Relation of tumor-cell ploidy to survival in children with medulloblastoma.

1993 ◽  
Vol 11 (11) ◽  
pp. 2211-2217 ◽  
Author(s):  
A J Gajjar ◽  
R L Heideman ◽  
E C Douglass ◽  
L E Kun ◽  
E H Kovnar ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Tumor Cell ◽  
Risk Group ◽  
Univariate Analysis ◽  
Flow Cytometric Analysis ◽  
High Risk Group ◽  
Low Risk ◽  
Clinical High Risk ◽  
Clinical Risk

PURPOSE To assess the value of tumor-cell ploidy as a predictor of survival in medulloblastoma. PATIENTS AND METHODS Ploidy determinations were based on the flow-cytometric analysis of cellular DNA content in fresh tumor specimens taken from 34 consecutively treated children with newly diagnosed medulloblastoma. Patients were assigned a high or low risk of failure depending on tumor size and invasiveness, and the presence or absence of metastatic disease. Treatment consisted of radiotherapy, with or without chemotherapy, according to institutional or cooperative group protocols. RESULTS Univariate analysis of candidate prognostic factors showed that only tumor-cell ploidy and clinical risk group had a statistically significant influence on survival. Patients with hyperdiploid stem lines (n = 9) had significantly longer survival times (P = .04) than did those with diploid lines (n = 20). The estimated 5-year survival probabilities (+/- SE) for these two subgroups were 89% +/- 11% and 48% +/- 13%, respectively. Although clinical risk status (high v low) showed essentially the same predictive strength as ploidy, the two features identified largely nonoverlapping subgroups. Thus, within the clinical high-risk group, it was possible to distinguish hyperdiploid patients whose 5-year survival rate (83% +/- 15%) was comparable to that of patients with localized, low-risk tumors. CONCLUSION This prospective study indicates that both ploidy and clinical risk group are important prognostic factors in medulloblastoma. Their combined use at diagnosis would distinguish patients who require more aggressive therapeutic intervention (diploid, clinical high-risk group) from those who could be expected to benefit most from standard treatment.

Adjuvant Chemotherapy Guidance for pT1-3N0-1 Breast Cancer Patients with HR+, HER2- subtype: a study based on SEER database

2021 ◽  
Author(s):  
juanjuan Qiu ◽  
Li Xu ◽  
Yu Wang ◽  
Jia Zhang ◽  
Jiqiao Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
High Risk ◽  
Cancer Patients ◽  
Risk Group ◽  
High Risk Group ◽  
Low Risk ◽  
Rank Test ◽  
Breast Cancer Patients ◽  
Group Score

Abstract Background Although the results of gene testing can guide early breast cancer patients with HR+, HER2- to decide whether they need chemotherapy, there are still many patients worldwide whose problems cannot be solved well by genetic testing. Methods 144 735 patients with HR+, HER2-, pT1-3N0-1 breast cancer from the Surveillance, Epidemiology, and End Results database were included from 2010 to 2015. They were divided into chemotherapy (n = 38 392) and no chemotherapy (n = 106 343) group, and after propensity score matching, 23 297 pairs of patients were left. Overall survival (OS) and breast cancer-specific survival (BCSS) were tested by Kaplan–Meier plot and log-rank test and Cox proportional hazards regression model was used to identify independent prognostic factors. A nomogram was constructed and validated by C-index and calibrate curves. Patients were divided into high- or low-risk group according to their nomogram score using X-tile. Results Patients receiving chemotherapy had better OS before and after matching (p < 0.05) but BCSS was not significantly different between patients with and without chemotherapy after matching: hazard ratio (HR) 1.005 (95%CI 0.897, 1.126). Independent prognostic factors were included to construct the nomogram to predict BCSS of patients without chemotherapy. Patients in the high-risk group (score > 238) can get better OS HR 0.583 (0.507, 0.671) and BCSS HR 0.791 (0.663, 0.944) from chemotherapy but the low-risk group (score ≤ 238) cannot. Conclusion The well-validated nomogram and a risk stratification model was built. Patients in the high-risk group should receive chemotherapy while patients in low-risk group may be exempt from chemotherapy.

An Automated and Quantitative Protein Expression-Based Classification System to Identify High Risk Multiple Myeloma Patients

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 735-735
Author(s):  
Alex Klimowicz ◽  
Paola Neri ◽  
Adnan Mansoor ◽  
Anthony Magliocco ◽  
Douglas A. Stewart ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
High Risk ◽  
Protein Expression ◽  
Classification System ◽  
Risk Group ◽  
Univariate Analysis ◽  
High Risk Group ◽  
Group Classification ◽  
Low Risk ◽  
High Expression

Abstract Background: Autologous stem cell transplantation (ASCT) has dramatically improved the survival of myeloma patients; however, this approach has significant toxicities and nearly 25% of MM patients progress within one year from their transplant. While gene expression profiling-based (GEP) molecular classification has permitted the identification of unresponsive high-risk patients, these approaches have proven too costly and complex to translate into clinical practice. Less expensive and more readily available methods are needed clinically to identify, at the time of diagnosis, MM patients who may benefit from more aggressive or experimental therapies. While protein-based tissue arrays offer such alternative, biases introduced by the “observer-dependent” scoring methods have limited their wide applicability. Methods: We have designed a simplified, fully automated and quantitative protein expression based-classification system that will allow us to accurately predict survival post ASCT in a cost effective and “observer-independent” manner. We constructed tissue microarrays using diagnostic bone marrow biopsies of 82 newly diagnosed MM patients uniformly treated with a dexamethasone based induction regimen and frontline ASCT. Using the HistoRx PM-2000 quantitative immunohistochemistry platform, coupled with the AQUA analysis software, we have examined the expression of the following proteins: FGFR3 which is associated with t(4;14), cyclin B2 and Ki-67 which are associated with cellular proliferation, TACI which is associated with maf deregulation, and phospho-Y705 STAT3 and p65NF-κB, which are associated with myeloma cell growth and survival. For FGFR3, patients were divided into FGFR3 positive and negative groups based on hierarchical clustering of their AQUA score. For all other proteins examined, based on AQUA scores, the top quartiles or quintiles of patients were classified as high expression groups. Based on the univariate analysis, patients were further classified as “High Risk” MM if they had been identified as high expressers of either TACI, p65NF-κB or FGFR3. The Kaplan-Meier method was used to estimate time to progression and overall survival. Multivariate analysis was performed using the Cox regression method. Results: 82 patients were included in this study. In univariate analysis, FGFR3 and p65NF-κB expression were associated with significantly shorter TTP (p=0.018 and p=0.009) but not OS (p=0.365 and p=0.104). TACI expression levels predicted for worse OS (p=0.039) but not TTP (p=0.384). High expression of Ki67 or phospho-Y705 STAT3 did not affect survival. Of the 82 cases, 67 were included in the multivariate analysis since they had AQUA scores available for all markers: 26 (38.8%) were considered as High Risk by their AQUA scores and had significantly shorter TTP (p=0.014) and OS (p=0.006) compared to the Low Risk group. The median TTP for the Low and High Risk groups was 2.9 years and 1.9 years, respectively. The 5-years estimates for OS were 60.6% for the High Risk group versus 83.5% for the Low Risk group. Multivariate analysis was performed using del13q and our risk group classification as variables. Both our risk group classification and del13q were independent predictors for TTP, having 2.4 and 2.3 greater risk of relapse, respectively. Our risk group classification was the only independent predictor of OS with the High Risk group having a 5.9 fold greater risk of death. Conclusions: We have found that the expression of FGFR3, TACI, and p65NF-κB, in an automated and fully quantitative tissue-based array, is a powerful predictor of survival post-ASCT in MM and eliminates the “observer-dependent” bias of scoring TMAs. A validation of this “High Risk” TMA based signature is currently underway in larger and independent cohorts. Figure Figure

Varying Importance of Prognostic Factors in Subgroups of Myelodysplastic Syndromes Defined by Blast Count, Cytogenetic Risk Group, or WHO Classification.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2776-2776
Author(s):  
Andrea Kuendgen ◽  
Corinna Strupp ◽  
Kathrin Nachtkamp ◽  
Barbara Hildebrandt ◽  
Rainer Haas ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
High Risk ◽  
Research Funding ◽  
Risk Group ◽  
Univariate Analysis ◽  
Risk Groups ◽  
High Risk Group ◽  
Intermediate Risk ◽  
Blast Count

Abstract Abstract 2776 Poster Board II-752 Introduction: We wondered whether prognostic factors have similar relevance in different subpopulations of MDS patients. Methods: Our analysis was based on patients with primary, untreated MDS, including 181 RA, 169 RARS, 649 RCMD, 322 RSCMD, 79 5q-syndromes, 290 RAEB I, 324 RAEB II, 266 CMML I, 64 CMML II, and 209 RAEB-T. The impact of prognostic variables in univariate analysis was compared in subpopulations of patients defined by medullary blast count, namely <5%, ≥5% (table), ≥10%, and ≥20% (not shown), as well as 3 subpopulations defined by the cytogenetic risk groups according to IPSS (table). Multivariate analysis of prognostic factors was performed for cytogenetically defined subgroups and WHO-subtypes. Results: Strong prognostic factors in all blast-defined subgroups were hemoglobin, transfusion dependency, increased WBC, age, and LDH. However, all variables became less important in patients with ≥20% blasts (RAEB-T) and increased WBC was rare. Platelet count and cytogenetic risk groups were relevant in patients with <5%, ≥5%, and ≥10% marrow blasts, but not in RAEB-T. Marrow fibrosis was important in patients with <5% or ≥5% blasts, but not ≥10%. Gender and ANC <1000/μl were significant only in patients with a normal blast count. Furthermore, we looked for the effect of the karyotypes, relevant for IPSS scoring (-Y, del5q, del20q, others, del7q/-7, complex), and found a comparable influence on survival, irrespective whether patients had < or ≥5% marrow blasts. In subpopulations defined by cytogenetic risk groups, several prognostic factors were highly significant in univariate analysis, if patients had a good risk karyotype. These included hemoglobin, sex, age, LDH, increased WBC, transfusion need, and blast count (cut-offs 5%, 10%, and 20%). In the intermediate risk group only LDH, platelets, WBC, and blasts were significant prognostic factors, while in the high risk group only platelets and blast count remained significant. Multivariate analysis was performed for the cytogenetic risk groups and for subgroups defined by WHO subtypes. The analysis considered blast count (</≥5%), hemoglobin, platelets, ANC, cytogenetic risk group, transfusion need, sex, and age. In the subgroup including RA, RARS, and 5q-syndrome, LDH, transfusion, and age in descending order were independent prognostic parameters. In the RCMD+RSCMD group, karyotype, age, transfusion, and platelets were relevant factors. In the RAEB I+II subgroup, the order was hemoglobin, karyotype, age, and platelets, while in CMML I+II only hemoglobin had independent influence. In RAEB-T none of the factors examined was of independent significance. Looking at cytogenetic risk groups, in the favorable group, several variables independently influenced survival, namely transfusion, blasts, age, sex, and LDH (in this order). Interestingly, in the intermediate and high risk group, only blast count and platelets retained a significant impact. Conclusion: Univariate analysis showed prognostic factors (except ANC) included in IPSS and WPSS are relevant in most subgroups defined by marrow blast percentage. However, they all lose their impact if the blast count exceeds 20%. Regarding cytogenetic risk groups, several prognostic factors lose their influence already in the intermediate risk group. This underscores the prognostic importance of MDS cytogenetics. Multivariate analysis showed MDS subpopulations defined by WHO types also differ with regard to prognostic factors. In particular, CMML and RAEB-T stand out against the other MDS types. Disclosures: Kuendgen: Celgene: Honoraria. Hildebrandt:Celgene: Research Funding. Gattermann:Novartis: Honoraria, Participation in Advisory Boards on deferasirox clinical trials. Germing:Novartis, Celgene: Honoraria, Research Funding.

Clinical assessment and angiographic finding in patients with non ST-elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Elbeyali
Keyword(s):  
Myocardial Infarction ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Low Risk ◽  
St Elevation Myocardial Infarction ◽  
Intermediate Risk ◽  
Coronary Syndrome ◽  
Clinical Risk ◽  
St Elevation

Abstract Background Non ST-elevation myocardial infarction is considered the intermediate form of acute coronary syndrome between unstable angina and ST-elevation myocardial infarction. Blockage either occurs in a minor coronary artery or causes partial obstruction of a major coronary artery. The rate of NSTEMI has increased to be 50% of all acute coronary syndrome. Purpose To compare some demographic, clinical risk assessments and angiographic data among high, intermediate and low risk NSTEMI patients. Methods We classified one hundred twenty (120) NSTEMI patients into 3groups by GRACE risk score (high risk group &gt;140, intermediate risk group from 109 to 140 and low risk group ≤108). The patients were evaluated by personal history taking, risk factors, clinical examination, ECG, laboratory investigations, echocardiography and percutaneous coronary intervention. Results We found that low risk group percentage was 47.5%, intermediate risk group percentage was 32.5% and high-risk group percentage was 20%. As regarding culprit lesion, LAD represent most affected artery (48.3% of patients).Recurrent ischemia and MI represent the highest percentage of major adverse cardiac event (MACE) among studied groups. All patients with LM disease have a MACE while 41.2% of MACE patients have significant LAD lesion. As time of intervention delayed the incidence of MACE increases among different groups. High risk group has significantly high percentage of type C lesion and TIMI 0/1 while type A lesion and TIMI III lesion highest among low risk patients. As regarding contour of the lesion, the irregularity increases as the clinical risk increases. Also as regarding occlusion of culprit artery, the incidence of total occlusion increases as the clinical risk increases. Conclusions We recommend selection of high-risk NSTEMI patient to direct them for early invasive therapy. Very high-risk directed for immediate revascularization like STEMI patient. NSTEMI considered precursors to STEMI and an early warning signal that aggressive medical intervention needed. Association between time to intervention Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): University budget

scholarly journals Risk-adapted therapy for early-stage extranodal nasal-type NK/T-cell lymphoma: analysis from a multicenter study

Blood ◽  
2015 ◽  
Vol 126 (12) ◽  
pp. 1424-1432 ◽  
Author(s):  
Yong Yang ◽  
Yuan Zhu ◽  
Jian-Zhong Cao ◽  
Yu-Jing Zhang ◽  
Li-Ming Xu ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Multicenter Study ◽  
Cell Lymphoma ◽  
Risk Group ◽  
Early Stage ◽  
High Risk Group ◽  
Low Risk ◽  
Nasal Type ◽  
Key Points

Key Points Patients with early-stage extranodal nasal-type NKTCL were classified as low risk or high risk using 5 independent prognostic factors. Risk-adapted therapy of RT alone for the low-risk group and RT consolidated by CT for the high-risk group proved the most effective treatment.

Evaluation of Early Prognostic Factors in Patients With Pancreatic Ductal Adenocarcinoma Receiving Gemcitabine Together With Nab-paclitaxel

2021 ◽  
Vol 1 (5) ◽  
pp. 399-409
Author(s):  
WATARU IZUMO ◽  
RYOTA HIGUCHI ◽  
TORU FURUKAWA ◽  
TAKEHISA YAZAWA ◽  
SHUICHIRO UEMURA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
High Risk ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Risk Group ◽  
High Risk Group ◽  
Low Risk ◽  
Nutrition Status ◽  
Ductal Adenocarcinoma ◽  
Changing Rate

Background: Gemcitabine together with nab-paclitaxel (GnP) has been shown to improve outcomes in patients with pancreatic ductal adenocarcinoma (PDAC). However, the predictive markers for treatment effects remain unclear. This study aimed to identify early prognostic factors in patients with PDAC receiving GnP. Patients and Methods: We analyzed 113 patients who received GnP for PDAC and evaluated the relationship between clinical factors and outcomes. Results: The median survival time (MST) was 1.2 years. In multivariate analysis, baseline carbohydrate antigen 19-9 (CA19-9) ≥747 U/ml [hazard ratio (HR)=1.9], baseline controlling nutrition status (CONUT) score ≥5 (HR=3.7) and changing rate of CA19-9 after two GnP cycles ≥0.69 (HR=3.7) were independent risk factors for poor prognosis. When examining outcomes according to pre-chemotherapeutic measurable factors (baseline CA19-9 and CONUT), the MSTs of patients with pre-chemotherapeutic zero risk factors (pre-low-risk group, n=63) and one or more risk factors (pre-high-risk group, n=50) were 1.7 and 0.65 years (p<0.001), respectively. The MST for those with a changing rate of CA19-9 after two GnP cycles <0.69 and ≥0.69 was significantly different in both groups (2.0 and 1.2 years in the pre-low-risk group, p<0.001; 1.0 and 0.52 years in the pre-high-risk group, p<0.001). Conclusion: These results may be useful for decision-making regarding treatment strategies in patients with PDAC receiving GnP.

Prognostic Factors in Primary Chronic Myelofibrosis in Patients Aged Less Than 70 Years: A Report on 207 Patients with the Description of a Scoring System and Its Validation on 100 Other Patients.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1524-1524 ◽  
Author(s):  
Tetsuya E. Tanimoto ◽  
Kazuya Shimoda ◽  
Takuhiro Yamaguchi ◽  
Takashi Okamura ◽  
Hideaki Mizoguchi ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Risk Group ◽  
Survival Rates ◽  
High Risk Group ◽  
Low Risk ◽  
Data Set ◽  
Hematopoietic Stem ◽  
External Data

Abstract Primary chronic myelofibrosis (PCMF) is a rare myeloproliferative disorder among young individuals. Conventional therapies are often ineffective and only palliative. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) using myeloablative or reduced-intensity conditioning offers the only possible curative treatment. However, the course of PCMF is highly variable from only a few months to more than a decade. To identify PCMF patients for allo-HSCT candidates, we analyzed a Japanese cohort aged less than 70 years and established a new prognostic system based on simple clinical parameters. In a training series, we used 207 patients with complete data, whose diagnoses were made over a period of 10 years (1988 to 1997) (Okamura T et al. Int J Hematol 2001). Patients who received allo-HSCT were not included. Using the Cox proportional hazard regression model, four initial variables were independently associated with shorter survival: Male sex (hazard ratio [HR], 2.26; 95% confidence interval [C.I.], 1.35–3.46), Hemoglobin < 10 g/dL (HR, 3.01; 95% C.I., 1.83–4.93), the presence of constitutional symptoms (fever, sweats and weight loss) (HR, 2.33; 95% C.I., 1.33–4.06), and circulating blasts ≥ 1% (HR, 1.53; 95% C.I., 1.00–2.33). Based on the above criteria, two groups were identified; a low-risk goup with up to one adverse prognostic factor and a high-risk group with two or more adverse prognostic factors. With the median follow-up time of 83 months, the median survival was 292 months in the low-risk group, and 66 months in the high-risk group, respectively (P <.0001, Figure). An external data set of 100 patients who diagnosed after 1999 was used for validation. The 4 prognostic systems separated the validation series in groups with significantly different survival rates despite the median follow-up time of 12 months. A simple prognostic model using the combination of sex, Hb level, constitutional symptoms and circulating blasts was developed and validated. This model might help to select patients with PCMF for treatment and to evaluate therapeutic results including allo-HSCT. Figure Figure

Bone Marrow Cellularity Is a Single Most Important Independent Prognostic Factor In AML Patients with t(8;21)

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 1707-1707
Author(s):  
Ho-Jin Shin ◽  
Jooseop Chung ◽  
Hyeoung Joon Kim ◽  
Sang Kyun Sohn ◽  
Yoo-Hong Min ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Prognostic Factor ◽  
Risk Group ◽  
High Risk Group ◽  
Independent Prognostic Factor ◽  
Low Risk ◽  
Intermediate Risk ◽  
Group 5 ◽  
Wbc Count

Abstract Abstract 1707 Core binding factor AML including t(8;21) and inv(16) have been associated with a relatively favorable prognosis compared with patients with normal or adverse karyotypes, and treated similarly. However, both t(8;21) and inv(16) AML seem to differ with respect to several biologic features and several reports demonstrated inferior outcome of t(8;21) compared with inv(16). Advanced age, higher WBC or granulocytic count, as well as CD56 expression or granulocytic sarcoma have been reported as poor prognostic factors in t(8;21) patients. Higher bone marrow (BM) blasts, lower platelets, and non-white race in t(8;21) AML adversely affected the probability to achieve CR. The KIT mutation is associated with poor prognosis in AML1-ETO-positive AML. Five-year survival rate was only around 40% in patients with t(8;21) having poor prognostic factors. Several chemotherapeutic strategies have been reported, among which high-dose cytarabine (HDAC) is generally the most effective option for successful postremission therapy. Furthermore, none of the randomized studies disclosed an advantage of allogeneic SCT (alloSCT) in this group of patients, given the relatively high treatment-related death (TRD) rate. Patients with t(8;21) AML with unfavorable prognosis may benefit from intensive postremission therapy such as early hematopoietic SCT. We conducted a retrospective study to investigate whether postremission therapies impact on survival according to prognostic factors in 132 AML patients with t(8;21) achieving first CR. Univariate analyses of prognostic factors for survival were performed in the patients with t(8;21), as well as more limited population of chemotherapy (CTx) group according to postremission therapies. The BM cellularity was a single most important independent prognostic factor on survival when using BM cellularity cutoffs as 90%. The 5-year overall survival (OS) in patients with t(8;21) and CTx group were significantly lower at 49.7% and 44.3% in patients with ≥ 90% BM cellularity, compared with 81.4% and 81.9% in those with < 90% BM cellularity, respectively (P = 0.001 and 0.027, respectively). The only other prognostic factor that influenced OS in CTx group was WBC count with cutoffs as 9.1 × 109/L. High WBC count was trend towards poor OS in CTx group (P = 0.067). In multivariate analysis, BM cellularity appeared to be the only independent prognostic factor for OS in either AML patients with t(8;21) (P = 0.002) or CTx group (P = 0.055). Interestingly, we found positive correlation between BM cellularity and WBC count (P = 0.013), peripheral blood (PB) blast percentage (P = 0.001) and serum LDH level (P = 0.017) but not hemoglobin level and BM blast percentage in a linear regression model. And also, we confirmed negative correlation between BM cellularity and platelet count (P = 0.009). It is speculated that BM cellularity represents on poor prognostic factors including WBC and platelet counts, and PB blast percentage in patients with t(8;21). By combining dichotomized WBC count and BM cellularity in a univariate analysis for OS in CTx group, three risk groups could be established: low risk group, WBC count less than 9.1 × 109/L and BM cellularity less than 90%; intermediate risk group, WBC count ≥ 9.1 × 109/L and BM cellularity less than 90%; high risk group, BM cellularity ≥ 90%. In CTx group, 5-year OS was 81.9% in low risk group, 64.8% in intermediate group, and 32.1% in high risk group (P = 0.041). In alloSCT group, 5-year OS was 94.1% in low risk group, 29.1% in intermediate risk group, and 77.8% in high risk group (P = 0.042). In low risk group, 5-year OS was 81.9% in CTx group, 65.6% in autologous SCT (autoSCT) group, 94.1% in alloSCT group. In intermediate risk group, 5-year OS was 64.8% in CTx group, 29.1% in alloSCT group. In high risk group, 5-year OS was 32.1% in CTx group, 52.5% in autoSCT group, and 77.8% in alloSCT group. We found that BM cellularity was the most powerful independent prognostic factor in AML patients with t(8;21). The newly proposed model using BM cellularity and WBC count demonstrated a simple and valid measurement as main prognostic factor. We suggest a risk-adapted postremissin strategies based on this prognostic model for AML with t(8;21) such as low and intermediate risk patients receiving three cycles or more than three cycles of HDAC CTx and high risk patients undergoing SCT in first CR as postremission therapy. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Echocardiography and EuroSCORE II for the stratification of low-gradient severe aortic stenosis and preserved left ventricular ejection fraction

2021 ◽  
Author(s):  
Yan Fan ◽  
Hong Shen ◽  
Brandon Stacey ◽  
David Zhao ◽  
Robert J. Applegate ◽  
...  
Keyword(s):  
High Risk ◽  
Left Ventricular Ejection Fraction ◽  
Risk Group ◽  
Severe Aortic Stenosis ◽  
Left Ventricular ◽  
High Risk Group ◽  
Low Risk ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Risk Patients

AbstractThe purpose of this study was to explore the utility of echocardiography and the EuroSCORE II in stratifying patients with low-gradient severe aortic stenosis (LG SAS) and preserved left ventricular ejection fraction (LVEF ≥ 50%) with or without aortic valve intervention (AVI). The study included 323 patients with LG SAS (aortic valve area ≤ 1.0 cm2 and mean pressure gradient < 40 mmHg). Patients were divided into two groups: a high-risk group (EuroSCORE II ≥ 4%, n = 115) and a low-risk group (EuroSCORE II < 4%, n = 208). Echocardiographic and clinical characteristics were analyzed. All-cause mortality was used as a clinical outcome during mean follow-up of 2 ± 1.3 years. Two-year cumulative survival was significantly lower in the high-risk group than the low-risk patients (62.3% vs. 81.7%, p = 0.001). AVI tended to reduce mortality in the high-risk patients (70% vs. 59%; p = 0.065). It did not significantly reduce mortality in the low-risk patients (82.8% with AVI vs. 81.2%, p = 0.68). Multivariable analysis identified heart failure, renal dysfunction and stroke volume index (SVi) as independent predictors for mortality. The study suggested that individualization of AVI based on risk stratification could be considered in a patient with LG SAS and preserved LVEF.

scholarly journals SARS-CoV-2 Seroprevalence in Healthcare Workers in Germany: A Follow-Up Study

2021 ◽  
Vol 18 (9) ◽  
pp. 4540
Author(s):  
Johannes Korth ◽  
Benjamin Wilde ◽  
Sebastian Dolff ◽  
Jasmin Frisch ◽  
Michael Jahn ◽  
...  
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
Risk Group ◽  
Close Contact ◽  
Virus Transmission ◽  
High Risk Group ◽  
Low Risk ◽  
University Hospital ◽  
Intermediate Risk ◽  
Igg Antibody

SARS-CoV-2 is a worldwide challenge for the medical sector. Healthcare workers (HCW) are a cohort vulnerable to SARS-CoV-2 infection due to frequent and close contact with COVID-19 patients. However, they are also well trained and equipped with protective gear. The SARS-CoV-2 IgG antibody status was assessed at three different time points in 450 HCW of the University Hospital Essen in Germany. HCW were stratified according to contact frequencies with COVID-19 patients in (I) a high-risk group with daily contacts with known COVID-19 patients (n = 338), (II) an intermediate-risk group with daily contacts with non-COVID-19 patients (n = 78), and (III) a low-risk group without patient contacts (n = 34). The overall seroprevalence increased from 2.2% in March–May to 4.0% in June–July to 5.1% in October–December. The SARS-CoV-2 IgG detection rate was not significantly different between the high-risk group (1.8%; 3.8%; 5.5%), the intermediate-risk group (5.1%; 6.3%; 6.1%), and the low-risk group (0%, 0%, 0%). The overall SARS-CoV-2 seroprevalence remained low in HCW in western Germany one year after the outbreak of COVID-19 in Germany, and hygiene standards seemed to be effective in preventing patient-to-staff virus transmission.

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