Rituximab May Be a Useful Option in Children with Severe Chronic Immunthrombocytopenia (ITP)

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4692-4692
Author(s):  
Susan Halimeh ◽  
Erdmuth Schubert ◽  
George Paulus ◽  
Hannelore Rott ◽  
Michael Schaefers ◽  
...  
Keyword(s):  
Platelet Count ◽  
Conflicts Of Interest ◽  
Clinical Results ◽  
Sudden Onset ◽  
Subsequent Treatment ◽  
Time Intervals ◽  
Time Period ◽  
Heavily Pretreated ◽  
History Of

Abstract Abstract 4692 This otherwise healthy 12-year-old girl presented in March, 2011 with a history of severe ITP that had been diagnosed in November, 2007. Since then, she had suffered from recurrent bruises, petechiae, epistaxis, persistent bleending after tooth-loss and during menstruation (menarche: April, 2010), and subsequent iron-deficiency. Severe headache of sudden onset turned out to be caused by intracranial hemorrhage (ICH) in December, 2009, and in September, 2010, respectively. CT-scans in September 2010 revealed 2 additional ICH which had occured without symptomps. Fortunately, she recovered without sequelae from these complications. The initial and the subsequent treatment consisted of immunoglobulie (IG) and prednisone (IV or orally) given in various doses and for various time-intervals, always followed by a rise in platelet count for short periods of time, and a subsequent decline, when the drugs were withdrawn. Both ICH occured in phases of watchful waiting, while platelet count were below 1000. Splenectomy was offered and repeatedly denied by the patient and her parents. After the second ICH (Sept 2010) the patient received continuous weekly IG as prophylaxis of further ICH. Serious side-effects of prednisone in this patient (Cushing’s habitus, abdominal striae, insomnia and secondary depression) led to withdrawal of this drug. Since February 2011, the efficacy of IG was decreasing significantly, and the patient was referred to hematological practice for further treatment. We obtained the patient’s and her parents’ informed consent for a trial of 4 weekly doses rituximab (375mg/ square meter body surface after premedication with an antihistamine and 50mg prednisone). The infusions were given over a time-period of 5 weeks (May – June 2011) and were well tolerated. Platelet counts began to rise significantly after the 2. course and have remained above 200 000 since the beginning of July, 2011 without any other medication. Through the long-term course in this patient yet has to be followed, we feel that Rituximab (though not licensed for ITP in Germany) has been a useful option in this heavily pretreated patient. Because of good clinical results from US trials, like cases confirm previous reports of B.U. Mueller and C.M. Benett (Pediatr. Blood Cancer 2009; 52:259 and Blood 2006; 107:2639) we are now able to perform this treatment. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Cured primary hyperparathyroidism after fine-needle aspiration biopsy-induced parathyroid disappearance

2017 ◽  
Vol 2017 ◽  
Author(s):  
Elda Kara ◽  
Elisa Della Valle ◽  
Sara De Vincentis ◽  
Vincenzo Rochira ◽  
Bruno Madeo
Keyword(s):  
Primary Hyperparathyroidism ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Complete Disappearance ◽  
List Type ◽  
Fine Needle ◽  
Time Period ◽  
History Of

Summary Spontaneous or fine-needle aspiration (FNAB)-induced remission of primary hyperparathyroidism (PHPT) may occur, especially for cystic lesions. However, the disease generally relapses over a short time period. We present a case of PHPT due to an enlarged hyperfunctioning parathyroid that underwent long-term (almost 9 years) clinical and ultrasonographic remission after the disappearance of the lesion following ultrasound (US)-assisted FNAB. A 67-year-old woman with PHPT underwent biochemical and US examinations that confirmed the diagnosis and showed a lesion suggestive for parathyroid adenoma or hyperplasia. US-FNAB of the lesion confirmed its parathyroid nature by means of elevated levels of parathyroid hormone within the needle washing fluid. At the second visit, the patient referred slight neck swelling that resolved spontaneously in the days after the US-FNAB. At subsequent follow-up, the enlarged parathyroid was not found; it was visible neither with US nor with magnetic resonance imaging. Biochemical remission persists after 9 years. This is the first reported case of cure of PHPT after US-FNAB performed on a hyperfunctioning parathyroid resulting in its complete disappearance over a period of 9 years of negative biochemical and ultrasonographic follow-up. Learning points: Spontaneous or fine-needle aspiration-induced remission of primary hyperparathyroidism can occur. Both circumstances may present disease relapse over a variable time period, but definite remission is also possible even though long-term periodic follow-up should be performed. Parathyroid damage should be ruled out in case of neck symptomatology after parathyroid fine-needle aspiration or spontaneous symptomatology in patients with history of primary hyperparathyroidism.

scholarly journals A-74 COVID-19 and Post-Acute Sequelae of SARS-CoV-2 Infection (PASC): Acute and Longitudinal Analysis of Anosmia and Ageusia with Delayed Sudden-Onset Neuropsychiatric Symptoms

2021 ◽  
Vol 36 (6) ◽  
pp. 1116-1116
Author(s):  
Patricia A Pimental ◽  
Anna Ciampanelli ◽  
Eisha H Vora
Keyword(s):  
Depressive Disorders ◽  
Neuropsychiatric Symptoms ◽  
Neuropsychological Testing ◽  
Sudden Onset ◽  
Diagnostic Specificity ◽  
Total Recovery ◽  
Time Period ◽  
Smell Test ◽  
History Of

Abstract Objective Patients with COVID-19 and PASC may exhibit chemosensory dysfunction associated with acute neuroinflammation from immune system overactivation (Uzunova, Pallanti, & Hollander, 2021). Neuropsychiatric disturbances in patients with no history of anxiety or depression have also been reported. These central nervous system manifestations of COVID-19 may be sequelae of trans-olfactory and infralimbic tract penetration (Speth et al., 2020). Methods Our case involved a 52-year-old, right-handed, American Indian female, who at three months post neuropsychological evaluation, was diagnosed with laboratory confirmed COVID-19 with onset of complete anosmia and ageusia. Two months later, a sudden-onset of panic and depression occurred with no precipitating event. All symptoms were documented daily until return of function. Results Pre-COVID-19 neuropsychological testing revealed findings consistent with ophthalmologic/vestibular migraine and ruled out dementia, and formal anxiety and depressive disorders. Post-COVID-19 neuropsychological analysis and follow-up revealed that anosmia and ageusia had largely resolved after 8-months, and that the delayed sudden-onset panic and depression also resolved within that same time period. Conclusions A paucity of data exists concerning COVID-19 and PASC anosmia and ageusia, and sudden-onset neuropsychiatric symptoms. Our case is unique since neuropsychological testing preceded the COVID-19 infection, which provided a baseline of functioning (e.g., Pocket Smell Test: 3/3 baseline and 0/3 acute COVID-19) and pre-morbid diagnostic specificity. The present case findings align with Cappali and Gatti (2021) whereby 91% of patients reported olfactory recovery, with 53% total recovery after 8-months. No other known reports simultaneously documented detailed recovery of anosmia, ageusia and delayed sudden-onset panic and depression, and COVID-19 antibody laboratory testing.

Evaluation of Yttrium 90 (90Y) Ibritumomab Tiuxetan (Zevalin®) in Patients with Non-Hodgkin’s Lymphoma (NHL) Having Previously Received Autologous Stem Cell Transplant (ASCT).

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5238-5238 ◽  
Author(s):  
Samuel A. Jacobs ◽  
Barry McCook ◽  
Frank Torok ◽  
Norbert Avril ◽  
Nick Vidnovic ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Platelet Count ◽  
B Cell ◽  
Cell Lymphoma ◽  
Prior History ◽  
Ibritumomab Tiuxetan ◽  
Heavily Pretreated ◽  
History Of ◽  
Lymphomatous Involvement ◽  
Yttrium 90

Abstract Background: As the first radioimmunotherapeutic (RIT) agent approved for the treatment of relapsed or refractory B-cell NHL, yttrium 90 (90Y) ibritumomab tiuxetan (Zevalin®) has been shown to achieve durable responses in heavily pretreated NHL patients. In phase 1–2, the eligibility criteria for 90Y ibritumomab tiuxetan therapy excluded patients with hypocellular bone marrow (<15%), lymphomatous involvement >25%, or prior ASCT due to concern of depleting the bone marrow reserve. However, Kaminski et al previously demonstrated that a parallel RIT agent, 131I tositumomab, was safe and efficacious when administered after ASCT (Blood2000; 96:1259–66). We report our experience of using ibritumomab tiuxetan in NHL patients with a prior history of ASCT. Methods: Patients with histologically confirmed relapsed or refractory B-cell NHL, ≥18 years, platelet counts >100,000/mm3, bone marrow cellularity >15%, and lymphomatous involvement <25% were eligible for treatment. In a series of 40 patients treated with ibritumomab tiuxetan at the UPMC Cancer Center, 6 patients with prior ASCT were treated. A standard course of ibritumomab tiuxetan was given, with the therapeutic dose of 90Y ibritumomab tiuxetan administered at 0.3 mCi/kg (the initial patient, and another with platelet count ≥150,000/mm3) or the standard dose of 0.4 mCi/kg 90Y in the 4 remaining cases (baseline platelet count >150,000/mm3). Pretreatment diagnostic PET/CT scans were taken for all patients and evaluated for areas of lymphomatous involvement. Follow-up scans were performed approximately 12 weeks after treatment to assess patient response. Maximum toxicities were monitored weekly over a 12-week period after therapy and classified according to CTCAE v. 3.0 toxicity criteria. Results: Patients with a prior history of ASCT had received a minimum of 4 previous regimens (range, 4–7). Subjects presented with follicular NHL (n = 3), transformed NHL (n = 1), large cell lymphoma (n = 1), and mantle cell lymphoma (n = 1). Six patients were evaluable for toxicity and 5 patients were evaluable for response. Observed toxicities were consistent with those expected in this patient population, with 33% (2/6) and 17% (1/6) of patients experiencing grade 4 thrombocytopenia and grade 3 neutropenia, respectively. Episodes of bleeding or neutropenic fever were not observed. Of the 5 patients evaluable for response, 1 patient with follicular lymphoma had a complete response to ibritumomab tiuxetan as determined by FDG-PET imaging. Conclusions: Ibritumomab tiuxetan therapy is feasible and safe in NHL patients who have previously received ASCT. Heavily pretreated patients can benefit from the administration of ibritumomab tiuxetan although additional data are needed to further characterize the degree of clinical response after ASCT.

Safety and Efficacy Of Rituximab In adult’s Immune Thrombocytopenia (ITP) : Results After One-Year Of Follow-Up In 252 Patients From The Prospective French ITP-Ritux Registry

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 450-450 ◽  
Author(s):  
Mehdi Khellaf ◽  
Olivier Fain ◽  
Louis Terriou ◽  
Jean-François Viallard ◽  
Stéphane Cheze ◽  
...  
Keyword(s):  
Platelet Count ◽  
Conflicts Of Interest ◽  
Biological Data ◽  
Fixed Dose ◽  
Case Report Form ◽  
International Guidelines ◽  
Severe Hypotension ◽  
One Year

Introduction Adults with ITP usually respond to corticosteroids but typically relapse after discontinuation. Rituximab is thought to be an effective off-label second-line treatment but only few prospective data exist about its long-term efficacy and its long-term safety is a matter of concern. The tolerance and particularly the risk of severe infection is a crucial factor for assessing the risk/benefit ratio of this treatment in ITP. Three years ago, we opened a non-interventional prospective registry in France to investigate the safety (primary outcome) and the efficacy of rituximab in off-trials adults with ITP (ClinicalTrials.Gov: NC1101295). Two hundred and fifty two patients were included on a two-year period. A follow-up duration of five-year is planned. We report here the first results after one year of follow-up. Methods The ITP-Ritux registry was set up by the French reference center of adult’s immune cytopenias. Thirty one centers participated to the study. Consecutive patients diagnosed with primary ITP according to the international guidelines (Rodeghiero et al, Blood 2009) who were treated with rituximab were included. Patients with a secondary ITP and those who were previously treated with rituximab were excluded. Response to treatment was assessed according to international guidelines: complete response (CR) was defined by platelet count ³100x109/L and response (R) by a platelet count between 30 and 100x109/L with at least a doubling of the pre-treatment count. The prospective and sequential monitoring of rituximab efficacy and safety was made by using of a standardized electronic case report form. Study nurses visited each center regularly to update the clinical and biological data on the enrolled patients. Results Between July 2010 and July 2012, 252 patients (64% of females) with a mean age of 51±21 (16-97) years were enrolled. The median duration of ITP was 1.3 (0-56) years with 44 patients (17%) with a newly diagnosed ITP, 61 (24%) with persistent ITP and 147 (58%) with chronic ITP at time of rituximab treatment. The median platelet counts at time of ITP diagnosis and rituximab first infusion were respectively 18x109/L (1-100) and 17x109/L (1-186). Patients received a median of 2 treatment lines (range 0-7) before rituximab and 25 (10%) were splenectomized. The standard regimen of 375 mg/m2 weekly rituximab infusions for 4 weeks was administered to 179 patients whereas 73 patients (29%) received a fixed dose of 1000 mg on day 1 and day 15. At time of the present analysis, the median follow-up was 18 months and the one-year response was available in 209 patients. A one-year overall response was observed in 90/209 (43%) patients including a CR in 28% and a R in 15%. Nineteen patients who failed to respond to rituximab were splenectomized during the year following rituximab infusions. Sixty eight adverse events occurred in 47 patients (19%). Rituximab infusions have to be stopped in only 3 patients for severe hypotension, dyspnoea with laryngeal discomfort and reversible serum sickness respectively. Three other patients developed severe adverse event related to rituximab requiring admission in hospital including 1 episode of profound neutropenia while 6 episodes of infections occurred in 2 patients. Seven patients (2.7%) have died during follow-up, 52 to 385 days after rituximab infusions. All patients who died but one aged of 18 were 68 to 98-year old. Only one death could be potentially related to rituximab (enterococcus faecium pulmonary infection), 2 deaths were of unknown origin, other causes were: suicide (n=1), multiple myeloma (n=1) and fatal haemorrhage related to ITP (n=2). We did not observe any episode of progressive multifocal encephalopathy or any other case of opportunistic infection. Discussion and conclusion Our preliminary results based on the first large non-interventional prospective registry of ITP-adults treated with rituximab in the “real life” confirm that this treatment leads overall to 40% of response after one year of follow-up. Safety of rituximab at 1 year appears to be good since severe infections were uncommon and no opportunistic infections were observed. The ongoing monitoring and upcoming analysis with a planned follow-up up to 5-years will provide more data on long-term safety. Disclosures: No relevant conflicts of interest to declare.

Predicting factors for early and long-term mortality after thoracotomy in patients with primary lung cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e18562-e18562
Author(s):  
Cynthia van Arkel ◽  
Daphne Dumoulin ◽  
Bart van Straten ◽  
Joost ter Woorst ◽  
Saskia Houterman ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Regression Analysis ◽  
Primary Lung Cancer ◽  
Early Mortality ◽  
Predicting Factors ◽  
Time Period ◽  
History Of ◽  
Long Term Mortality

e18562 Background: To determine factors predicting early and long term mortality in patients who underwent a thoracotomy because of primary lung cancer. Methods: Data of patients who underwent a thoracotomy in the Catharina Hospital Eindhoven between 1 January 1995 and 1 January 2011 have been collected retrospectively from the medical files. Early mortality was defined as mortality <30 days after surgery. Last date of follow up was 1 January 2013. Patients were divided in three periods according to date of surgery (1: 1995-1999, 2: 2000-2004 and 3: 2005-2010). Predicting factors for early mortality were assessed with uni- and multivariate logistic regression analysis. For long term mortality and survival predicting factors were assessed using the Cox proportional hazards model and Kaplan-Meier survival curves. Results: In total 501 patients underwent a thoracotomy due to primary lung cancer. Overall 30 day mortality was 5.8% (n=29). Early mortality was 3.0% for lobectomy (n=289), 0.2% for bilobectomy (n=29) and 11% for pneumonectomy (n=109). Multivariate analysis showed that age over 70 (p=0.002), pneumonectomy (p=0.008) and a pre-operative VO2max of <15 ml/kg/min (p=0.02) were significant predictors of early mortality. With respect to long term survival, 308 (62%) patients had died at the end of the follow-up period. Median survival time was 44 months, with an overall 5- and 10- year survival of 45% and 27% respectively. The 5- and 10-year survival for stage I, II and III-IV was 61% and 37%; 46% and 30%;16% and 6.6%, respectively (p<0.0001, log rank test). Finally Cox regression analysis showed that stage (stage I (HR 0.30; 95% CI 0.22-0.42), stage II (HR 0.38; 95% CI 0.26-0.57) compared to stage III-IV, FEV1% ≤70% (HR 1.57; 95% CI 1.61-2.11), a history of cerebrovascular disease (CVD) (HR 1.97; 95% CI 1.20-3.23) and surgery in an earlier time period (1 (HR 1.50; 95% CI 1.04-2.17); 2 (HR 1.46; 95% CI 1.05-2.02) compared to 3) were significant predictors of long term mortality. Conclusions: In this cohort age, pneumonectomy and pre-operative VO2max are significant predictors of early mortality. Significant predictors of long term mortality are disease stage, FEV1%, a history of CVD and surgery in an earlier time period.

scholarly journals MON-098 Risk of Long-Term Endocrine Sequelae in Survivors of Progressing Childhood Optic Pathway Glioma Treated by Upfront Chemotherapy: Preliminary Analyses of 102 Subjects from the French Multicentric BB-SFOP Registry

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Helene Hippolyte ◽  
Emilie De Carli ◽  
Isabelle Pellier ◽  
Xavier Rialland ◽  
Regis Coutant
Keyword(s):  
Odds Ratio ◽  
Subsequent Treatment ◽  
Biological Assessment ◽  
Optic Pathway Glioma ◽  
Acth Deficiency ◽  
Early Predictors ◽  
History Of ◽  
The Mean ◽  
Few Data

Abstract For the brain tumor committee of SFCE (Societe ́ Française des Cancers de l’Enfant). Objective: Therapeutic approach favors chemotherapy as the first-line-treatment in progressing OPG. There are few data on long term endocrine outcomes of aggressive OPG treated by upfront chemotherapy. Our main objective was to describe the long-term endocrine sequelae in these patients and to identify potential early predictors of the endocrine involvement. Subjects and methods: Children diagnosed with OPG at an age younger than 16 years from the French multicentric BBSFOP registry were included. They were treated with upfront chemotherapy according to the BB-SFOP protocol in France between June 1990 and December 2004, and subsequent treatment (second-line chemotherapy, surgery, radiotherapy) was used depending on tumor progression. They underwent a late evaluation with clinical and biological assessment between January 2011 and March 2016. Results: One hundred and two patients were included in our study. The mean age at tumor diagnosis was 3.3±0.3 years. The mean time of follow-up was 13.9±3.7 years. A history of precocious puberty was present in 36% of the subjects. At least one endocrine deficiency was present in 93% of the subjects (GHD 74%, TSH deficiency 57%, ACTH deficiency 36%, hypogonadotropism 33%, gonadic deficiency 30%, diabetes insipidus 15%; inappropriate AVP secretion 7%). 37% of males and 39% of females were overweight or obese. Mean adult height, reached in 51 subjects, was -1.2±1.3 SDS in males, and -0.7±1.4 SDS in females. Chemotherapy only was protective from pituitary deficiencies (odds ratio 0.19 to 0.37, P &lt; 0.05). NF1 was protective from TSH and ACTH deficiencies (odds ratio 0.25 to 0.35, P &lt; 0.05). Tumor volume on diagnostic MRI was not predictive of pituitary deficiencies. Gonadic deficiency was significantly more frequent in males than females (46,5% vs 12.2%, P &lt; 0.05), and associated with chemotherapy only (OR 3.2, P &lt; 0.05) and NF1 (OR 4.8, P &lt; 0.05). Overweight/Obesity was associated with ACTH deficiency (OR 5, P &lt; 0.05).Conclusion: Obesity and late endocrine dysfunction were frequent in subjects treated by upfront chemotherapy for aggressive OPG during childhood. However, chemotherapy only, when possible, was protective from pituitary involvement.

scholarly journals Achieving Complete Cytogenetic Response and BCR-ABL PCRIS <1% within 12 Moths Are Important Goals for Imatinib Therapy in Newly Diagnosed, TKI-Naive Chronic Myeloid Leukemia Accelated Phase Patients

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3158-3158
Author(s):  
Hawk Kim ◽  
Eun-Jung Jang ◽  
Sung-Eun Lee ◽  
Won Sik Lee ◽  
Sukjoong Oh ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Platelet Count ◽  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Conflicts Of Interest ◽  
Cytogenetic Response ◽  
Molecular Response ◽  
Hematopoietic Stem ◽  
Long Term Outcome

Abstract Background; Accelerated phase of chronic myeloid leukemia (AP-CML) is not clearly defined yet. There are different definitions to classify AP. In European Leukemia Net (ELN) 2013 recommendation, considerable therapeutic approach of de novo AP would be hematopoietic stem cell transplantation (HSCT) followed by frontline tyrosine kinase inhibitor (TKI). To explore long-term efficacy of frontline imatinib (IM) treatment and early predictors of long-term outcome, we analyzed a total of 73 patients who received frontline IM.. Method; AP defined as a definition of ELN recommendation.. A progression to blastic phase and loss of response were considered as progression. Patients who had received HCT were censored at the time of HCT when calculating overall survival (OS) and progression-free survival (PFS). Results; Of 83 patients who diagnosed as AP, 73 patients received IM and other 10 patients had HSCT (n=7) or no treatment (n=3). Of 73 IM-treated patients, 36 patients maintained IM therapy and 37 patients discontinued IM with switch to 2G TKI (n=23) or HSCT (n=14). Analysis of baseline characteristics revealed prior cytogenetic response (CyR), and molecular response at 6 and 12 months for prediction of survivals. Clinical factors for better survival including Sokal score (p=0.203), Hasford sore (p=0.832), peripheral blood (PB) basophil count (p=0.374), spleen size (p=0.656), bone marrow (BM) promelocyte (p=0.839), BM basophil (p=0.478 were not significant. PB blast<10% (p=0.0670), PB eosinophil count>5% (p=0.031), platelet count >20x109/L (p=0.008), PB promyelocyte<2% (p=0.171), PB blast+promelocyte<20% (p=0.095), BM blast+promelocyte<20% (p=0.006), BM blast<10% (p=0.020) at diagnosis, achieving CCyR (p<0.001), achieving BCR-ABL PCRIS <10% (MR1.0) at 3M (p=0.020), BCR-ABL PCRIS <1% (MR2.0) at 6M (p=0.005) and MR2.0 at 12M (p=0.001) were included in multivariate analysis. Platelet count >20x109/L at diagnosis (p=0.002), achieving CCyR (p=0.007) and MR2.0 at 12M (p=0.048) were significant prognostic factors in multivariate analysis. Probability of 10Y OS for patients who acheived CCyR vs. no CCyR were 85.2% vs. 0% (p<0.001); median survival for patients without CCyR was 31.737 (95% CI, 16.269-47.147) months (Figure 2). Probabilities of 10Y OS for MR1.0 at 6M and MR2.0 at 12M were 81.3% vs. 59.7% (p=0.016) and 96.5% vs. 57.4% (p=0.003), respectively. However, time to CCyR<6M was not significant 10Y OS rate 75% vs. 67.6%, p=0.173). The 10Y PFS probability in patients who had acheived CCyR was 66.0% vs. 0% (p<0.001); median PFS for patients without CCyR was 9.462 (95% CI, 1.978-16.946) months. Probabilities of 10Y PFS in MR1.0 at 6M and MR2.0 at 12M were 63.2% vs. 44.9% (p=0.076) and 77.1% vs. 39.8% (p=0.005), respectively. Median PFS for patients not achieving MR1.0 at 6M and MR2.0 at 12M were 30.555 (95% CI, 0.0-61.252) and 22.867 (95% CI, 0.0-50.208), respectively. Time to CCyR<6M was not significant for PFS (10Y PFS rate 50.8% vs. 58.5%, p=0.828). Conclusion: Achievement of CCyR or achievement of MR1.0 at 12M was important goals not only in progression but also in survival. Therefore if a patient doesnÕt achieve the goals, the treatments need to be changed. Figure 1 Figure 1. Figure 2 Figure 2. Disclosures No relevant conflicts of interest to declare.

scholarly journals New historical data for long-term swordfish ecological studies in the Mediterranean Sea

2021 ◽  
Vol 13 (12) ◽  
pp. 5867-5877
Author(s):  
Brian R. MacKenzie ◽  
Teresa Romeo ◽  
Piero Addis ◽  
Pietro Battaglia ◽  
Pierpaolo Consoli ◽  
...  
Keyword(s):  
Mediterranean Sea ◽  
Fishery Management ◽  
Data Availability ◽  
Knowledge Based ◽  
Time Period ◽  
Before And After ◽  
Trap Fishery ◽  
History Of ◽  
The Mediterranean

Abstract. Management of marine fisheries and ecosystems is constrained by knowledge based on datasets with limited temporal coverage. Many populations and ecosystems were perturbed long before scientific investigations began. This situation is particularly acute for the largest and commercially most valuable species. We hypothesized that historical trap fishery records for bluefin tuna (Thunnus thynnus Linnaeus, 1758) could contain catch data and information for other, bycatch species, such as swordfish (Xiphias gladius Linnaeus, 1758). This species has a long history of exploitation and is presently overexploited, yet indicators of its status (biomass) used in fishery management only start in 1950. Here we examine historical fishery records and logbooks from some of these traps and recovered ca. 110 years of bycatch data (1896–2010). These previously neglected, but now recovered, data include catch dates and amounts in numbers and/or weights (including individual weights) for the time period before and after major expansion of swordfish fisheries in the Mediterranean Sea. New historical datasets such as these could help understand how human activities and natural variability interact to affect the long-term dynamics of this species. The datasets are online and available with open access via three DOIs, as described in the “Data availability” section of the article.

scholarly journals A Sudden Onset of Severe Thrombocytopenia While Using Evolocumab

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Ikuo Inoue ◽  
Yasuhiro Takenaka ◽  
Yoshitora Kin ◽  
Satoshi Yamazaki ◽  
Yuichi Ikegami ◽  
...  
Keyword(s):  
Platelet Count ◽  
Immunoglobulin Therapy ◽  
Sudden Onset ◽  
High Dose ◽  
Severe Thrombocytopenia ◽  
First Line Therapy ◽  
Thrombopoietin Receptor ◽  
Thrombopoietin Receptor Agonist ◽  
History Of ◽  
Coa Reductase

A 72-year-old man with a 10-year history of coronary heart disease started evolocumab treatment once a month after developing excess myalgia due to therapy with a 3-hydroxy-methylglutaryl CoA reductase inhibitor. No side effects such as myalgia symptoms had been reported during the first 14 months of evolocumab treatment; however, he suddenly presented with acute severe thrombocytopenia following the 14th treatment. His platelet count continued to decrease to a nadir of 1,000/μL. His platelet-associated immunoglobulin G level had elevated to 790 ng/107 cells. He started receiving a combination of steroid therapy, high-dose immunoglobulin therapy, and platelet transfusions, but the first-line therapy was ineffective. He was subsequently treated with a thrombopoietin receptor agonist, and his platelet count recovered to 250,000/μL.

scholarly journals Long-term, intermittent, low-level elephant endotheliotropic herpesvirus 1A viremia in a captive Asian elephant calf

2018 ◽  
Vol 30 (6) ◽  
pp. 917-919 ◽  
Author(s):  
Kendra L. Bauer ◽  
Erin Latimer ◽  
Mitch Finnegan
Keyword(s):  
Platelet Count ◽  
Clinical Signs ◽  
Asian Elephant ◽  
Elephas Maximus ◽  
Conventional Pcr ◽  
Low Level ◽  
Platelet Counts ◽  
Additional Information ◽  
Time Period

A 2-y-old male Asian elephant ( Elephas maximus), with an elevated platelet count (1,100 × 109/L [1,100 × 103/mm3]), tested positive for elephant endotheliotropic herpesvirus 1A (EEHV-1A) on conventional PCR (cPCR) of EDTA whole blood. No clinical signs were ever reported and no treatment was administered, but low-level viremia persisted for 2.5 y based on results of cPCR and/or real-time PCR (rtPCR). Sequencing confirmed that the EEHV-1A detected was identical at the beginning through the end of the time period. No other elephants in the herd tested positive for EEHV-1 during this time period. Platelet counts remained elevated throughout the viremia and throughout the animal’s life, and direct correlation between the elevated platelet counts and EEHV-1A viremia could not be confirmed. We document long-term, intermittent, low-level viremia of EEHV-1A and provide additional information to consider when determining if treatment is warranted in a case of EEHV infection.

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