plasmapheresis in the treatment of severe hyperlipoproteinemias, is plasma-exchange, where all plasma components are unselectively removed. More recently, the systems (dextransulphate cellulose LDL-apheresis [DSC/LDL-A], heparin induced LDL precipitation-apheresis [HELP/LDL-A], immunoadsorption LDL-apheresis [IMA/LDL-A], direct adsorption of lipids [DALI]) have permitted a selective removal of LDL and of other apo B100-containing lipoproteins. The higher selectivity, thus the higher efficacy and safety, has also allowed the treatment of high risk patients with severe cardiovascular conditions, and pediatric patients. Therefore, it is currently possible to begin treatment with LDL-apheresis, even at a very early age. The most recent system for LDL-apheresis (DALI: Direct Adsorption of Lipids) even permits the removal of LDL from whole blood, without previous cell/plasma separation. This system is promising for further progress in the technology related to LDL-apheresis.

scholarly journals Cardiovascular Efficacy and Safety of Bococizumab in High-Risk Patients

2017 ◽  
Vol 376 (16) ◽  
pp. 1527-1539 ◽  
Author(s):  
Paul M Ridker ◽  
James Revkin ◽  
Pierre Amarenco ◽  
Robert Brunell ◽  
Madelyn Curto ◽  
...  
Keyword(s):  
High Risk ◽  
Efficacy And Safety ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals 1756. Prediction of Bloodstream Infection Prior to Onset of Symptoms by Plasma Metagenomic Sequencing in Pediatric Patients With Relapsed or Refractory Malignancy (PREDSEQ)

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S60-S60 ◽  
Author(s):  
Kathryn Goggin ◽  
Yuki Inaba ◽  
Veronica Gonzalez-Pena ◽  
Kim J Allison ◽  
Ka Lok Chan ◽  
...  
Keyword(s):  
High Risk ◽  
Bloodstream Infection ◽  
Pediatric Patients ◽  
Clinical Samples ◽  
Metagenomic Sequencing ◽  
Research Support ◽  
Documented Infection ◽  
Risk Patients ◽  
Bacteria And Fungi ◽  
Refractory Malignancy

Abstract Background Patients undergoing treatment for relapsed or refractory malignancies are at high risk of life-threatening bloodstream infection (BSI). A predictive screening test for BSI might allow pre-emptive therapy, but no validated test is currently available. We tested the hypothesis that plasma metagenomic next generation pathogen sequencing (NGS) would predict BSI before the onset of attributable symptoms. Methods We enrolled 31 pediatric patients receiving for treatment relapsed or refractory malignancy in an IRB-approved prospective cohort study (PREDSEQ) of predictive sequencing. Episodes of febrile neutropenia or documented infection were collected prospectively from the medical record. BSI was defined according to NHSN criteria. Control Samples were defined as samples collected ≥7 clear days before or after any fever or documented infection. Residual clinical samples were stored for NGS; after filtering human sequences, reads were aligned to a curated pathogen database, and organisms above a predefined threshold were reported (Karius Inc., Redwood City, CA). Only bacteria and fungi were included in this analysis. Results A total of 11 BSI episodes occurred in 9 participants (Table 1) during the study period. Predictive sensitivity of NGS in the 2 days before onset of infection (n = 9) was 78% (95% CI 45–94%), and diagnostic sensitivity on the day of infection (n = 11) was 82% (95% CI 52–95%). Specificity of NGS for development of fever or infection within 7 days (n = 16) was 81% (95% CI 57–93%). NGS was positive up to 6 days prior to onset of BSI. In samples collected before or during documented infections, NGS also identified additional bacteria and fungi that were not detected by standard clinical testing. Conclusion Plasma NGS shows promise for the detection of BSI prior to onset of symptoms in high-risk patients. Disclosures K. Goggin, Karius Inc.: Investigator, Research support. K. L. Chan, Karius Inc.: Employee, Salary. D. Hollemon, Karius Inc.: Employee, Salary. A. Ahmed, Karius, Inc.: Employee, Salary. D. Hong, Karius, Inc.: Employee, Salary. R. Hayden, Roche Molecular: Scientific Advisor, Consulting fee. Abbott Molecular: Scientific Advisor, Consulting fee. Quidel: Scientific Advisor, Consulting fee. C. Gawad, Karius Inc.: Investigator, Research support. J. Wolf, Karius Inc.: Investigator, Research support.

Risk-Adapted Therapy with ABVD for Low- and Intermediate-Risk Patients and Oepa-Copdac for High Risk Patients Plus Involved-Field Radiation Therapy (IFRT) Based on Prognosis at Diagnosis and Early Response: Results from Pediatric Argentinian Collaborative Group Gatla Study for Children and Adolescents with Hodgkin Lymphoma

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 13-13
Author(s):  
David Alejandro Veron ◽  
Patricia Streitenberger ◽  
Cecilia Riccheri ◽  
Monica Matus ◽  
Pedro Negri Aranguren ◽  
...  
Keyword(s):  
High Risk ◽  
Pediatric Patients ◽  
Conflicts Of Interest ◽  
Risk Groups ◽  
Early Response ◽  
Collaborative Group ◽  
Bulky Disease ◽  
Number Of Patients ◽  
Field Radiation ◽  
Risk Patients

Background: The GATLA Collaborative Group has a 50 year (y) long experience of running cooperative trials for lymphomas in Argentina. Aim: Describe the outcome of pediatric patients(pts) treated according to the international cooperative work with AHOPCA and St. Jude Children's Research Hospital (11-EHP-12) adopting OEPA/COPDAC strategy for High Risk (HR) pts and ABVD for Intermediate (IR) and Low Risk (LR) pts. Methods: 11-EHP-12: Risk assignment according Stanford/Danna Farber/ SJCRH Consortium classification. LR: ABVD x 4± IFRT (20 Gy). IR: ABVD x 6 ± IFRT (20 Gy). HR: OEPA-COPDAC+IFRT (20/25 Gy). Response evaluation: LR after 4th cycle, IR and HR after the 2nd cycle. Complete Remission (CR): response > 80% reduction and PET negative. Partial Remission (PR): response >50% and <80% reduction and/or PET positive. 170 pediatric patients (pts) were enrolled since November 2012. 133 evaluable pts. 37 on treatment and/or a follow up of less than 5 years. Sex: M/F: 85 (63,9%) /48. Median age: 13 y (range 4-18 y). Histology: nodular sclerosis 91 (68,4%), mixed celularity 31 (23.3%), lymphocyte rich 1 (0,7%), lymphocyte depleted 1 (0,7%), nodular lymphocyte predominant 8 (6,9%). Stage: I :16 (12%), II: 51 (38.4%), III: 27 (20.3%), IV: 39 (29.3%). B Symptoms: 66 (49.6%). Interim evaluation: PET/TC: 109/133 (82%), TC: 24. Distribution by risk groups: HR pts.: 77 (57,9%), IR: 35 (26,3%), LR: 21 (15,8%). Results: 5 y OS was 94% (100% for LR and IR, and 91% HR) and 5y EFS was 88% (100% for LR, 91% IR, and 84% HR). 95% of the LR pts and 72% of the IR pts did not undergo radiotherapy. 70% of the HR pts achieved CR after the 2nd OEPA and received 20 Gy IFRT. According PR or CR after 2nd OEPA, the 5y EFS in HR pts was 84% and 90% respectively. Conclusion: Thanks to this international cooperation We could significantly improve the results in Argentina compared to our previous experience (7-PHD-96: COPP-ABV x 6 + IFRT Bulky disease or PR (20/25Gy): 5yOS:85%, 5yEFS:67%), reduce the number of patients who required radiotherapy and reproduce the Euronet experience for HR pts in a different context. Figure Disclosures No relevant conflicts of interest to declare.

Comparison of Efficacy and Safety after Administering High Potency Statin to High Risk Patients: Rosuvastatin 10 mg versus Atorvastatin 20 mg

2007 ◽  
Vol 37 (4) ◽  
pp. 154 ◽  
Author(s):  
Kyeong Ho Yun ◽  
Hyun-Young Park ◽  
Jun-Ho Choi ◽  
Mi-Jin Song ◽  
Eun Mi Park ◽  
...  
Keyword(s):  
High Risk ◽  
Efficacy And Safety ◽  
High Potency ◽  
High Risk Patients ◽  
Risk Patients
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