Impact of Age on Survival after Intensive Therapy in Newly Diagnosed Multiple Myeloma. The Nordic Myeloma Study Group (NMSG).

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 924-924
Author(s):  
Stig Lenhoff ◽  
Martin Hjorth ◽  
Peter Gimsing ◽  
Jon Magnus Tangen ◽  
Jan Westin
Keyword(s):  
Stem Cell ◽  
Prognostic Factors ◽  
Median Survival ◽  
Intensive Therapy ◽  
Population Based ◽  
Control Group ◽  
Newly Diagnosed ◽  
Significant Difference ◽  
Historic Control ◽  
The Impact

Abstract Introduction: Intensive therapy (IT) including autologous stem cell transplantation (ASCT) is considered superior to conventional therapy in newly diagnosed myeloma pts <60 yrs. For older pts the benefit of IT is less clear. In 1998 the NMSG started a population-based, prospective trial (#7/98) aiming to study the impact of age on event-free survival (EFS) and survival after IT, and to compare survival to a conventionally treated historic control group. Patients: Newly diagnosed symptomatic pts <65 yrs were included into a protocol with four phases; I) VAD x 3–4; II) cyclophosphamide 2g/sqm, G-CSF (filgrastim) and stem cell harvest; III) melphalan 200 mg/sqm, stem cell infusion and G-CSF; IV) interferon maintenance. Double ASCT was optional. From Jan 1998 to June 2000, 452 pts were registered and 414 (92%) of these were included into the IT protocol (=Intensive Therapy Group (ITG)). 294 were <60 yrs (=ITG-60) and 120 were 60–64 yrs (=ITG-65). The historic control group was derived from a previous population-based, randomized NMSG study (#4/90) where melphalan and prednisone +/− interferon was given as initial therapy. Of the 281 pts <65 yrs registered in this trial, 243 (86%) fulfilled the eligibility criteria for IT stated in the #7/98 protocol and constituted the Control Group (CG). 146 were <60 yrs (=CG-60) and 97 were 60–64 years (=CG-65). Results: In the ITG-60, 261 pts (89%) were actually transplanted (80% single ASCT, 18% double ASCT and 2% allogeneic SCT). In the ITG-65, 98 pts (82%) were transplanted (84% single and 16% double ASCT). Median follow-up is 50 months. Major response rate (CR+PR) was 88% in the ITG-60 and 81% in the ITG-65. EFS at 4 yrs for the ITG-60 was 37% and median EFS 36 months, while the corresponding figures for the ITG-65 were 19% and 24 months (P=.005). Survival at 4 yrs for the ITG-60 was 67% and median survival 67 months, while the corresponding figures for the ITG-65 was 50% and 48 months (P=.004). In a multivariate analysis of the entire ITG, two variables were significantly associated with EFS and survival; beta-2-microglobulin at diagnosis and age < or ≥ 60 yrs. The survival in the ITG-60 was prolonged compared to the CG-60 with a risk ratio (RR) of 0.50 (95%CI 0.38–0.67; p<.0001). Survival at 4 yrs was 67% in the ITG-60 and 44% in the CG-60, with a median survival of 67 and 43 months, respectively. The survival advantage persisted (RR 0.57, 95%CI 0.42–0.78; p=.0004) after statistical analysis of prognostic factors and correction for differences between the groups. Also for patients 60–64 yrs old survival was prolonged in the ITG compared to the CG with a RR of 0.65 (95%CI 0.42–0.92; p=.02). Survival at 4 yrs was 50% in the ITG-65 and 40% in the CG-65 with a median survival of 48 and 28 months, respectively. However, after correction for the difference in prognostic factors between the groups there was no significant difference in survival (RR 0.80, 95%CI 0.55–1.16; p=.23). Conclusions: In this population-based study older age was found to have a negative influence on outcome after IT. Our results indicate that there is an upper age limit that remains to be defined for superiority of IT over conventional chemotherapy.

TIMP-1 and TIMP-2 Levels Are Directly Correlated with Neoangiogenesis and Are Prognostic Factors in Multiple Myeloma Patients.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4866-4866
Author(s):  
Luciana Correa Oliveira de Oliveira ◽  
Juliana Alves Uzuelli ◽  
Ana Paula Alencar de Lima Lange ◽  
Barbara Amelia Aparecida Santana-Lemos ◽  
Marcia Sueli Baggio ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Bone Disease ◽  
Cox Regression ◽  
Conflicts Of Interest ◽  
Newly Diagnosed ◽  
Significant Difference ◽  
The Impact

Abstract Abstract 4866 Background Multiple myeloma (MM) is an incurable malignant disease, characterized by increased angiogenesis in the bone marrow (BM) microenvironment and aberrant BM metabolism. Matrix metalloproteinases (MMP) are a family of zinc-dependent endopeptidases implicated in tumour progression, invasion, metastasis and angiogenesis, via proteolytic degradation of extracellular matrix. MMPs are inhibited by tissue inhibitors of metalloproteinase (TIMP). Although recent studies have implicated MMP 9 in MM bone disease, little is known about the role of the TIMPs. Objectives a) to compare levels of sRANKL, OPG, MMP-2, MMP-9, TIMP-1, TIMP-2, VEGF, bFGF, microvessel density (MVD) between newly diagnosed MM patients and healthy controls; b) to determine the association of these molecules with disease progression, bone disease and neoangiogenesis and c) to evaluate the impact of these variables on survival. Patients and Methods As of July 2009 38 newly diagnosed and untreated multiple myeloma patients were enrolled in the study. The median age was 61years-old (range 39-91) with 24 (63%) males. Patients were diagnosed and categorized according The International Myeloma Working Group criteria and ISS, respectively. Bone involvement was graded according to standard X-ray: patients with no lesions, or with one/ two bones involved or diffuse osteoporosis were classified as low score, whereas patients with lesions in more than two bones or presence of bone fracture were classified as high score. MMP-2 and MMP-9 were determined by PAGE gelatin zymography from plasma as previously described. MMP-9, TIMP-1 and TIMP-2, OPG and sRANKL concentrations were measured by ELISA. The levels of VEGF, bFGF were obtained using cytometric bead array. Ten healthy volunteers were used as controls. Bone marrow MVD measured in hotspots was evaluated in 26 out of 38 patients at diagnosis and 15 patients with Hodgkin Lymphoma stage IA and IIA (used as controls) by staining immunohistochemically for CD34. Comparisons among groups were analyzed by ANOVA and the correlation by the Spearman's correlation coefficient. Cox regression were performed for overall survival (OS) analysis. Results Patients with MM had elevated TIMP-1, TIMP-2 and OPG values compared with controls. No significant difference was found between plasma sRANKL, pro-MMP2, pro-MMP9 and MMP-9 levels. We found that plasma TIMP-1 levels correlated positively with bFGF, VEGF, MVD, beta-2 microglobulin (B2M) and OPG (r: 0.514, p=0,001, r: 0.350, p=0,031; r: 0.610, p<0.0001; r: 0.760, p<0.0001 and r: 0.701, p<0.0001, respectively) and TIMP-2 levels with bFGF, DMV, B2M and OPG (r: 0.512, p=0.002; r: 0.595, p<0.0001; r: 0.587, p<0.0001 and r: 0.552, p<0.0001, respectively). TIMP-1 and TIMP-2 levels correlated with the ISS stage (p<0.0001, p=0.006, respectively). The only variables that correlated with clinical bone disease staging were hemoglobin, B2M and albumin levels, whereas TIMP-1, TIMP-2, bFGF, VEGF and OPG correlated with DMV. On the univariate analyses, age, gender, proMMP2, TIMP-1, TIMP-2, creatinine, B2M and MVD were significantly associated with overall survival. In Cox regression model, TIMP-1, TIMP-2 and B2M levels remained to be significantly associated with OS. In conclusion, our results suggest that TIMP-1 and TIMP-2 levels are strongly associated with neoangiogenesis and are independent prognostic factors in MM. Disclosures No relevant conflicts of interest to declare.

Intensive Therapy in Multiple Myeloma. Long-Term Follow-Up with Focus on Relapse after Transplantation. The Nordic Myeloma Study Group (NMSG).

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 938-938
Author(s):  
Stig Lenhoff ◽  
Martin Hjorth ◽  
Johan Lanng Nielsen ◽  
Ingemar Turesson ◽  
Finn Wislöff ◽  
...  
Keyword(s):  
Clinical Features ◽  
Median Survival ◽  
Conventional Therapy ◽  
Response Rate ◽  
Intensive Therapy ◽  
Population Based ◽  
Control Group ◽  
Survival After Relapse ◽  
Relapse Therapy

Abstract 1994–97 the NMSG conducted a population-based prospective study evaluating the effect of intensive therapy (IT) including autologous transplantation (ASCT) as up-front therapy in newly diagnosed symptomatic myeloma pts <60 yrs. The primary aim was to compare survival to a historic control group. We have now updated these results with a median follow-up of 62 months (m), focusing on factors influencing survival and the clinical features in pats relapsing after ASCT. 313 pts were included in the treatment protocol, constituting the intensive therapy group (ITG). The control group (CG) was derived from five previous population-based Nordic studies on conventional therapy and comprised 274 pts who retrospectively were found to fulfil the eligibility criteria for IT. Both groups were highly representative, comprising >80% of the known and >60% of the expected new myeloma pts <60 yrs. Response rate in the ITG was 34% CR, 42% PR and 11% MR, EFS at 5 yrs was 23%, and median EFS was 28m. Survival at 5 yrs was 55% in the ITG vs 35% in the CG, and the median survival 63 vs 44m (p<.0001). 247 of the 313 pts (79%) in the ITG actually underwent transplantation at a median of 5m from diagnosis. In this transplanted group (TG) 43% achieved CR, 47% PR and 8% MR. Transplant-related mortality at 100 days was 1.6%. Median EFS and survival for the TG from transplantation was 29 and 66m. A landmark analysis 6m after transplantation showed that achieving CR was significantly associated with prolonged progression-free survival (median 40 vs 27m), but not with survival (71 vs 64m). These observations were maintained in multivariate analyses where the other prognostic factors (beta-2-microglobulin, hemoglobin and LDH at diagnosis) were included. 162 pts in the TG have relapsed and 92 of these have died. The patterns of relapse were heterogeneous but could be divided into four groups; “insidious” (31% of the relapses), “classical” (51%), “plasmocytic” (14%) and “transformed” (4%). The only factor associated with the pattern of relapse was response after transplantation. The “classical” and “plasmocytic” forms were more common in pts relapsing from CR and the “insidious” form was more common in pts relapsing from non-CR. 96% of relapsing pts received therapy, the majority melphalan-based (e.g. MP) or steroid-based (e.g. VAD) regimens. The response rate to relapse therapy was 70%. For the relapsed patients, the median time from diagnosis to relapse was 25m and the median survival after relapse 29m. Time to relapse was strongly associated with survival after relapse. Pts relapsing <6, 6–2 and >12m from transplantation had a median survival after relapse of 3, 16 and 32m, respectively. Pts with “insidious” relapse pattern had the longest survival and pts with “transformed” pattern the shortest. There were no differences between pts relapsing from CR or non-CR regarding response to relapse therapy or survival after relapse. We conclude that achieving CR after ASCT is significantly associated with prolonged EFS but not with survival. The majority of pts relapsing after ASCT respond to conventional second-line therapy. The clinical features at relapse after transplantation are heterogeneous but do not seem to differ from those seen after conventional therapy.

Prognostic Value of Bone Marrow Angiogenesis in Patients with Multiple Myeloma Undergoing High-Dose Therapy and Autologous Stem Cell Transplantation.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3321-3321
Author(s):  
Olga Pokrovskaya ◽  
Larisa Mendeleeva ◽  
Irina Kaplanskaya ◽  
Elena Parovichnikova ◽  
Sergei Kulikov ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Stem Cell ◽  
Prognostic Factors ◽  
Stem Cell Mobilization ◽  
Control Group ◽  
High Dose ◽  
Newly Diagnosed ◽  
High Dose Therapy ◽  
Cell Mobilization

Abstract BACKGROUND. Angiogenesis is a constant hallmark of multiple myeloma (MM) progression. It has also been reported that bone marrow angiogenesis is a predictive factor of poor survival in newly diagnosed myeloma. The aim of the current study was to investigate the dynamics of bone marrow (BM) microvessel density (MVD) in patients undergoing high-dose therapy (HDT) and autologous stem cell transplantation (ASCT). PATIENTS AND METHODS. 36 patients with newly diagnosed MM (22 in stage II and 14 in stage III according to Salmon and Durie) were included in the study – 21 male and 15 female, median age – 51 ys (range 31–67). All patients underwent HDT that included 3–4 cycles of induction therapy (VAD), stem cell mobilization with cyclophosphamide 6 g/m2 and G-CSF 5 mcg/kg, EDAP and single or tandem ASCT with melphalan 200 mg/ m2. The BM biopsies for histological and immunohistochemical analysis were performed at the time of diagnosis, after induction, after stem cell mobilization before the 1st ASCT and after the end of therapy (5 times during the treatment). The Control group consisted of normal BM donors (7 male and 3 female, median age 29, (17–59)) who underwent BM biopsy during BM harvesting for alloBMT. Blood vessels were highlighted by immunostaining of endothelial cells with a monoclonal antibody to CD34 (Novocastra Lab Ltd). The MVD was calculated in 10 fields using an 40x objective and 16x ocular lens. RESULTS. At diagnosis in all MM pts, MVD was extremely high compared to normal donors (152±8 vs 74±4). A significant decrease of BM MVD was observed after each phase of therapy: after the induction therapy the MVD was 124±6; before the 1st ASCT – 109±5 and at the end of treatment – 97±3. There was a statistically significant increase of MVD after stem cell mobilization due to G-CSF (143±4). Although there was a marked decrease of BM MVD in MM pts with CR or VGPR, it nevertheless stayed significantly higher compared with control group (p<0,001). The analysis of probability of CR or VGPR duration after ASCT according to MVD at different phases of therapy showed that MVD at diagnosis and before the 1-st ASCT are important prognostic factors. Probability of duration of CR or VGPR was 63% in group with low MVD before the 1st ASCT compared with 15% in group with high MVD (p<0,02). MVD was revealed to be more powerful prognostic factor for progression free survival (PFS) then CR or VGPR achievement. CONCLUSION. BM angiogenesis is increased in patients with MM. BM MVD is decreased during and after treatment however even after the completion of HDT and ASCT, the MVD is higher then in the normal control group. There is a statistically significant increase of MVD after stem cell mobilization with cyclophosphamide and G-CSF. MVD at the time of diagnosis and before the 1-st ASCT are important prognostic factors for overall-survival and PFS after ASCT. MVD before the 1-st ASCT appears to be a more powerful prognostic factor for PFS then remission rate.

The Impact of Sex Steroids Inhibiter on Thymic Function Following Hematopoietic Stem Cell Transplantation

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4599-4599
Author(s):  
Xiaodan Luo ◽  
Qifa Liu ◽  
Zhiping Fan ◽  
Yu Zhang ◽  
Juan Ning
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Acute Gvhd ◽  
Control Group ◽  
Hematopoietic Stem ◽  
Thymic Function ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Impact

Abstract Objective To evaluate the impact of luteinizing hormone-releasing hormone (LHRH) on the protection of thymic function after allogenic hematopoietic stem cell transplantation (allo-HSCT). Methods Established model of allogenic murine HSCT (C57BL/6→BALB/c). The severity of acute graft-versus-host-disease (GVHD) was assessed by a clinical scoring system that incorporates five clinical parameters: weight loss, posture, activity, fur texture and skin integrity. The intra-cellular levels of interferon-γ (INFγ), tumor necrosis factor-α (TNFα) and interleukin-1β (IL-1β) in thymocyte were analyzed by protein array and thymic function was evaluated by quantification of signaljoint TCR rearrangement excision circles (sjTRECs). Results Recipients in group A (allogenic mice), B( allogenic LHRH castrated-mice) and C (syngenic mice) all attained hematopoiesis reconstitution. White blood cell counts of mice in groups A, B and C were over 1.0×109/L on day (10.60±1.34), day (9.40±0.55) and day (9.40±0.89), respectively. There was no significant difference among the time of hematopoiesis reconstitution in three groups. The time of acute GVHD occuring was on day +11±0.5 and +14±0.5 posttransplantation, respectively, in groups A and B, and all mice had acute GVHD with the incidence of 100% in groups A and B. The average scores of acute GVHD in groups A and B were (1.56±0.51) and (0.92±0.49), respectively. Acute GVHD scores in group A was significantly higher than that in group B (P=0.000). The levels of INFγ, TNFα and IL-1β in control groups were 1.67±1.76 ng/ml, 1.69±1.07 pg/ml and 5.55±3.56 pg/ml, respectively. The levels of INFγ in groups A, B and C were (10.74±2.55) ng/ml,(6.81±2.33) ng/ml and (5.52±3.96) ng/ml, respectively. The levels of TNFα were (7.51±2.89) pg/ml, (4.30±0.63) pg/ml and (3.36±2.31) pg/ml, respectively. The levels of IL-1β were (25.83±8.91) pg/ml, (19.33±3.03) pg/ml and (11.94±4.00) pg/ml, respectively. There were significant differences in the levels of cytokines between group A and the control group (P=0.000, 0.000, 0.000). The levels of cytokines in group B were significantly higher than those of control group (P 0.010,0.037,0.000). The levels of INFγ in group C were significantly higher than those of the control group (P=0.044). Among groups A, B and C, there were significant differences in the levels of INFγ, TNFα and IL-1β (P=0.001,0.000,0.000). The levels of INFγ and TNFα in group A were significantly higher than those in group B (P=0.041,0.013). The levels of INFγ, TNFα and IL-1β in group A were significantly higher than those in group C (P=0.009, 0.002, 0.000). The analysis of linear regression showed that the average levels of INFγ paralled with aGVHD scores (r2 0.363,P=0.038). The average sjTRECs copies/1000 PBMNCs were (39.41±44.68) in the control group and (12.29±13.02), (58.01±71.82) and (19.61±14.59) in groups A, B and C, respectively. There was no significant difference in the multiple comparisons of peripheral blood levels of sjTRECs among these four groups (P=0.575). Conclusion INFγ ATNFα and IL-1β might be involved in the damage to the thymus by acute GVHD. Sex steroid inhibitor can not only reduce the severity of thymic damage after allo-HSCT, but also reduce the severity of aGVHD and the mechanism might be associated with the reduction of intracellular levels of INFγ and TNFα in thymocyte.

scholarly journals Association between Atrial Fibrillation, Myocardial Infarction, Heart Failure and Mortality in Patients with Nontuberculous Mycobacterial Infection: a nationwide population-based study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Chan Soon Park ◽  
Eue-Keun Choi ◽  
Bongseong Kim ◽  
Kyung-Do Han ◽  
So-Ryoung Lee ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Mycobacterial Infection ◽  
Population Based ◽  
Newly Diagnosed ◽  
Increased Risk ◽  
Significant Difference ◽  
Risk Patients ◽  
The Impact

Abstract NTM infection demonstrates an increasing incidence and prevalence. We studied the impact of NTM in cardiovascular events. Using the Korean nationwide database, we included newly diagnosed 1,730 NTM patients between 2005 and 2008 and followed up for new-onset atrial fibrillation (AF), myocardial infarction (MI), heart failure (HF), ischemic stroke (IS), and death. Covariates-matched non-NTM subjects (1:5, n = 8,650) were selected and analyzed. Also, NTM infection was classified into indolent or progressive NTM for risk stratification. During 4.16 ± 1.15 years of the follow-up period, AF, MI, HF, IS, and death were newly diagnosed in 87, 125, 121, 162, and 468 patients. In multivariate analysis, NTM group showed an increased risk of AF (hazard ratio [HR] 2.307, 95% confidence interval [CI] 1.560–3.412) and all-cause death (HR 1.751, 95% CI 1.412–2.172) compared to non-NTM subjects, whereas no significant difference in MI (HR 0.868, 95% CI 0.461–1.634), HF (HR 1.259, 95% CI 0.896–2.016), and IS (HR 1.429, 95% CI 0.981–2.080). After stratification, 1,730 NTM patients were stratified into 1,375 (79.5%) indolent NTM group and 355 (20.5%) progressive NTM group. Progressive NTM showed an increased risk of AF and mortality than indolent NTM group. Screening for AF and IS prevention would be appropriate in these high-risk patients.

scholarly journals VTD in comparison with VCD does not affect stem cell yields with G-CSF only mobilization

2020 ◽  
Vol 51 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Matevz Skerget ◽  
Barbara Skopec ◽  
Matjaz Sever
Keyword(s):  
Stem Cell ◽  
Outcome Measures ◽  
Standard Of Care ◽  
National Registry ◽  
Newly Diagnosed ◽  
Treatment Groups ◽  
Cell Counts ◽  
Significant Difference ◽  
The Impact ◽  
Cell Harvest

AbstractTriplet induction regimens are standard of care for newly diagnosed transplant eligible multiple myeloma patients. The combinations of bortezomib and dexamethasone with either cyclophosphamide (VCD) or thalidomide (VTD) are widely used. There are no data available on the impact of the two regimens on stem cell harvest by using G-CSF only mobilization. In this study, we retrospectively analyzed data from our national registry. The outcome measures were mobilization failure, CD34+ cell counts on collection day, number of apheresis procedures, and the number of collected cells. Overall, 72 patients were treated with either VCD or VTD. The mobilization failure rates were 7% and 9% (p = 0.771) and the total number of collected stem cells were 7.0 × 106 and 6.7 × 106 per kg body weight (p = 0.710) for VCD and VTD, respectively. We found no statistically significant difference between the treatment groups in the outcome measures. The addition of thalidomide to bortezomib and dexamethasone (VTD) does not adversely affect stem cell harvest in patients mobilized with G-CSF only.

scholarly journals Presenting features and prognosis of chronic lymphocytic leukemia in younger adults [see comments]

Blood ◽  
1991 ◽  
Vol 78 (6) ◽  
pp. 1545-1551 ◽  
Author(s):  
E Montserrat ◽  
F Gomis ◽  
T Vallespi ◽  
A Rios ◽  
A Romero ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Chronic Lymphocytic Leukemia ◽  
Median Survival ◽  
Risk Groups ◽  
Lymphocytic Leukemia ◽  
Control Group ◽  
Younger Adults ◽  
Female Ratio ◽  
Prognostic Features ◽  
The Impact

We have analyzed 117 younger patients with chronic lymphocytic leukemia (CLL) (mean age, 44.5 years; SD, 4.8; range, 19 to 49; male/female ratio, 2.08) with three main objectives: (1) to see whether these patients have distinctive presenting clinical features; (2) to investigate the impact of the disease on survival; and (3) to analyze whether already well-known prognostic factors are also useful when applied to these patients. As compared with an older age population (greater than or equal to 50 years), there were no major differences in presenting features except for an increased proportion of males (2.08 v 1.21; P less than .025) and a higher hemoglobin level (13.47 +/- 2.70 g/dL v 12.84 +/- 2.77 g/dL; P less than .05) in the younger group. Median survival is 12.3 years (expected median from a control group, 31.2 years). Clinical stages, bone marrow patterns, blood lymphocyte counts, and its doubling time are all useful to separate different risk groups of patients. Whereas patients with favorable prognostic factors have a survival probability of about 80% 14 years after diagnosis, those with poor prognostic features have a median survival of less than 3 years. It is concluded that CLL in younger adults has no major distinctive presenting features and that known prognostic factors are useful to separate different risk groups of patients. These results should be of help in planning therapy for younger persons with CLL.

scholarly journals Presenting features and prognosis of chronic lymphocytic leukemia in younger adults [see comments]

Blood ◽  
1991 ◽  
Vol 78 (6) ◽  
pp. 1545-1551 ◽  
Author(s):  
E Montserrat ◽  
F Gomis ◽  
T Vallespi ◽  
A Rios ◽  
A Romero ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Chronic Lymphocytic Leukemia ◽  
Median Survival ◽  
Risk Groups ◽  
Lymphocytic Leukemia ◽  
Control Group ◽  
Younger Adults ◽  
Female Ratio ◽  
Prognostic Features ◽  
The Impact

Abstract We have analyzed 117 younger patients with chronic lymphocytic leukemia (CLL) (mean age, 44.5 years; SD, 4.8; range, 19 to 49; male/female ratio, 2.08) with three main objectives: (1) to see whether these patients have distinctive presenting clinical features; (2) to investigate the impact of the disease on survival; and (3) to analyze whether already well-known prognostic factors are also useful when applied to these patients. As compared with an older age population (greater than or equal to 50 years), there were no major differences in presenting features except for an increased proportion of males (2.08 v 1.21; P less than .025) and a higher hemoglobin level (13.47 +/- 2.70 g/dL v 12.84 +/- 2.77 g/dL; P less than .05) in the younger group. Median survival is 12.3 years (expected median from a control group, 31.2 years). Clinical stages, bone marrow patterns, blood lymphocyte counts, and its doubling time are all useful to separate different risk groups of patients. Whereas patients with favorable prognostic factors have a survival probability of about 80% 14 years after diagnosis, those with poor prognostic features have a median survival of less than 3 years. It is concluded that CLL in younger adults has no major distinctive presenting features and that known prognostic factors are useful to separate different risk groups of patients. These results should be of help in planning therapy for younger persons with CLL.

Reducing the Social Stigma Associated with Obsessive Compulsive Disorder: A Controlled Trial of an Intervention Program in a Turkish Community Sample

2020 ◽  
Vol 20 (2) ◽  
pp. 101-120
Author(s):  
Ayça Aktaç Gürbüz ◽  
Orçun YORULMAZ ◽  
Gülşah DURNA
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Intervention Program ◽  
Controlled Trial ◽  
Community Sample ◽  
Case Vignette ◽  
Control Group ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Significant Difference ◽  
The Impact

Scientific research into the reduction of stigmatization, particularly related to specific problems such as Obsessive-Compulsive Disorder (OCD), is scarce. In the present study, we examine the impact of a video-based antistigma intervention program for OCD in a pretest-posttest control group research. After being randomly assigned to either an intervention (n= 101) or control group (n= 96), the participants reported their attitudes on a hypothetical case vignette before and after OCD vs. Multiple Sclerosis (MS) videos, and again six months later as a follow up assessment. The mixed design analyses for the group comparisons indicated that although there was no significant difference in the measures of the control group, the participants watching the anti-stigma OCD video, in which the focus was psychoeducation and interaction strategies, reported significantly lower scores on social distances and negative beliefs for the case vignettes they read, and this difference was maintained six months later. Then, the present results indicate the effectiveness of our anti-stigma intervention program for OCD. Interventions to reduce stigmatization can also be viewed as effective tools for changing the attitudes of people toward OCD, although further research and applications are needed related to specific disorders if a longlasting impact is to be achieved.

scholarly journals The Antioxidant Effect of Curcumin and Rutin on Oxidative Stress Biomarkers in Experimentally Induced Periodontitis in Hyperglycemic Wistar Rats

Molecules ◽  
2021 ◽  
Vol 26 (5) ◽  
pp. 1332
Author(s):  
Gilda M. Iova ◽  
Horia Calniceanu ◽  
Adelina Popa ◽  
Camelia A. Szuhanek ◽  
Olivia Marcu ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Diabetic Rats ◽  
Gingival Tissue ◽  
Control Group ◽  
Albino Rats ◽  
Oxidative Stress Biomarkers ◽  
Significant Difference ◽  
The Impact ◽  
Experimentally Induced

Background: There is a growing interest in the correlation between antioxidants and periodontal disease. In this study, we aimed to investigate the effect of oxidative stress and the impact of two antioxidants, curcumin and rutin, respectively, in the etiopathology of experimentally induced periodontitis in diabetic rats. Methods: Fifty Wistar albino rats were randomly divided into five groups and were induced with diabetes mellitus and periodontitis: (1) (CONTROL)—control group, (2) (DPP)—experimentally induced diabetes mellitus and periodontitis, (3) (DPC)—experimentally induced diabetes mellitus and periodontitis treated with curcumin (C), (4) (DPR)—experimentally induced diabetes mellitus and periodontitis treated with rutin (R) and (5) (DPCR)—experimentally induced diabetes mellitus and periodontitis treated with C and R. We evaluated malondialdehyde (MDA) as a biomarker of oxidative stress and reduced glutathione (GSH), oxidized glutathione (GSSG), GSH/GSSG and catalase (CAT) as biomarkers of the antioxidant capacity in blood harvested from the animals we tested. The MDA levels and CAT activities were also evaluated in the gingival tissue. Results: The control group effect was statistically significantly different from any other groups, regardless of whether or not the treatment was applied. There was also a significant difference between the untreated group and the three treatment groups for variables MDA, GSH, GSSG, GSH/GSSG and CAT. There was no significant difference in the mean effect for the MDA, GSH, GSSG, GSH/GSSG and CAT variables in the treated groups of rats with curcumin, rutin and the combination of curcumin and rutin. Conclusions: The oral administration of curcumin and rutin, single or combined, could reduce the oxidative stress and enhance the antioxidant status in hyperglycemic periodontitis rats.

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