Prognostic factors for response and overall survival in 282 patients with higher-risk myelodysplastic syndromes treated with azacitidine

Blood ◽  
2011 ◽  
Vol 117 (2) ◽  
pp. 403-411 ◽  
Author(s):  
Raphael Itzykson ◽  
Sylvain Thépot ◽  
Bruno Quesnel ◽  
Francois Dreyfus ◽  
Odile Beyne-Rauzy ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Myelodysplastic Syndrome ◽  
Prognostic Score ◽  
Performance Status ◽  
Independent Set ◽  
Risk Groups ◽  
Red Blood Cell Transfusion ◽  
Abnormal Karyotype ◽  
Transfusion Dependency

Abstract Prognostic factors for response and survival in higher-risk myelodysplastic syndrome patients treated with azacitidine (AZA) remain largely unknown. Two hundred eighty-two consecutive high or intermediate-2 risk myelodysplastic syndrome patients received AZA in a compassionate, patient-named program. Diagnosis was RA/RARS/RCMD in 4%, RAEB-1 in 20%, RAEB-2 in 54%, and RAEB-t (AML with 21%-30% marrow blasts) in 22%. Cytogenetic risk was good in 31%, intermediate in 17%, and poor in 47%. Patients received AZA for a median of 6 cycles (1-52). Previous low-dose cytosine arabinoside treatment (P = .009), bone marrow blasts > 15% (P = .004), and abnormal karyotype (P = .03) independently predicted lower response rates. Complex karyotype predicted shorter responses (P = .0003). Performance status ≥ 2, intermediate- and poor-risk cytogenetics, presence of circulating blasts, and red blood cell transfusion dependency ≥ 4 units/8 weeks (all P < 10−4) independently predicted poorer overall survival (OS). A prognostic score based on those factors discriminated 3 risk groups with median OS not reached, 15.0 and 6.1 months, respectively (P < 10−4). This prognostic score was validated in an independent set of patients receiving AZA in the AZA-001 trial (P = .003). Achievement of hematological improvement in patients who did not obtain complete or partial remission was associated with improved OS (P < 10−4). In conclusion, routine tests can identify subgroups of patients with distinct prognosis with AZA treatment.

scholarly journals Neutrophil-lymphocyte ratio in metastatic breast cancer is not an independent predictor of survival, but depends on other variables

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Alejandra Ivars Rubio ◽  
Juan Carlos Yufera ◽  
Pilar de la Morena ◽  
Ana Fernández Sánchez ◽  
Esther Navarro Manzano ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Metastatic Breast Cancer ◽  
Performance Status ◽  
Univariate Analysis ◽  
Metastatic Breast ◽  
Prognostic Impact ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

AbstractThe prognostic impact of neutrophil-lymphocyte ratio (NLR) in metastatic breast cancer (MBC) has been previously evaluated in early and metastatic mixed breast cancer cohorts or without considering other relevant prognostic factors. Our aim was to determine whether NLR prognostic and predictive value in MBC was dependent on other clinical variables. We studied a consecutive retrospective cohort of patients with MBC from a single centre, with any type of first line systemic treatment. The association of NLR at diagnosis of metastasis with progression free survival (PFS) and overall survival (OS) was evaluated using Cox univariate and multivariate proportional hazard models. In the full cohort, that included 263 MBC patients, a higher than the median (>2.32) NLR was significantly associated with OS in the univariate analysis (HR 1.36, 95% CI 1.00–1.83), but the association was non-significant (HR 1.12, 95% CI 0.80–1.56) when other clinical covariates (performance status, stage at diagnosis, CNS involvement, visceral disease and visceral crisis) were included in the multivariate analysis. No significant association was observed for PFS. In conclusion, MBC patients with higher baseline NLR had worse overall survival, but the prognostic impact of NLR is likely derived from its association with other relevant clinical prognostic factors.

scholarly journals Breast Subtypes and Prognosis of Breast Cancer Patients With Initial Bone Metastasis: A Population-Based Study

2020 ◽  
Vol 10 ◽  
Author(s):  
Deyue Liu ◽  
Jiayi Wu ◽  
Caijin Lin ◽  
Lisa Andriani ◽  
Shuning Ding ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Metastatic Breast Cancer ◽  
Bone Metastasis ◽  
Cancer Patients ◽  
Metastatic Breast ◽  
Risk Groups ◽  
Population Based ◽  
Breast Cancer Patients

BackgroundMetastatic breast cancer (MBC) is a highly heterogeneous disease and bone is one of the most common metastatic sites. This retrospective study was conducted to investigate the clinical features, prognostic factors and benefits of surgery of breast cancer patients with initial bone metastases.MethodsFrom 2010 to 2015, 6,860 breast cancer patients diagnosed with initial bone metastasis were analyzed from Surveillance, Epidemiology, and End Results (SEER) database. Univariate and Multivariable analysis were used to identify prognostic factors. A nomogram was performed based on the factors selected from cox regression result. Survival curves were plotted according to different subtypes, metastatic burdens and risk groups differentiated by nomogram.ResultsHormone receptor (HR) positive/human epidermal growth factor receptor 2 (HER2) positive patients showed the best outcome compared to other subtypes. Patients of younger age (&lt;60 years old), white race, lower grade, lower T stage (&lt;=T2), not combining visceral metastasis tended to have better outcome. About 37% (2,249) patients received surgery of primary tumor. Patients of all subtypes could benefit from surgery. Patients of bone-only metastases (BOM), bone and liver metastases, bone and lung metastases also showed superior survival time if surgery was performed. However, patients of bone and brain metastasis could not benefit from surgery (p = 0.05). The C-index of nomogram was 0.66. Cutoff values of nomogram point were identified as 87 and 157 points, which divided all patients into low-, intermediate- and high-risk groups. Patients of all groups showed better overall survival when receiving surgery.ConclusionOur study has provided population-based prognostic analysis in patients with initial bone metastatic breast cancer and constructed a predicting nomogram with good accuracy. The finding of potential benefit of surgery to overall survival will cast some lights on the treatment tactics of this group of patients.

scholarly journals Nomogram for predicting the overall survival and cancer-specific survival of patients with extremity liposarcoma: a population-based study

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lin Ye ◽  
Chuan Hu ◽  
Cailin Wang ◽  
Weiyang Yu ◽  
Feijun Liu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Area Under The Curve ◽  
Risk Groups ◽  
Population Based ◽  
Cancer Specific Survival ◽  
Kaplan Meier ◽  
Extremity Soft Tissue Sarcoma ◽  
Individual Survival ◽  
Size Grade

Abstract Background Extremity liposarcoma represents 25% of extremity soft tissue sarcoma and has a better prognosis than liposarcoma occurring in other anatomic sites. The purpose of this study was to develop two nomograms for predicting the overall survival (OS) and cancer-specific survival (CSS) of patients with extremity liposarcoma. Methods A total of 2170 patients diagnosed with primary extremity liposarcoma between 2004 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox analyses were performed to explore the independent prognostic factors and establish two nomograms. The area under the curve (AUC), C-index, calibration curve, decision curve analysis (DCA), Kaplan-Meier analysis, and subgroup analyses were used to evaluate the nomograms. Results Six variables were identified as independent prognostic factors for both OS and CSS. In the training cohort, the AUCs of the OS nomogram were 0.842, 0.841, and 0.823 for predicting 3-, 5-, and 8-year OS, respectively, while the AUCs of the CSS nomogram were 0.889, 0.884, and 0.859 for predicting 3-, 5-, and 8-year CSS, respectively. Calibration plots and DCA revealed that the nomogram had a satisfactory ability to predict OS and CSS. The above results were also observed in the validation cohort. In addition, the C-indices of both nomograms were significantly higher than those of all independent prognostic factors in both the training and validation cohorts. Stratification of the patients into high- and low-risk groups highlighted the differences in prognosis between the two groups in the training and validation cohorts. Conclusion Age, sex, tumor size, grade, M stage, and surgery status were confirmed as independent prognostic variables for both OS and CSS in extremity liposarcoma patients. Two nomograms based on the above variables were established to provide more accurate individual survival predictions for extremity liposarcoma patients and to help physicians make appropriate clinical decisions.

scholarly journals Mortality calculator as a possible prognostic predictor of overall survival after gastrectomy in elderly patients with gastric cancer

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Hidenori Akaike ◽  
Yoshihiko Kawaguchi ◽  
Suguru Maruyama ◽  
Katsutoshi Shoda ◽  
Ryo Saito ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Elderly Patients ◽  
Performance Status ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Clinical Database ◽  
National Clinical Database ◽  
Cox Proportional Hazard

Abstracts Background The number of elderly patients with gastric cancer has been increasing. Most elderly patients have associated reduced physiologic functions that can sometimes become an obstacle to safe surgical treatment. The National Clinical Database Risk Calculator, which based on a large Japanese surgical database, provides predicted mortality and morbidity in each case as the surgical-related risks. The purpose of this study was to investigate the clinical significance of the risk for operative mortality (NRC-mortality), as calculated by the National Clinical Database Risk Calculator, during long-term follow-up after gastrectomy for elderly patients with gastric cancer. Methods We enrolled 73 patients aged ≥ 80 years and underwent gastrectomy at our institution. Their surgical risk was evaluated based on the NRC-mortality. Several clinicopathologic factors, including NRC-mortality, were selected and analyzed as the possible prognostic factors for elderly patients who have undergone gastrectomy for gastric cancer. Statistical analysis was performed using the log-rank test and Cox proportional hazard model. Results NRC-mortality ranged from 0.5 to 10.6%, and the median value was 1.7%. Dividing the patients according to mortality, the overall survival was significantly worse in the high mortality group (≥ 1.7%, n = 38) than in the low mortality group (< 1.7%, n = 35), whereas disease-specific survival was not different between the two groups. In the Cox proportional hazard model, multivariate analysis revealed NRC-mortality, performance status, and surgical procedure as the independent prognostic factors for overall survival. For disease-specific survival, the independent prognostic factors were performance status and pathological stage but not NRC-mortality. Conclusion The NRC-mortality might be clinically useful for predicting both surgical mortality and overall survival after gastrectomy in elderly patients with gastric cancer.

Follicular large-cell lymphoma: intermediate or low grade?

1994 ◽  
Vol 12 (7) ◽  
pp. 1349-1357 ◽  
Author(s):  
N L Bartlett ◽  
M Rizeq ◽  
R F Dorfman ◽  
J Halpern ◽  
S J Horning
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Medical Center ◽  
Performance Status ◽  
Survival Rates ◽  
Large Cell ◽  
Poor Performance Status ◽  
Low Grade ◽  
Curative Intent ◽  
Overall Survival Rates

PURPOSE To evaluate the benefit of anthracycline-based chemotherapy, identify prognostic factors, and determine the value of the International Prognostic Factors Index for patients with follicular large-cell (FLC) lymphoma. PATIENTS AND METHODS This retrospective study includes 96 patients with FLC lymphoma treated at Stanford University Medical Center between 1969 and 1991. Fifty-five patients received doxorubicin plus cyclophosphamide-containing chemotherapy regimens, 21 patients received other chemotherapy regimens, 15 patients received radiotherapy only, and five patients received no initial therapy. Thirty-four patients had stage I or II disease and 62 patients had stage III or IV disease. RESULTS With a median follow-up duration of 5.2 years (range, 1 to 18), the actuarial 5- and 10-year overall survival rates were 75% and 54%, with actuarial 5- and 10-year freedom from progression (FFP) rates of 53% and 42%, respectively. Patients treated with chemotherapy regimens that contained both doxorubicin and cyclophosphamide had a superior actuarial 10-year FFP rate (55% v 25%, P = .06) and overall survival rate (65% v 42%, P = .04) compared with patients treated with other chemotherapy regimens. Only one patient treated with doxorubicin plus cyclophosphamide relapsed after 3 years. In the multivariate analysis, discordant lymphoma and treatment with chemotherapy regimens not containing both cyclophosphamide and doxorubicin predicted for worse FFP and overall survival rates. In addition, poor performance status and increasing areas of diffuse histology predicted for a worse survival, while anemia and male sex predicted for a worse FFP. The age-specific International Index was useful in predicting outcome; however, few patients with FLC lymphoma had high-risk features. CONCLUSION The plateau in FFP implies that patients with FLC lymphoma enjoy sustained remissions after standard anthracycline-based chemotherapy. FLC lymphoma should continue to be approached as an intermediate-grade lymphoma with curative intent.

Venous Thromboembolism Risk Model Predicts Early Progression and Overall Mortality in Cancer Patients Receiving Chemotherapy

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 172-172 ◽  
Author(s):  
Nicole M. Kuderer ◽  
Alok A. Khorana ◽  
Charles W. Francis ◽  
Eva Culakova ◽  
Thomas L. Ortel ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Venous Thromboembolism ◽  
Disease Progression ◽  
Cancer Patients ◽  
Risk Score ◽  
Risk Model ◽  
Risk Groups ◽  
Group I ◽  
All Cause Mortality

Abstract Background: Venous Thromboembolism (VTE) is a common complication of cancer and is strongly associated with early all-cause mortality during the course of cancer chemotherapy (Kuderer et al. ASCO 2008). A clinical model for predicting the risk of VTE in cancer patients initiating chemotherapy has been recently developed and validated (Khorana et al. Blood 2008). Risk of VTE in low (group I), intermediate (group II) and high risk patients (group III) was 0.8%, 1.8% and 7.1%, respectively. The aim of current study is to evaluate the ability of the VTE risk model to predict disease progression and early all-cause mortality. Methods: A prospective study of 4,458 adult cancer patients with solid tumors or malignant lymphoma initiating a new chemotherapy regimen was conducted between 2002 and 2006 at 115 randomly selected practice sites throughout the USA. Demographic, clinical and treatment-related information was captured prospectively at baseline and during the first four cycles of chemotherapy, including rates of documented VTE, disease recurrence and deaths from all causes. Progression-free survival (PFS) and overall survival (OS) within 4 months of starting chemotherapy were estimated by the method of Kaplan-Meier and adjusted hazard ratios (HR ± 95% CI) were estimated by a Cox regression model, incorporating VTE as a time-dependent covariate. Results: Patient age ranged from 18–97 with a mean of 60 years. VTE occurred in 3% of patients by 4 months with a median of 38 days following initiation of chemotherapy. The HR for VTE occurrence among risk score groups II and III, compared to group I, were 3.07 [1.39–6.77] and 11.73 [5.22–16.37], (P&lt;0.0001) respectively. Within 4 months, disease progression occurred in 298 patients and 137 patients died. Death or disease progression was reported in 7%, 18% and 28% of risk score groups I, II and III, respectively. HR for reduced PFS among risk groups II and III compared to group I were 2.77 [1.97–3.87] and 4.27 [2.90–6.27], respectively (P&lt;0.0001). Death from all causes within 4 months of treatment initiation was reported in 1.2%, 5.9% and 12.7% patients for risk groups I, II and III. HR estimates for mortality among groups II and III were 3.56 [1.91–6.66] and 6.89 [3.50–13.57], respectively (P&lt;0.0001). In multivariate analysis, the risk score and VTE occurrence were both significant independent predictors for early mortality and reduced PFS after adjusting for major prognostic factors including: age, stage, cancer type, ECOG performance status, Charlson comorbidity index, body mass index, relative dose intensity, and year of enrollment. Conclusions: VTE is strongly associated with increased early all-cause mortality during the course of cancer chemotherapy. A recently validated risk score is not only predictive of VTE occurrence, but also of progression-free and overall survival demonstrating a strong association with prognostic factors for disease progression and mortality.

A Prognostic Score of Overall Survival In Adults with Acute Myeloid Leukemia

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2730-2730
Author(s):  
Murtadha K. Al-Khabori ◽  
Gordon Guyatt ◽  
Mark D. Minden ◽  
Karen Yee ◽  
Vikas Gupta ◽  
...  
Keyword(s):  
Overall Survival ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Prognostic Score ◽  
Performance Status ◽  
Intermediate Risk ◽  
Good Discrimination ◽  
Prior Malignancy ◽  
Acute Myeloid ◽  
Deviance Residuals

Abstract Abstract 2730 Background: Acute myeloid leukemia (AML) is a malignant myeloid disorder with heterogeneous outcomes. A number of factors have been shown to be prognostic; age, white blood cell (WBC), prior malignancy, performance status (Eastern Cooperative Oncology Group; ECOG) and cytogenetics. Methods: We planned to develop and validate a prognostic score for the 5-year (y) overall survival (OS) of adults with AML receiving intensive induction chemotherapy. We used Cox model to estimate the regression coefficients and Kaplan-Meier to estimate the 5-y OS. We used Cox-Snell, Schoenfeld and deviance residuals for model diagnostics and bootstrap validation to estimate the performance measures; Harrell's concordance and deviance residuals. Results: We retrospectively analyzed 779 patients treated between 1998–2008, using a prospectively collected database. The median age was 58 y. Most patients had intermediate risk cytogenetics (61%) and good performance status (ECOG 0–1: 79%). The median follow up for the surviving patients was 26.7 months (95% CI 18.8–32.9 months). The 5-y OS was 26% (22- 30%). All variables were statistically significant in the multivariable Cox regression model; age (y) (Hazard Ratio, HR 1.02; 95% CI 1.018–1.034), WBC (1*10^9/L) (HR 1.004; 1.002–1.006), prior malignancy (HR 1.58; 1.26–2.00), ECOG (ECOG 2 HR 1.41; 1.06–1.88, ECOG 3–4 HR 9.99; 4.72–21.18) and cytogenetics (intermediate risk HR 2.49; 1.41–4.39, poor risk HR 4.74; 2.65–8.50). The score divided patients into four risk groups; good (n=47), intermediate (n=129), poor (n=198) and extremely poor (n=87). The estimated 5-y OS was 0.70 (95% CI: 0.53–0.81), 0.37 (0.28–0.46), 0.15 (0.10–0.21) and 0.03 (0.01–0.10) respectively. The model showed good discrimination with large differences between survival curves and good Harrell concordance of 0.69. It showed good calibration using Cox-Snell and deviance residuals. In the intermediate risk cytogenetic group, the model showed good discrimination with over 45% difference in 5-y OS between the good and extremely poor groups. Conclusions: Our study confirmed the prognostic impact of the 5 variables reported in the literature. Using these factors, we developed a score to predict long term OS that showed good discrimination and calibration. The score added further discrimination in the intermediate risk cytogenetic group. Prospective external validation of the score is needed. Disclosures: No relevant conflicts of interest to declare.

Prognostic Factors for Patients with Diffuse Large B Cell Lymphoma and Transformed Indolent Lymphoma Undergoing Autologous Stem Cell Transplantation in the PET Era

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1980-1980
Author(s):  
Sarah Welch ◽  
Philippe Armand ◽  
Haesook T Kim ◽  
Ann S. LaCasce ◽  
Eric Jacobsen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Risk Group ◽  
Prognostic Score ◽  
B Cell Lymphoma ◽  
Advanced Stage ◽  
Prognostic Assessment ◽  
Large B Cell Lymphoma ◽  
Symptomatic Relapse ◽  
Prognostic Importance

Abstract Abstract 1980 High dose chemotherapy followed by autologous stem cell transplantation (ASCT) remains the standard of care for patients with relapsed or refractory (R/R) diffuse large B cell lymphoma (DLBCL) who are chemosensitive to salvage therapy. There is now evidence that the achievement of complete remission by PET scan (PET-CR) after salvage therapy is a favorable determinant of ASCT outcome, implying that PET response should be part of the prognostic assessment for patients considering ASCT. However, it is unclear whether other prognostic factors are still relevant in patients getting post-salvage PET scanning. Moreover, while ASCT is often also used for patients with R/R transformed indolent lymphoma (TIL), there are no data on whether prognostic factors that are important for DLBCL patients, especially PET response to salvage, are similarly prognostic in this population. We studied 163 consecutive adult patients who underwent ASCT at 2 institutions over the last decade for R/R DLBCL (122 patients) or R/R TIL (41 patients) and had a post-salvage PET scan. 98% were chemosensitive after salvage by conventional criteria. Among the 122 patients with DLBCL, 52 (43%) remained PET positive after salvage. PET-positivity was more likely for patients with advanced stage at relapse, and for those whose first remission duration was less than 6 months. After a median follow-up of 49 months from ASCT, the 4-year overall survival (OS) for PET-positive patients was 54% versus 74% for PET-negative patients (p=0.016), while the corresponding 4-year progression-free survival (PFS) was 30% versus 63% (p<0.0001). In multivariable models, the following were adverse prognostic factors for OS and PFS: PET positivity after salvage, age ≥60 years, CNS involvement at relapse, symptomatic relapse, and advanced stage at relapse (for OS only). Based on those factors, we constructed a prognostic score, assigning 1 point for each of the above factors (except for CNS relapse which was assigned 3 points). Patients in the low-risk group (0–1 points) had a 4y OS of 90% and 4y PFS of 74%, compared to 63% and 45% for patients in the intermediate-risk group (2–3 points), and 19% and 0% for patients in the high-risk group (4+ points) (p<0.0001 for both OS and PFS differences) (Figure 1A). The post-ASCT outcome of patients with TIL was not significantly different from that of DLBCL patients (4y OS 53% versus 69%, p=0.23, and 4y PFS 44% versus 54%, p=0.4). Notably, in this group, PET status after salvage had no prognostic relevance (Figure 1B). In fact, in multivariable models for OS and PFS, only short duration of 1st remission and elevated LDH at relapse (for OS only) were significant. Figure. Overall Survival after ASCT. A. DLBCL cohort, stratified by prognostic score; B. TIL cohort, stratified by post-salvage PET. Figure. Overall Survival after ASCT. A. DLBCL cohort, stratified by prognostic score; B. TIL cohort, stratified by post-salvage PET. This study confirms the prognostic importance of post-salvage PET remission status. However, If PET response is included in the prognostic assessment, traditional risk factors such as receipt of 1st line rituximab, short duration of 1st remission, or elevated second-line aaIPI appear to lose their prognostic importance. Instead, we identified 4 other clinical factors that were strongly associated with outcome: advanced age, CNS relapse, advanced stage at relapse, and symptomatic relapse. Our prognostic score is simple to calculate and stratifies patients into 3 groups with significantly different OS and PFS. An important potential use of this score, if further validated, could be to identify a high-risk population whose outcomes after ASCT are dismal (0% PFS and 19% OS at 4 years), and who should be considered for alternative treatment approaches. Moreover, our results suggest that prognostic factors for patients with TIL may be entirely different; in particular, PET response to salvage may not be prognostically important. This is important to consider when designing clinical trials or interpreting their results in this patient population. Disclosures: No relevant conflicts of interest to declare.

Transient Elastography for the Detection of Hepatic Iron Overload in Patients with Myelodysplastic Syndrome

2016 ◽  
Vol 12 (02) ◽  
pp. 103
Author(s):  
Malene Risum ◽  
Toke Barfod ◽  
Klas Raaschou-Jensen ◽  
◽  
◽  
...  
Keyword(s):  
Myelodysplastic Syndrome ◽  
Iron Overload ◽  
Transient Elastography ◽  
Myeloproliferative Neoplasm ◽  
Liver Stiffness ◽  
Surrogate Marker ◽  
Red Blood Cell Transfusion ◽  
Hepatic Iron Overload ◽  
Transfusion Dependency ◽  
Myelomonocytic Leukemia

Background: In myelodysplastic syndrome (MDS), anemia often leads to red blood cell transfusion dependency and iron overload (IOL). Serum ferritin (SF) is used as a surrogate marker for IOL. IOL can lead to liver failure. Transient elastography (TE) also known as fibroscan is an easy and noninvasive procedure for liver stiffness measurements (LSM). Methods: Sixty patients with either MDS, chronic myelomonocytic leukemia with dysplastic features, acute myeloid leukemia progressed from MDS or myelodysplastic/ myeloproliferative neoplasm, unclassifiable were included. All patients underwent a fibroscan, had their SF measured and disease duration calculated. Patients were grouped according to transfusion dependency or independency status. Results: Transfusion dependent patients had significantly higher LSM than those who were transfusion independent (p=0.003). There was no positive correlation between SF and LSM (p=0.103) or time since diagnosis and LSM (p=0.886). Patients with elevated SF did not have significantly higher LSM compared to those with normal SF (p=0.583). Conclusion: These data indicate that transfusion dependency has an impact on liver stiffness in MDS. Longitudinel studies are needed to conclude whether TE is of value in monitoring IOL in MDS.

Identification of a microRNA (miRNA) based signature for survival in advanced non-small cell lung cancer (NSCLC) patients (pts) treated with cisplatin-vinorelbine: A ELCWP study.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e18006-e18006
Author(s):  
Thierry Berghmans ◽  
Luc Willems ◽  
Marianne Paesmans ◽  
Lieveke Ameye ◽  
Jean-Jacques Lafitte ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Score ◽  
Performance Status ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Hazard Ratio ◽  
Cox's Regression ◽  
And Performance ◽  
A Prospective Study ◽  
Nsclc Patients

e18006 Background: Main prognostic factors for survival in NSCLC pts are stage and performance status (PS) while sex, histology and others are reported. However, these variables do not allow predicting individual prognosis, justifying further research. MiRNA are small non-coding RNAs regulating gene expression. As a secondary aim of a prospective study, we looked at the prognostic value of tumour miRNA on survival in NSCLC pts treated by cisplatin (60 mg/m2 D1) and vinorelbine (25 mg/m2, D1+8) 1st line chemotherapy. Methods: During the diagnostic bronchoscopy, a biopsy was lysed into Tripure Isolation Reagent (Roche Diagnostics) on ice, snap frozen and stored at -80°C. MiRNA expression was assessed using TaqMan Low Density Arrays (756 human miRNA panel, Applied Biosystems) and normalized using the delta delta CT method to RNU48 (SNORD48) CT value for every sample. Survival was measured from the registration date. Results: The main characteristics of 38 eligible pts were: median age 60 years, male 27 (71%), 80-100 Karnofsky PS in 26 (68%), adenocarcinoma 20 (53%), stage IV 30 (79%). At time of analysis, 25 pts were dead. After stepwise selection among 756 analysed miRNA, a combination of 4 miRNA including miR-200c, miR-424, miR-29c and miR-124 provided a prognostic signature for survival. Using a linear combination of the miRNA CT values with Cox's regression coefficients as weights, we constructed a prognostic score. With a cut-off of 52, the signature distinguished pts with good (n = 18) and poor (n = 20) prognosis with respective median survival of 47.3 months (95% CI 29.8-52.4) and 15.5 months (95% CI 9.1-22.8) (p <0.001; hazard ratio 21.1, 95% CI 4.7-94.9). The same signature discriminated pts with “good progression-free survival” (median 19.8 months; 95% CI 15.3-33.8) from the others (median 9.1 months; 95% CI 6.3-15.5) (p <0.001; hazard ratio 3.8, 95% CI 1.7-8.7). Conclusions: A 4 miRNA signature is associated with improved survival in patients with advanced stage NSCLC treated with 1st line cisplatin and vinorelbine. These results need confirmation in an independent cohort and the signature has to be compared to conventional prognostic factors.

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