Long-Term Results of Donor Lymphocyte Transfusions for the Treatment of Relapse After Allogeneic Transplantation for Chronic Myelogenous Leukemia - Is There a Role for Immunotherapy in CML?.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2258-2258
Author(s):  
Hans-Jochem Kolb ◽  
Dagmar Bund ◽  
Helga Schmetzer ◽  
Christoph Schmid ◽  
Raymund Buhmann ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Allogeneic Transplantation ◽  
Myelogenous Leukemia ◽  
Long Term Results ◽  
Treatment Modalities ◽  
Simultaneous Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Gm Csf

Abstract Abstract 2258 Poster Board II-235 The long-term outcome of donor lymphocyte infusions (DLI) as first line treatment of relapse of chronic myeloid leukemia (CML) after allogeneic stem cell transplantation was studied and compared to other treatment modalities. Forty five patients were treated with DLI and 36 without DLI. Patients given DLI first did not differ significantly from those given other treatments in gender, age, donor, gender and histocompatibility of the donor, source of stem cells (blood vs marrow), depletion of T cells, stage of the disease, time from diagnosis and year at the time of transplant, acute and chronic graft-versus-host disease (GVHD) and remission duration. The survival of the DLI group was 66.4 percent at 10 and 15 years after transplantation, it was 42.2 and 23.8 percent respectively in the non-DLI group (p=0.019, log rank). Excluding patients with early relapse in the first 6 months the survival of the DLI group was 78 percent at 15 and 20 years, 70 and 26 percent respectively of the non-DLI group (p=0.009). Recurrent leukemia was the predominant cause of death in both groups (11 of 14 patients of the DLI-, 21 of 23 patients of the non-DLI group). Three patients in the DLI group died of recurrent infections, bronchiolitis obliterans (BO) and heart failure respectively, and 2 patients of BO in the non-DLI group. The proportion of surviving patients with positive PCR for bcr/abl was not different in both groups (2 of 13 patients of the non-DLI and 7 of 30 patients in the DLI group). The better survival of the DLI group indicates a better control of residual leukemia by a persistent immune effect. The response to DLI was improved by simultaneous treatment with low doses of interferon-a and GM-CSF. The combination of these cytokines without DLI and transplantation remains to be defined in patients that do not tolerate or respond incompletely to Imatinib. The role of immunotherapy for induction and maintenance of remission is well established in transplant patients. Disclosures: No relevant conflicts of interest to declare.

PS01.005: HIGH-RESOLUTION MANOMETRY GUIDING SURGICAL PROCEDURE FOR TREATMENT OF ACHALASIA OF THE ESOPHAGUS. LONG-TERM RESULTS OF A PROSPECTIVE STUDY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 51-51
Author(s):  
Tania Triantafyllou ◽  
Georgia Doulami ◽  
Charalampos Theodoropoulos ◽  
Georgios Zografos ◽  
Dimitrios Theodorou
Keyword(s):  
High Resolution ◽  
Prospective Study ◽  
Conflicts Of Interest ◽  
Long Term Results ◽  
Type I ◽  
Laparoscopic Myotomy ◽  
Term Outcome ◽  
Long Term Outcome ◽  
High Resolution Manometry

Abstract Background Laparoscopic myotomy and fundoplication for the treatment of achalasia presents with 90% success rate. The intraoperative use of manometry during surgery has been previously introduced to improve the outcome. Recently, we presented our pilot study proposing the use of the HRM during surgery. The aim of this study is to evaluate the long-term outcome of the intraoperative use of High-Resolution Manometry (HRM) in achalasia patients. Methods In this prospective study, consecutive achalasia patients underwent laparoscopic myotomy and fundoplication along with real-time use of HRM. Eckardt scores (ES) and HRM results were collected before and after surgery. Results Twenty-three achalasia patients (22% Type I, 57% Type II, 22% Type III, according to Chicago Classification v3.0) with a mean age 48 years underwent calibrated and uneventful myotomy and fundoplication. Eleven myotomies were further extended, while sixteen fundoplications were intraoperatively modified, according to manometric findings. During postoperative follow-up, mean resting and residual pressures of the LES were significantly decreased after surgery (16,1 vs. 41,9, P = 0 and 9 vs. 28,7, P = 0, respectively). The ES was also diminished (1 vs. 7, P = 0). Conclusion The intraoperative use of HRM during laparoscopic myotomy and fundoplication for the treatment of achalasia of the esophagus is a safe, promising and efficient approach aiming to individualize both myotomy and fundoplication for each achalasia patient. Disclosure All authors have declared no conflicts of interest.

Long Term Results of Stanford V Regimen and Highly Active Antiretroviral Therapy (HAART) In 59 Patients (pts) with HD and HIV Infection (HD-HIV)

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4827-4827
Author(s):  
Michele Spina ◽  
Jean Gabarre ◽  
Salvatrice Mancuso ◽  
Alessandro Re ◽  
Clara Schiantarelli ◽  
...  
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Conflicts Of Interest ◽  
Prognostic Score ◽  
Disease Free Survival ◽  
Long Term Results ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Free Survival

Abstract Abstract 4827 Background: The introduction of HAART has significantly improved the outcome of pts with HD-HIV. However there are no data on the long term follow-up of HD-HIV pts treated with conventional chemotherapy (CT) regimens. In 2002, we reported the results of a prospective phase II study with the intensive 12-week CT with adjuvant radiotherapy (Stanford V) and concomitant HAART in 59 pts (Spina et al. Blood 2002;100:1984-1988). Methods: To analyze the long term outcome of patients included in the Stanford V and HAART protocol. Results: The median follow-up is 67months (range 3–156 months The 5-yr overall survival (OS), freedom from progression (FFP), disease free survival and event free survival are 54%, 52%, 60% and 37%, respectively. The 5-year OS is significantly different in pts with an international prognostic score (IPS) >2 in comparison to that of pts with an IPS <3 (84% vs 36%, p= 0.0005). Similarly, the percentages of FFP at 5 years in these groups are 72% and 45% (p= 0.03). Conclusions: Our data confirm the long term efficacy of Stanford V regimen in combination with HAART in HD-HIV. However, Stanford V is significantly less effective in pts with IPS>2 and therefore new strategies be tested in this setting. Supported by AIRC and ISS grants. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Long Term Outcome Following Splenectomy in Children

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5887-5887
Author(s):  
Tugberk Akca ◽  
Zafer Salcioglu ◽  
Gonul Aydogan ◽  
Tuba Nur Tahtakesen Güçer ◽  
Cengiz Bayram ◽  
...  
Keyword(s):  
Hereditary Spherocytosis ◽  
Conflicts Of Interest ◽  
Thalassemia Major ◽  
Long Term Results ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Disease Response ◽  
Hematologic Diseases ◽  
Age Of Diagnosis

Abstract Aim: The aim of the study is to evaluate the efficacy, complications and long term results of splenectomy in children with hematologic diseases. Patients and Methods: This study includes retrospective analysis of the medical records of 158 children between 0-18 years old who underwent splenectomy due to hematologic diseases from 1989 to 2017. Gender, splenectomy indications, age of diagnosis, splenectomy age, vaccination status, splenectomy outcomes, complications and mortality were evaluated. Results: Of the cases, 88 (55.7%) were female and 70 were male (44.3%). Indications for splenectomy were hereditary spherocytosis in 59 (37.3%), immune thrombocytopenia (ITP) in 50 (31.6%) and thalassemia major in 40 (25.3%) children. The median age of diagnosis was 3.9 years, the median splenectomy age was 9.2 years, the median time from diagnosis to splenectomy was 5.3 years in all cohort. Mean follow-up time of patients after splenectomy was 7.3±5.2 years. All patients except one were immunized before splenectomy. Responses were assessed based on standart criteria for each disease. Response was seen in 94.7% of patients with hereditary spherocytosis and 80% of ITP patients. Twenty-two percent of splenectomised children with thalassemia major had a decrease in transfusion frequency. Infections following splenectomy were reported in 22.8%. One patient had thrombosis related to splenectomy, none of the cases had major bleeding. There was no death due to sepsis. One patient with ITP died due to Subacute Sclerosing Panencephilitis (SSPE). Conclusion: Splecetomy is associated with good remission rates following ITP and hereditary spherocytosis. Splenectomy should be performed only in selected cases with transfusion dependent thalassemia. Post-splenectomy sepsis is uncommon. Future studies should focus on health quality of life and cost analysis of splenectomy in children. Disclosures No relevant conflicts of interest to declare.

The bird dancer and the warrior king: Divergent lived experiences of Tourette syndrome in Bali

2017 ◽  
Vol 54 (4) ◽  
pp. 540-561 ◽  
Author(s):  
Robert Lemelson ◽  
Annie Tucker
Keyword(s):  
Lived Experience ◽  
Tourette Syndrome ◽  
Subjective Experience ◽  
Influential Factors ◽  
Treatment Modalities ◽  
Visual Anthropology ◽  
Subjective Experiences ◽  
Term Outcome ◽  
Long Term Outcome

In the past two decades, ethnographic, epidemiological and interdisciplinary research has robustly established that culture is significant in determining the long-term outcomes of people with neurodevelopmental, neuropsychiatric and mood disorders. Yet these cultural factors are certainly not uniform across discrete individual experiences. Thus, in addition to illustrating meaningful differences for people with neuropsychiatric disorder between different cultures, ethnography should also help detail the variations within a culture. Different subjective experiences or outcomes are not solely due to biographical idiosyncrasies—rather, influential factors arising from the same culture can have different impacts on different people. When taking a holistic and intersectional perspective on lived experience, it is crucial to understand the interaction of these factors for people with neuropsychiatric disorders. This paper teases apart such interactions, utilizing comparative case studies of the disparate subjective experiences and illness trajectories of two Balinese people with Tourette syndrome who exhibit similar symptoms. Based on longitudinal person-centered ethnography integrating clinical, psychological, and visual anthropology, this intersectional approach goes beyond symptom interpretation and treatment modalities to identify gendered embodiment and marital practices as influenced by caste to be significant determinants in subjective experience and long-term outcome.

Fractures and Fracture Dislocations of the Midfoot: Occurrence, Causes and Long-term Results

2001 ◽  
Vol 22 (5) ◽  
pp. 392-398 ◽  
Author(s):  
Martinus Richter ◽  
Burkhard Wippermann ◽  
Christian Krettek ◽  
Hanns Eberhard Schratt ◽  
Tobias Hufner ◽  
...  
Keyword(s):  
Open Reduction ◽  
Traffic Accidents ◽  
Fracture Dislocation ◽  
Long Term Results ◽  
Treatment Optimization ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Fracture Dislocations

Etiology and outcome of 155 patients with midfoot fractures between 1972 and 1997 were analyzed to create a basis for treatment optimization. Cause of injuries were traffic accidents (72.2%), falls (11.6%), blunt injuries (7.7%) and others (5.8%). Isolated midfoot fractures (I) were found in 55 (35.5%) cases, Lisfranc fracture dislocations (L) in 49 (31.2%), Chopart-Lisfranc fracture dislocations (CL) in 26 (16.8%) and Chopart fracture dislocations (C) in 25 (16%). One hundred and forty eight (95%) of the midfoot fractures were treated operatively; 30 with closed reduction, 115 with open reduction, 3 patients had a primary amputation. Seven (5%) patients were treated non-operatively. Ninety seven (63%) patients had follow-up at an average of 9 (1.3–25, median 8.5) years. The average scores of the entire follow-up group were as follows: AOFAS – sum of all four sections (AOFAS-ET): 296, AOFAS-Midfoot (AOFAS-M): 71, Hannover Scoring System (HSS): 65, and Hannover Questionnaire (Q): 63. Regarding age, gender, cause, time from injury to treatment and method of treatment no score differences were noted (t-test: p > 0.05). L, C or I showed similar scores and CL significantly lower scores (AOFAS-ET, AOFAS-M, HSS, Q). The highest scores in all groups were achieved in those fractures treated with early open reduction and operative fixation. Midfoot fractures, particularly fracture dislocation injuries, effect the function of the entire foot in the long-term outcome. But even in these complex injuries, an early anatomic (open) reduction and stable (internal) fixation can minimize the percentage of long-term impairment.

Abstract WP130: Long Term Outcome of Large and Giant Unruptured Intracranial Aneurysms

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Issei Kan ◽  
Toshihiro Ishibashi ◽  
Ichiro Yuki ◽  
Masayuki Ebara ◽  
Hideki Arakawa ◽  
...  
Keyword(s):  
Endovascular Therapy ◽  
Intracranial Aneurysms ◽  
Long Term Results ◽  
Final Visit ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Unruptured Intracranial Aneurysms ◽  
Retreatment Rate

Objectives: Long term outcome of large / giant unruptured intracranial aneurysms (LG-UIAs) after endovascular therapy is still unknown. We retrospectively analyzed long-term results of patients with LG-UIAs who were followed up more than 5 years after endovascular therapy. Methods: We included patients from our complete database with UIAs greater than 10mm and treated at our hospital from January 2003 to December 2013. Retreatment rate of targeted aneurysms, rupture rate, and the modified Rankin scale (mRS) at last visit were evaluated till December 2018. Results: From 142 patients treated during the period were excluded 3 patients with perioperative rupture and 38 patients with less than 5 years follow-up period, finally analyzing 101 patients. The median aneurysm size was 12.0 mm (IQR 10.8-15). The median follow-up period was 9.4 years (IQR: 7-11), the longest being 13.3 years. Retreatment was performed on 36 patients (35.6%). Comparing cumulative re-treatment rates in groups with aneurysm sizes <15 mm and> 20 mm, it was predominantly higher for aneurysms> 20 mm (P = 0.02, Figure1 ). Rupture of targeted aneurysms was observed in 2 cases (1.98%, Figure2 ), and the longest period from last treatment was up to 12 years. The mRS 0-1 at the first treatment and the final visit were 98% and 93%, respectively, and mRS deterioration remained at 5%. Conclusion: The retreatment rate tended to increase in proportion to the size of the aneurysm, however the final neurological outcome was favorable when considering the natural history of these aneurysms. Since aneurysmal rupture could occur after 12 years of treatment, long-term follow-up should be considered for LG-UIAs.

scholarly journals Long-term outcome after flexible ureteroscopy with holmium laser for simultaneous treatment of a single renal cyst and ipsilateral renal stones

2019 ◽  
Vol 47 (8) ◽  
pp. 3601-3612 ◽  
Author(s):  
Zhu Zewu ◽  
Chen Hequn ◽  
Cui Yu ◽  
Li Yang ◽  
Yang Zhongqing ◽  
...  
Keyword(s):  
Renal Cyst ◽  
Intraoperative Complications ◽  
Renal Cysts ◽  
Holmium Laser ◽  
Flexible Ureteroscopy ◽  
Simultaneous Treatment ◽  
Period Range ◽  
Term Outcome ◽  
Long Term Outcome

Objective To assess the long-term outcome of simultaneous treatment of a single renal cyst and ipsilateral stones with transurethral flexible ureteroscopy (FURS) lithotripsy and internal cyst drainage. Methods Patients who underwent simultaneous treatment with FURS lithotripsy and internal cyst drainage in our institution between July 2014 and September 2017 were enrolled. The cyst wall was identified endoscopically and a 1–3-cm window was created in the wall using a holmium laser. The proximal end of a double-J stent was placed in the cystic cavity to facilitate internal drainage. Results Thirteen patients underwent simultaneous treatment. No intraoperative complications with Clavien grading score >2 were noted in any patients. Mean stone burden and cyst diameter were 1.6 (range: 0.9–2.5) cm and 5.8 (range: 3.0–7.1) cm, respectively. Stone-free rates after single and complementary procedures were 84.6% and 92.3%, respectively. During the mean 33.1-month follow-up period (range: 17–54 months), seven patients (53.8%) achieved full resolution of renal cysts, five patients (38.5%) maintained >50% size reduction, and one patient (7.6%) experienced recurrence at 18 months postoperatively. Conclusions FURS with a holmium laser may constitute a safe and effective alternative procedure for simultaneous treatment of a single renal cyst and ipsilateral stones.

Conservation Therapy of the Breast: Optimizing Long-term Results

1997 ◽  
Vol 4 (3) ◽  
pp. 220-225 ◽  
Author(s):  
Harvey M. Greenberg
Keyword(s):  
Breast Cancer ◽  
Breast Conservation ◽  
Breast Conservation Therapy ◽  
Long Term Results ◽  
Term Outcome ◽  
Skin Reactions ◽  
Collagen Vascular Diseases ◽  
Long Term Outcome ◽  
Acute Skin Reactions

Background Radiation therapy is a key component of breast conservation therapy for breast cancer. There is great interest in safety and long-term outcome issues for this still underutilized approach. Methods The author reviews a series of factors that may affect the end results of conservation therapy and highlights those that are likely to be of clinical significance. Results Daily dose fractions are usually less than 2 Gy and a homogeneous whole-breast dose is used. Care is needed with patients with collagen vascular diseases, large breasts, breast trauma, and prior infections, but these factors are not absolute contraindications to breast conservation therapy. Acute skin reactions are not predictive of long-term complications. Conclusions With adherence to proper surgical and radiation techniques, most patients presenting with localized breast cancer can be managed safely and effectively with breast conservation.

STEREOTACTIC VENTRICULOPERITONEAL SHUNTING FOR REFRACTORY IDIOPATHIC INTRACRANIAL HYPERTENSION

Neurosurgery ◽  
2007 ◽  
Vol 60 (6) ◽  
pp. 1039-1044 ◽  
Author(s):  
Basel Abu-Serieh ◽  
Keyvan Ghassempour ◽  
Thierry Duprez ◽  
Christian Raftopoulos
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Long Term Results ◽  
Ventricular Catheter ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Visual Deficits ◽  
Ventriculoperitoneal Shunting

Abstract OBJECTIVE Recent reports have shown promising short- to medium-term results in patients with refractory idiopathic intracranial hypertension (IIH) treated using the stereotactic ventriculoperitoneal shunting (SVPS) technique. However, the long-term clinical efficacy of this technique remains questionable. This report provides the long-term results of SVPS in treating refractory IIH patients. METHODS We reviewed the medical charts of nine consecutive patients (mean age, 26.4 yr; range, 4–63 yr) treated using either a frame-based or frameless SVPS technique for IIH. RESULTS The mean postoperative follow-up period was 44.3 months (range, 6–110 mo). Before shunting procedures were performed, each patient presented with intractable headache, and five patients (55.6%) had mild to moderate visual deficits. The last follow-up assessment showed that after shunting was performed, eight patients (89%) were headache-free. Only one patient had recurrent headache; however, this patient's pain was much less frequent and severe than before the shunting procedure was completed and was concomitant with recent weight increase. Visual deficits were resolved in three patients and remained stable in two who already had optic nerve atrophy before shunting was completed. Twelve SVPS procedures were performed on our patients. Nine shunt revisions were needed in six patients because of infection (n = 5, including two revisions in one patient), valve dysfunction (n = 2), distal obstruction (n = 1), and ventricular catheter malpositioning (n = 1). No patient had proximal catheter obstruction. CONCLUSION Given the favorable long-term outcome of the SVPS technique for refractory IIH, we are encouraged to apply this procedure on our patients. More invasive approaches should be reserved for patients who have SVPS failure.

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