Impact of Therapeutics On Fatigue in Chronic Immune Thrombocytopenia (ITP).

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4455-4455
Author(s):  
James B. Bussel
Keyword(s):  
Immune Thrombocytopenia ◽  
Conflicts Of Interest ◽  
Short Form ◽  
Medical Center ◽  
Laboratory Finding ◽  
Age Group ◽  
Therapeutic Modalities ◽  
Role Physical ◽  
The Mean ◽  
Chronic Immune Thrombocytopenia

Abstract Abstract 4455 Complaints of tiredness, lethargy or lack of energy are common in patients with chronic Immune ThrombocytoPenia (ITP), however they are not well understood. This study assessed whether different clinical and laboratory aspects are related to fatigue and how different therapeutic modalities might impact these symptoms. Methods Patients with chronic ITP older than 15 years old were enrolled from 2007-2008 at the Platelet Disorders Center at the Weill-Cornell Medical Center, NY. They completed the Short-Form 36 questionnaire (SF-36) and Fatigue severity scale (FSS) (2 standardized Health-related quality of life [HRQoL] questionnaires) and the Beck Depression Inventory (BDI). Laboratory testing included CBC, TSH, ferritin, iron + TIBC, and blood serotonin levels. Results 83 patients with a mean age of 40.2 years (67.5% women) were enrolled. The mean platelet counts were 109,000/ul (range of 12,000-500,000/ul). Forty-one % of patients had duration of ITP of 10 years or more and 25% had had previous splenectomy. Sixty-one% were on treatment: 11% steroids, 23% Tpo-R agents and 28% “Other” (7.2 % Rigel, 13.3 % IVIG, 3.6 % anti-D, 2.4 % rituximab and 1.2% Danazol/Azathioprine). Surprisingly, analysis of the SF36 showed that the study (ITP) population is similar to the general US population and that they do not report increased fatigue or depression. These results contrast with a previous report by McMillan, AJH, 2007 (fig 1). However when the current patients were divided according to age, abnormal low scores on SF36 were observed on vitality domain (mean 50) for the age group of 45-55 years and on role physical domain (mean 48) for the age group of 55-65 years. Furthermore, differences were observed in patients stratified according to treatment (figure 2) where the mean scores for patients on the steroid group on the respective domains were lower: vitality 49 and role physical 42. The Tpo-R agonists group had better results in all SF36 domains; similar findings were seen with the FSS and BDI. The only laboratory finding is that patients with low ferritin levels had worse results on FSS. Conclusion Although fatigue and related symptoms have been previously reported by others including an improvement with successful treatment eg in studies of the TPO-R agonists, to our surprise we did not find the same results. Whether this study population is intrinsically different or receiving different treatments, eg avoidance of steroids, might impact these results here are 2 possible hypotheses. Use of different fatigue assessments as ITP-PAQ or CDC symptom inventory and further studies addressing the role of the pro-inflammatory cytokines in these patients would be useful. Disclosures: No relevant conflicts of interest to declare.

Megakaryocytic Progenitors (CFU-M) Increase Nonspecifically In Chronic Immune Thrombocytopenia

1981 ◽  
Author(s):  
S A Burstein ◽  
S K Erb ◽  
J W Adamson ◽  
L A Harker
Keyword(s):  
Platelet Count ◽  
Immune Thrombocytopenia ◽  
Foreign Protein ◽  
Rabbit Serum ◽  
Normal Rabbit Serum ◽  
Intravenous Injections ◽  
The Mean ◽  
Macrophage Colony ◽  
Phosphate Buffered Saline ◽  
Chronic Immune Thrombocytopenia

Previous studies from our laboratory have suggested that the numbers of CFU-M do not increase primarily in response to acute thrombocytopenia. To determine the effect and specificity of prolonged thrombocytopenia on CFU-M number, mice were given 4 intravenous injections on alternate days of multiply absorbed rabbit anti-mouse platelet serum (APS), while control animals received a similar regimen of rabbit anti-mouse red cell serum (ARS), normal rabbit serum (NRS), or phosphate-buffered saline (PBS). Two days aftefcthe final injection, the mean platelet count was.0.314 ± 0.129 × 106/ul in animals given APS vs. 1.105 ± 0.048 × 106/ul in animals given other regimens. The numbers of CFU-M, day 7 and day 14 erythroid burst forming cells (BFU-E), and granulocyte-macrophage colony forming cells (CFU-C) were determined in humerus and spleen.The generalized increase in progenitor cells in marrow in response to APS together with increases in CFU-M in spleen following ARS and NRS indicate that these cells may respond nonspecifically to foreign protein. The data suggest that the elevation in CFU-M numbers with chronic immune thrombocytopenia is at least partially independent of the platelet count.

Platelet Utilization In a Tertiary Care Hospital: An Opportunity for Reduced Transfusion?

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2575-2575
Author(s):  
Vipra Sharma ◽  
Maya Shah ◽  
Ravi Pullela ◽  
Alice J. Cohen
Keyword(s):  
Disease Transmission ◽  
Tertiary Care Hospital ◽  
Conflicts Of Interest ◽  
Medical Center ◽  
Tertiary Care ◽  
Invasive Procedure ◽  
Care Hospital ◽  
Tertiary Care Medical Center ◽  
The Mean ◽  
Transfusion Guidelines

Abstract Abstract 2575 Background: Use of platelet (plt) transfusions to treat and prevent bleeding varies widely between hospitals and by medical and surgical services. Standard indications include active bleeding with thrombocytopenia or plt dysfunction, pre or peri-invasive procedure, and prophylaxis for low plt counts. Rising demand for plt transfusions and donor shortage, coupled with the risks of transfusion (including infectious disease transmission and alloimmunization) are concerns which often lead to strict regulation of plt transfusion in hospitals. In order to evaluate appropriate use of plt transfusion based on Newark Beth Israel Medical Center transfusion guidelines, a review of plt use was undertaken at this tertiary care hospital. Design: A retrospective review was performed of plt utilization over a 3 month period from October to December 2009. All charts of hospitalized and outpatient patients receiving plt transfusions were reviewed to determine reasons for plt transfusion. Pre-transfusion plt values, site/service ordering plt transfusions, number of units transfused and cost were determined. Results: 421 plt units were transfused to 125 patients (51.6% female), mean age 44 years (yrs.) (range 0–89). All plt transfusions were single donor units. The mean plt count prior to transfusion for all procedures was 127,000, well above hospital guidelines. The majority of plt utilized were by cardiothoracic (CT) surgery (168/421, 40%) with the highest cost (Table 1). 124/421(29%) of transfusions occurred pre- or peri- invasive procedure, with 88/124 (71%) of those transfusions occurring prior or peri- cardio-thoracic procedure. 83/421 (20%) of transfusions had no clear indication based on hospital guidelines, predominately ordered by CT surgery and occurring post-op for asymptomatic thrombocytopenia (cost $45, 650). The mean plt count at which transfusion was found to have no indication was 55,000 (range 25,000–105,000). 136/421(32%) of the cases were prophylactic transfusions with a plt count < 20,000, with 121/136 (89%) in the oncology patients, and the rest in the medical pts due to sepsis. 114/421(27%) of the transfusions were for bleeding. Only 5 patients, 3 in the CT group, and 2 in neonate group had plt dysfunction as the indication for transfusion prior to procedure. The lowest incidence of plt transfusions without an indication was in the adult oncology department. Conclusion: Platelet utilization varied by departments. CT surgery followed by neonatal and pediatric oncology are the principal users of plt in our tertiary care medical center. CT surgery, general surgery, and neonatal services had the highest pre-transfusion plt counts. As 20% of all transfusions had no clinical reason for plt use (no bleeding, invasive procedure, or severely low plt count) the opportunities may exist for lower platelet usage by educating physicians about compliance to transfusion guidelines in order to decrease the risks associated with transfusion and resultant complications. Disclosure: No relevant conflicts of interest to declare.

scholarly journals Increased FVIII and Anti-Phospholipid Antibodies Do Not Modify the Clinical Course of Chronic Immune Thrombocytopenia

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5013-5013
Author(s):  
Meet Kumar ◽  
Maitryee Bhattyacharyya ◽  
Shyamali Datta
Keyword(s):  
Platelet Count ◽  
Lupus Anticoagulant ◽  
Immune Thrombocytopenia ◽  
Clinical Course ◽  
Conflicts Of Interest ◽  
Age Groups ◽  
Platelet Counts ◽  
Bleeding Score ◽  
Chronic Immune Thrombocytopenia

Abstract INTRODUCTION: Immune thrombocytopenia is a heterogenous disease with majority patients having a mild bleeding phenotype and one-fourth being asymptomatic. Bleeding episodes are usually seen in patients with platelet counts typically <30,000/cumm. There is no study till date to identify patients with platelet count <30,000/cumm and at high risk for bleeding. Although patients who harbor anti phospholipid antibodies have a higher risk of arterial and venous thrombosis, it is not known whether presence of acquired thrombophilia modifies the clinical course of bleeding in low platelet count ITP patients. We evaluated the role of FVIII and lupus anticoagulant in modifying the clinical course of such patients. MATERIALS AND METHODS: Patients of all age groups with persistent and chronic immune thrombocytopenia were eligible for study enrolment. Patients with acute ITP and secondary ITP were excluded. Eligible patients were evaluated with baseline parameters, ITP bleeding score (ITP-BAT, version 1.0 by IWG on ITP) at baseline and then at every visit and FVIII and lupus anticoagulant at baseline and repeat at six months.Patients were called for monthly scheduled visits if platelet counts were >30,000/cummand more frequently at lower platelet counts. Patients with any evidence of underlying infection or raised c-reactive protein and procalcitonin were deferred evaluation.All patients were treated as per institutional protocol to avoid treatment bias. Patients were followed up for one year. We finally calculated the average bleeding scores of all patients at different platelet counts (for eg. average of skin, mucosal and organ bleeding scores of all patients that had platelet counts <10,000/cumm, 10-30,000/cumm etc) and analysed it with FVIII and anti-phospholipid antibody levels. RESULTS: A total of 45 patients were enrolled with M:F=1:3.2. Median age of patients is 28years (3-72 years). Two patients were excluded (both progressed to SLE) and another two were lost to follow-up. Median duration from ITP diagnosis to study enrolment was 62.4months (8-590 months). Median follow-up of all patients was 14.2 months (13.2-16.4 months). Nine patients had persistent and 32 patients had chronic ITP. ITP-BAT could differentiate intensity of bleeding at different platelet counts by means of bleeding scores (Table 1). Correlation of bleeding scores with prothrombotic markers could not establish a disease course modifying relationship between the two (Table 2). CONCLUSION: Presence of high FVIII and anti phosphoilipid antibodies donot modify the bleeding risks in patients with ITP and low platelet counts. Table 1Platelet count (x109/cumm)Total episodesAverage bleeding scoreP value<1014S2.4 M1.4 O0 0.00210-3015S1.4 M0.9 O030-6018S0.3 M0.1 O0>600S0 M0 O0 Table 2 Platelet count <10,000/cumm Platelet count 10-30,000/cumm N Av BS P= N Av BS P= FVIII>150 5 S2.5M1.1O0 0.02 6 S1.1M0.8O0 0.1 FVIII<150 9 S2M0.7O0 11 S1.4M0.6O0 LA1:LA2>2 1 S2.2M1.5O0 0.03 S1.1M0.8O0 0.2 LA1:LA2<1 12 S2.6M1.2O0 S1.2M0.6O0 Table 3 Platelet count 30-60,000/cumm Av BS P= FVIII>150 4 S0.9M0.1O0 0.2 FVIII<150 11 S0.3M0.1O0 LA1:LA2>2 Nil LA1:LA2<1 9 S1.1M0.4O0 Disclosures No relevant conflicts of interest to declare.

Effects of Reduced Dose of Imatinib to Korean Chrionic Myeloid Leukemia in Chronic Phase.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4290-4290
Author(s):  
Se Ryeon Lee ◽  
Yong Park ◽  
Hee Yun Seo ◽  
Hwa Jung Sung ◽  
Seok Jin Kim ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Dose Reduction ◽  
Conflicts Of Interest ◽  
Standard Dose ◽  
Medical Center ◽  
Chronic Phase ◽  
Severe Neutropenia ◽  
Reduced Dose ◽  
The Mean ◽  
The Difference

Abstract Abstract 4290 Background Some patients of CML in chronic phase receive reduced doses of imatinib due to some adverse effects. Recently, the efficacy of reduced dose of imatinib for the patients with small BSA was reported by our group and Japanese group, recently. This study was tried to verify the hypothesis of which BSA of CML patients might be an important factor to predict the effect of reduced dose imatinib. Method Fifty-six patients having record of BSA from the Korea University Medical Center who were treated with imatinib were retrospectively analyzed. Result All of the patients started the imatinib therapy with 400mg/day dose. 20 patients (35.7%) among them were reduced dose to 300mg and 4 of them were further reduced to 200mg/day. The main reasons for dose reduction were severe neutropenia or thrombocytopenia (grade 3 or 4) (89.4%). Following the dose reduction, the rate of toxicity was reduced and treatment was resumed and the dose was gradually increased until 9 patients tolerated a maintenance dose of 400mg/day and remainder had been taken the reduced dose. The cumulative CCR at 12 months was similar in both group (P = 0.89, 70.0% in reduced dose vs 72.7% in standard dose). The mean imatinib dose/BSA was significantly lower in patients receiving the reduced dose compared with those receiving the standard dose (P < 0.001)(183.4 ± 26.9 vs 230.5 ± 21.4), although the mean BSA didn't show the difference according to reduction of dose (P = 0.079)(1.62 ± 0.20 vs 1.75 ± 0.13). After median follow-up period of 37.3 months (6.0-76.1 months), 15 patients (75.0%) have sustained CCR in patients receiving reduced dose of imatinib. Conclusion From this study, we could find that the reduced dose of imatinib in CML patients might assure the relatively satisfactory response with low intolerable adverse effects. But we could not verify that BSA was the main factor to predict the effect of reduced dose of imatinib. So, further studies including though level of imatinib will be needed to clarify the effect of reduced dose of imatinib. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Cutaneous Hemorrhage Types As Supportive Factors for Predicting Chronic Immune Thrombocytopenia in Children

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4906-4906
Author(s):  
Nehama Sharon
Keyword(s):  
Chronic Disease ◽  
Odds Ratio ◽  
Immune Thrombocytopenia ◽  
Conflicts Of Interest ◽  
Univariate Analysis ◽  
Older Age ◽  
Chronic Patients ◽  
Acute Itp ◽  
Acute Patients ◽  
Chronic Immune Thrombocytopenia

Our objective was to assess risk factors for developing chronic immune thrombocytopenia (ITP) in children. The charts of all consecutive children diagnosed with ITP between 2000 and 2015 at a single center were retrospectively reviewed, and clinical characteristics at initial presentation were analyzed. Sixty-two children were included in the study (mean age, 6.15 y); 44 (71%) were found to have acute ITP, and 18 (29%) developed chronic ITP (permanent or relapsing thrombocytopenia >12 mo). In a univariate analysis, cutaneous hemorrhages were observed significantly more in acute patients (90.9%) than in chronic patients (61.1%). Patients who had acute ITP were more likely to present with a combination of petechiae, purpura, and/or ecchymosis (75%) than patients with chronic disease (44.4%, P=0.010). In multivariate analysis, older age increased the risk (odds ratio=1.1; P<0.05) for chronic disease, and manifestations of combination skin hemorrhages (petechiae/purpura/ecchymosis) reduced the risk (odds ratio=0.167; P<0.05). In conclusion, the most important risk factor for chronic disease is older age. Skin hemorrhage types were found to be a supportive factor for the prediction process: the combination of petechia/purpura/ecchymosis was associated with a lower risk for developing chronic disease compared with petechiae alone. Future studies should assess the prognostic value of skin hemorrhage types that are a simple way to predict the course of ITP in children. Disclosures No relevant conflicts of interest to declare.

Factorial Composition of the Short Form of the Stanford-Binet with Culturally Disadvantaged Head Start Children

1973 ◽  
Vol 32 (3_suppl) ◽  
pp. 1048-1050
Author(s):  
Daniel P. Hallahan ◽  
Donald W. Ball ◽  
James S. Payne
Keyword(s):  
Head Start ◽  
Short Form ◽  
Verbal Ability ◽  
Age Group ◽  
Visual Ability ◽  
Head Start Children ◽  
Specific Factors ◽  
The Mean ◽  
Culturally Disadvantaged ◽  
Factorial Composition

This study reports a factor analysis of the 1960 revision of the Stanford-Binet (Short Form). The Binet was administered to 363 children ranging in age from 3.0 to 5.8 yr. with a mean of 4.3 yr. All Ss were classified as culturally disadvantaged. The mean IQ for this group was 91.6. Three factors were found—a general one and two specific factors of visual ability and judgment and verbal ability. The study was compared with Ramsey and Vane's study which applied a similar analysis to a similar age group of middle-class Ss using Stanford-Binet.

scholarly journals Autoimmune Markers in Children with Chronic Immune Thrombocytopenia

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 2447-2447
Author(s):  
Tuba Nur Tahtakesen Güçer ◽  
Ali Aycicek ◽  
Gonul Aydogan ◽  
Zafer Salcioglu ◽  
Ebru Yilmaz ◽  
...  
Keyword(s):  
Autoimmune Diseases ◽  
Immune Thrombocytopenia ◽  
Conflicts Of Interest ◽  
Tissue Transglutaminase ◽  
Hormone Replacement ◽  
Autoimmune Disorder ◽  
Hashimoto Thyroiditis ◽  
Chronic Itp ◽  
Number Of Patients ◽  
Chronic Immune Thrombocytopenia

Abstract Introduction: Chronic immune thrombocytopenia (ITP) is defined as isolated thrombocytopenia lasting longer than 12 months. Rheumatologic diseases, immunodeficiencies and thyroid diseases may coexist with chronic ITP due to possible immune dysregulation. Aim: To evaluate the accompanying autoimmune diseases in children with chronic ITP. Materials-Methods: A total of 154 children with chronic ITP (F /M: 1) diagnosed between 1995 and 2018 were included. Patients were evaluated with immunoglobulin levels, ANA, anti dsDNA, C3, C4, anti TPO, anti TG, T4, TSH, tissue transglutaminase IgA and Ig G. Results: Of the 154 patients, 79 were female (51.3%) and 75 were male (48.7%). Mean age of the patients was 13.6 ± 5.8 years, mean age of diagnosis was 7 years ± 4. None of the patients had severe infections requiring hospitalisation. None of the patients had symptoms or findings of an autoimmune disorder. Of 154, two had low IgA levels (<7 mg / dL) and they were diagnosed as IgA deficiency. IgM and IgG levels were normal in all. C3 level was low in four patients (3%) and C4 level was low in one patient (0.7%). ANA was positive in 16 (12%) of the patients and anti-dsDNA was positive in four patients (0,3%). In three patients, Anti-dsDNA positivity was accompanied with ANA positivity and in one patient, C3 was low. These patients were followed up by pediatric rheumatology clinic. Twenty two patients had elevated anti TPO (15.5%) and 18 patients had elevated anti TG (12.7%) levels. Majority of patients with high thyroid autoantibodies were female (67.5%). Out of 129 patients evaluated by thyroid tests including fT4, TSH, AntiTPO and AntiTG, 29 (% 22,4) were diagnosed as Hashimoto thyroiditis. Thyroid hormone replacement was started in one patient . Of 93 patients evaluated with anti-tissue transglutaminases, 7 were found to have at least one positive TTG IgA or IgG. Two of these patients underwent endoscopy, but no evidence of celiac disease was found. In total, the number of patients with at least onepositive autoimmune marker was 54 (35%). Discussion and Conclusion: Chronic ITP is known to accompany autoimmune diseases. Autoimmune diseases in patients with ITP may occur at any time in 10 years of diagnosis. Further studies for the detection of subclinical autoimmune conditions should be performed with a profit- loss account. Antibodies may be positive even when there is no clinical findings of the diseases. Further follow-up is needed to understand the clinical significance of autoimmune markers in chronic ITP. Disclosures No relevant conflicts of interest to declare.

scholarly journals A Systematic Literature Review to Assess Long-Term Outcomes Associated with Splenectomy in Patients with Chronic Immune Thrombocytopenia

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5881-5881
Author(s):  
Dave Nellesen ◽  
Qayyim Said ◽  
Nina Shak ◽  
Cody Patton ◽  
Sedge Lucas ◽  
...  
Keyword(s):  
Immune Thrombocytopenia ◽  
Long Term Outcomes ◽  
Time Points ◽  
Analysis Group ◽  
The Mean ◽  
Relapse Rates ◽  
Over Time ◽  
Chronic Immune Thrombocytopenia

Abstract Introduction: Chronic immune thrombocytopenia (cITP) is an autoimmune disorder defined by low platelet count (<100 x 109/L) lasting ≥12 months in the absence of other causes of thrombocytopenia. Splenectomy is an option for patients with cITP who fail to respond to oral corticosteroids and/or intravenous immunoglobulin or relapse after treatment is discontinued. A systematic literature review (SLR) conducted in 2004 (Kojouri et al) identified articles describing outcomes associated with splenectomy in patients with cITP. The objective of this study was to update this SLR with a focus on contemporary data on long-term outcomes (≥12 months of follow-up). Methods: MEDLINE, Embase, Cochrane CENTRAL and recent congresses were searched in June 2018. Results were screened against predefined criteria by two independent researchers. Included studies assessed patients with cITP (N≥15) who underwent splenectomy; studies of patients with secondary ITP, newly diagnosed ITP, and/or persistent ITP were excluded unless separate outcomes were reported for cITP subgroups. Outcomes of interest were clinical efficacy (response and relapse rates), safety (rates of complications), mortality, and health-related quality of life (HRQoL). Prospective or retrospective clinical studies or real-world study types were included. English-language studies published during or after 2000 were included, with no geographic restrictions. Results: The literature search identified 3140 records for title-abstract screening. Of these, 159 full-text studies were evaluated and 108 were included in the analysis. Most studies (93) were retrospective. Fifteen prospective studies (9 interventional, 6 observational) but no randomized controlled trials were identified. Nine studies were comparative (all retrospective): splenectomy vs rituximab (3), splenectomy vs rituximab vs romiplostim (1), and splenectomy vs non-splenectomy (5). Reports of the long-term efficacy of splenectomy varied widely, with multiple definitions of response and remission across the heterogeneous study types. Among 40 studies, the mean complete response (CR) rate within 12 months of surgery was 77% (median: 81%; range: 26-97%). Relapse rates varied widely, ranging from 0-94% among 47 studies with ≥12 months of follow up. Five of 7 studies reporting remission rates at multiple time points at ≥1 year noted a decrease in clinical remission over time. Mortality generally increased with length of follow up: in studies with ≤1 month of follow-up (28 studies) the mean mortality rate was 1% (range: 0-5%), while in studies with 1-5 years of follow-up (20 studies) and ≥5 years of follow-up (15 studies), the mean mortality rate was 2% (range: 0-17%) and 11% (range: 0-30%), respectively. Four studies reported that long-term response rates were higher with splenectomy than rituximab; all other efficacy comparisons were inconclusive. Although 11 of 15 prospective studies and 61 of 93 retrospective studies reported some safety information, there were very limited data on the long-term safety of splenectomy. Commonly reported complications were bleeding (mean: 14%; median: 12% range: 0-50%; 22 studies), infections (mean: 8%; median: 4% range: 0-33%; 38 studies), venous thromboembolism (VTE) (mean: 5%; median: 3% range: 0-21%; 27 studies) and sepsis/septic shock (mean: 2%; median: 0%; range: 0-11%; 18 studies). Rates of postoperative complications (≤30 days) ranged from 3-50% (mean: 13%; 31 studies), and 2 studies suggested that older age may be associated with higher rates of postoperative complications. HRQoL data were rarely reported (3 studies). Rates of remission, relapse, and infections for studies reporting at least 1 of these outcomes at 1 or more discrete time points are shown in Figure 1. Conclusions: Although more than 100 studies reported long-term outcomes for patients with cITP treated with splenectomy, available evidence on the durability of response and long term safety are limited. In general, most measures of efficacy declined over time, while complications (infections, bleeding, VTE) and mortality increased over time. The extent to which the outcomes for splenectomy differ from currently available treatments is unclear. Additional data are needed to understand the long-term benefits and risks of splenectomy in patients with cITP. Disclosures Nellesen: Analysis Group, Inc.: Employment; Novartis Pharmaceuticals Corporation: Consultancy. Said:Novartis: Employment. Shak:Analysis Group, Inc.: Employment; Novartis Pharmaceuticals Corporation: Consultancy. Patton:Novartis Pharmaceuticals Corporation: Consultancy; Analysis Group, Inc.: Employment. Lucas:Novartis Pharmaceuticals Corporation: Consultancy; Analysis Group, Inc.: Employment. Graves:Novartis: Employment. Nezami:Novartis Pharmaceuticals: Employment. Cuker:Kedrion: Membership on an entity's Board of Directors or advisory committees; Spark Therapeutics: Research Funding; Synergy: Consultancy; Genzyme: Consultancy.

PS02.224: ESOPHAGEAL CANCER IN MALAYSIA: THE NEED FOR EARLY DETECTION!

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 185-185
Author(s):  
Hui Ying Khoo ◽  
Kelvin Voon ◽  
Keat How Teoh ◽  
Shyang Yee Lim ◽  
Premnath Nagalingam ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Early Detection ◽  
Conflicts Of Interest ◽  
Neuroendocrine Tumour ◽  
Medical Center ◽  
Multimodality Treatment ◽  
Duration Of Symptoms ◽  
Tertiary Hospitals ◽  
Male Patients ◽  
The Mean

Abstract Background Esophageal cancer is one of the deadliest cancer in Malaysia. However, neither the incidence nor prevalence has been recorded nationally. We report our experience in dealing with esophageal cancer in Penang Hospital (PH) and Universiti Kebangsaan Malaysia Medical Center (UKMMC), two tertiary hospitals in Northern and Central region of Malaysia, respectively. Methods A review of 143 esophageal cancer that were diagnosed in PH and UKMMC in year 2014–2017. Results Among the 143 esophageal cancers, 60 cases were from HPP and 83 from UKMMC. The mean age at diagnosis was 62.5 ± 14.2. 67.4% were male patients. Esophageal cancer was commonest in Chinese ethnicity (41%), followed by Malay (29.9%), Indian (17.4%) and others (11.8%). Dysphagia was the commonest presenting symptom (84.6%) and the mean duration of symptoms were 14 weeks. Majority of the cancers were located at the cardioesophageal junction (38.6%), followed by lower third of esophagus (32.1%), mid esophagus (23%), upper third of esophagus (11.5%) and cervical esophagus (5.7%). More than 90% of patients presented with advanced disease, 35% and 55% of patients with stage 3 and stage 4 disease, respectively. Squamous cell carcinoma (45.8%) was the commonest histology type, slightly more than adenocarcinoma (45.1%). The rest were neuroendocrine tumour, gastrointestinal tumour and lymphoma. To date, surgery with curative intend were done in 44.1% of patients while the rest were managed with palliative treatment. Conclusion It is striking that majority of patients presented with late disease. Disease awareness campaign, early detection and multimodality treatment are crucial to improve outcomes of patients. Disclosure All authors have declared no conflicts of interest.

scholarly journals ASSESSING OF MALNUTRITION IN PATIENTS WITH CANCER BY USING PATIENT-GENERATED SUBJECTIVE GLOBAL ASSESSMENT SHORT FORM (PG-SGA-SF)

2021 ◽  
pp. 131-141
Author(s):  
Maha Almatary ◽  
Fatma Ghait ◽  
Hajer Mohammed ◽  
Ali Ateia Elmabsout
Keyword(s):  
Nutritional Status ◽  
Cancer Patients ◽  
Short Form ◽  
Medical Center ◽  
Life Quality ◽  
Cross Sectional Study ◽  
Negative Consequences ◽  
Chi Square ◽  
Cross Sectional ◽  
The Mean

Introduction: Cancer-related malnutrition has negative consequences are taken too lightly in most oncology wards. The objective of this study is to determine the malnutrition risk (MR)/malnutrition (MN) in cancer patients using PG-SGA short form. Methods: This cross sectional study was conducted with cancer patients in oncology unit at Benghazi medical center on 229 patients in which 107 male and 122 female. The data collected through PG-SGA short form and analyzed by either frequencies or by suing Chi-square for significant differences. Results and discussion: The study enrolled 229 oncology patients. The mean age was 58.34 ± 11.60 years. One hundred and twenty tow (53.7.3%) of the patients were female. The most common three tumor types were breast tumors (27.9%) followed by colorectal cancer (14%) whereas, almost similar report for lung, liver and upper GIT (10.9%). (11.4%) and (11.8%) respectively . The mean BMI of the patients was 26.17 ± 0.3 kg/m2. According to PG-SGA short form of the patients were in moderate risk of nutritional status and overall score of PG-SGA short form was 18. 34± 0.56. Furthermore the prevalence of cancer in this study was significant high in male (P< 0.05) Conclusion: In cancer patients, the risk of malnutrition is significantly high, and this may alter the patient’s life quality and expectancy. Therefore, the nutritional status of the patient that is diagnosed with cancer should be assessed in early stages of the disease. KEYWORDS: malnutrition, cancer, PG-SGA Nutrition Assessments

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