Prognostic factors in patients with advanced renal carcinoma.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 391-391
Author(s):  
C. Muriel ◽  
E. Esteban ◽  
A. Astudillo ◽  
P. Martinez-Camblor ◽  
N. Corral ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Retrospective Cohort ◽  
Poor Prognosis ◽  
Renal Carcinoma ◽  
Good Prognosis ◽  
Biological Agents ◽  
Enhanced Expression ◽  
Favorable Prognostic Factor ◽  
Low Expression

391 Background: A retrospective cohort of 135 patients with advanced RCC treated with biological agents and/or cytokines (CK) was analysed between July 1996 and February 2010. Methods: The expression of several biomarkers by immunohistochemistry and 2 analytical variables: thrombocytosis and neutrophilia were analysed and were correlated with prognosis. Results: 67 patients were treated only with biological agents and 68 with CK (23 received also biological agents). The univariate statistical analysis showed that the enhanced expression of HIF-1alpha correlated with a poor prognosis in patients treated with sunitinib (PFS was 5.4 vs. 13.4 months in those with low expression, p=0.001). The overexpression of ACIX was associated to a better prognosis in patients that received biological agents (PFS was 18.3 vs. 5.2 months in those with decreased expression, p<0.001; OS was 32.1 vs. 7.8 months, p<0.001), including sunitinib (PFS was 16.8 vs. 5.5 months, p<0.001), sorafenib (PFS was 8 vs 3.5 months, p<0.001)) and CK (PFS was 6.3 vs. 2.7 months, p=0.003; OS was 32.9 vs. 5.9 months, p=0.001). Positive PTEN was related to a good prognosis in patients treated with sunitinib (PFS was 15.1 vs. 6.5 months, p=0.003) and CK (PFS was 7.5 vs. 3.8 months, p=0.037, OS was 13.7 vs 7.9 months, p=0.039). The increased expression of p21 was related to a poor prognosis in patients that received biological agents (PFS was 5.9 vs. 16.8 months with high expression, p=0.024), including sunitinib (PFS was 6.2 vs 18.9 months, p<0.001), sorafenib (PFS was 4 vs 9 months, p=0.013) and CK (PFS was 3.9 vs. 7.5 months, p<0.001). Thrombocytosis was related to a poor prognosis in patients treated with CK (PFS was 2.6 vs. 5.1 months p=0.017; OS was 5.9 vs. 14.3 months p=0.010). Neutrophilia was related to a poor prognosis in patients that received CK (PFS was 2.6 vs. 5.7 months, p=0.019; OS was 5.9 vs. 12.8 months, p=0.035). In the multivariate analysis, the overexpression of ACIX was a favorable prognostic factor independent of PFS with a HR of 0.107 (p<0.001) and OS with a HR of 0.055 (p<0.001). Conclusions: Our experience has suggested the utility of de HIF-1alpha, ACIX, PTEN, p21, thrombocytosis and neutrophilia as prognostic factors in patients with advanced RCC. ACIX has shown to be an independent prognostic factor. No significant financial relationships to disclose.

Prognostic factor of distal bile duct cancer (DBDC) and ampullary cancer (AC) after pancreatoduodenectomy.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 333-333
Author(s):  
Shinjiro Tomiyasu ◽  
Keita Sakamoto ◽  
Mitsuhiro Inoue ◽  
Masayoshi Iizaka ◽  
Nobuyuki Ozaki ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Poor Prognosis ◽  
Univariate Analysis ◽  
Good Prognosis ◽  
Tract Cancer ◽  
Node Metastasis ◽  
Duodenal Invasion ◽  
Duct Cancer ◽  
Pancreatic Invasion

333 Background: Ampullay cancer (AC) is relatively good prognosis in the biliary tract cancer. Such as LN metastasis, pancreatic invasion is a prognostic factor in AC. On the other hand, Distal bile duct cancer (DBDC) is somewhat good prognosis in the biliary tract cancer. Such as ductal resection margin positive is a prognostic factor in DBDC. There are few papers considered to both difference. Therefore, we conducted this study to examine the difference of AC and DBDC. Methods: To evaluate Cancer-Specific Survival (CaSS), Recurrence-Free Survival (RFS) and prognostic factors after pancreatoduodenectomy (including pylorus-preserving pancreatoduodenectomy: PPPD, subtotal stomach-preserving pancreatoduodenectomy: SSPPD) based on a series of 80 patients of AC and 36 patients of DBDC from 1996 to 2015. We reviewed and analyzed the clinicopathologic data, recurrence and survival. Results: Five years CaSS and RFS of AC were 72.3% and 72.5%. In univariate analysis, pancreatic invasion, R1or R2 resection, duodenal invasion and lymph node metastasis are significantly poor prognosis. In multivariate analysis, pancreatic invasion and R1or R2 resection are poor prognostic factors (pancreatic invasion, p = 0.0012, hazard ratio (HR) 5.65 [confidence interval (CI) 1.92-19.5 95%], R1or R2 resection, p = 0.0043, HR 6.22 [CI 1.68-40.2 95%]). On the other hand, five years CaSS and RFS of DBDC were 35.8% and 46.8%. In univariate analysis, pancreatic invasion (+) ≥ 5 mm in depth, and duodenal invasion are significantly poor prognosis. In multivariate analysis, duodenal invasion is the only poor prognostic factors (p = 0.0227, HR 2.90 [CI 1.16-7.39 95%]). Conclusions: DBDC is considerable poor prognosis compared with AC. Lymph node metastasis is not prognostic factor depends on D2 LN dissection in AC, than pancreatic invasion. Cancer cells invaded pancreatic parenchyma in AC; pancreatic invasion may be the most important prognostic factor by biology-like pancreatic cancer. Duodenal invasion in DBDC was prognostic factor reflects the degree of development of the cancer beyond pancreatic parenchyma. Further clinicopathological and biological studies are needed to confirm our findings.

Prognostic factors for response to systemic treatments carried out in patients with advanced renal carcinoma.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 369-369
Author(s):  
C. Muriel ◽  
E. Esteban ◽  
P. Martinez-Camblor ◽  
A. Astudillo ◽  
G. Crespo ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Renal Carcinoma ◽  
Systemic Treatment ◽  
Independent Predictor ◽  
Biological Agents ◽  
Prediction Of Response ◽  
Systemic Treatments ◽  
To Receive

369 Background: The analysis of predictive factors of response could help to select those patients with advanced renal cell carcinoma (RCC) who would be good candidates for systemic treatments Methods: The expression of several biomarkers was retrospectively analysed by immunohistochemistry (IHC), as well as 2 analytical variables: thrombocytosis and neutrophilia, in 135 patients with advanced RCC treated with cytokines (CK) and/or biological agents and was correlated to the response. Results: 67 patients were treated only with biological agents and 68 with CK (23 treated also with biological agents). Univariate statistical analysis: HIF-1alpha did not correlate significantly with the response to these drugs. The overexpression of ACIX was associated to a larger response (%) to biological agents such as sunitinib (65.9 vs. 16.7 p<0.001) or sorafenib (61.9 vs 0 p=0.007), and CK (22.6 vs. 0 p=0.038). PTEN showed a predictive value for response (%) to sunitinib (70.8 vs. 34.1 with PTEN negative p=0.005). p21 was associated to a lower response (%) with sunitinib (35.9 vs. 65.4 with p=0.025). Thrombocytosis was not significantly associated with the response (%) to biological agents, although it was associated to CK (0 vs. 20 without thrombocytosis p=0.017). Neutrophilia correlated with a smaller response to biological agents (29.6 vs. 57.5 without neutrophilia, p=0.045), although it did not associate with a response to CK. In the multivariate analysis, overexpression of ACIX was an independent predictor of a larger response to biological agents and CK with an OR of 8,773 (p<0.001). Conclusions: Our findings prove the usefulness of ACIX to select patients with advanced RCC candidates to receive systemic treatment. PTEN and p21 could be important in the prediction of response to sunitinib. Thrombocytosis and neutrophilia appear to relate to the response to CK and biological agents respectively. No significant financial relationships to disclose.

scholarly journals Clinical Features and Prognostic Factors of Acute Ischemic Stroke Related to Malignant Gastrointestinal Tumor

2021 ◽  
Vol 12 ◽  
Author(s):  
Yating Liu ◽  
Xin Li ◽  
Feixue Song ◽  
Xin Yan ◽  
Zhijian Han ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Prognostic Factors ◽  
Acute Ischemic Stroke ◽  
Malignant Tumor ◽  
Poor Prognosis ◽  
Good Prognosis ◽  
Imaging Features ◽  
Prognosis Group ◽  
D Dimer

Objectives: To analyze the clinical and imaging features of acute ischemic stroke (AIS) related to gastrointestinal malignant tumor, and to explore the prognostic factors.Methods: Clinical data of consecutive patients with gastrointestinal malignant tumor complicated with AIS admitted to the Department of Neurology and Oncology in Lanzhou University Second Hospital from April 2015 to April 2019 were retrospectively analyzed. Patients were divided into good prognosis (mRS 0–2) and poor prognosis (mRS &gt; 2) based on a 90-day mRS score after discharge. The multivariate logistic regression model was used to analyze the prognostic factors.Results: A total of 68 patients were enrolled with an average age of 61.78 ± 6.65 years, including 49 men (72.06%). There were 18 patients in the good prognosis group and 50 patients in the poor prognosis group. The univariate analysis showed that Hcy, D-dimer, thrombin–antithrombin complex (TAT), and three territory sign in magnetic resonance imaging (MRI) were the risk factors for poor prognosis. Multivariate analysis showed that increased D-dimer (OR 4.497, 95% CI 1.014–19.938) and TAT levels (OR 4.294, 95% CI 1.654–11.149) were independent risk factors for the prognosis in such patients.Conclusion: Image of patients with gastrointestinal malignant tumor-related AIS is characterized by three territory sign (multiple lesions in different vascular supply areas). Increased TAT and D-dimer levels are independent prognostic risk factors. TAT is more sensitive to predict prognosis than D-dimer.

Prognostic significance of immunohistochemical markers in endometrial cancer treated with chemotherapy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16551-e16551
Author(s):  
S. R. Lord ◽  
N. Vasudev ◽  
S. Knight ◽  
V. Speirs ◽  
G. Hall
Keyword(s):  
Endometrial Cancer ◽  
Prognostic Factors ◽  
Poor Prognosis ◽  
Early Stage ◽  
Good Prognosis ◽  
Serous Carcinoma ◽  
Positive Staining ◽  
Endometrioid Adenocarcinoma ◽  
Similar Frequency ◽  
Early Stage Endometrial Cancer

e16551 Background: The proportion of patients receiving chemotherapy for endometrial cancer is increasing both in the adjuvant and advanced setting. The literature describes many prognostic immunohistochemical factors in early stage endometrial cancer, the majority of whom will not receive chemotherapy. The aim of this study was to describe the biomarker expression for endometrial tumours treated with chemotherapy and to assess what constitutes a favourable and unfavourable profile for this patient group. Methods: For a subset of patients with either endometrioid, serous or a mixed mullerian morphology treated with chemotherapy at our centre between 1996 and 2008 an immunohistochemical profile of 14 biomarkers was studied (ERα, Erβ1, Erβ2, PR, PRB, P53, Rb, E-cad, MDM2, MIB-1, E2F1, p16, p13, and p21). A univariate analysis using cox regression of potential prognostic factors was then carried out. Results: In total 199 patients received chemotherapy for endometrial cancer over the 12 year period studied. Two year survival from commencement of chemotherapy for patients receiving adjuvant treatment was 45.2% and palliative treatment 28.1%. The commonest histological subtypes were endometrioid adenocarcinoma (40%), serous carcinoma (24.1%) and mixed mullerian tumours (14.6%). For the subset of 35 patients 38.2% of patients had positive immunohistochemical staining for ERα, 53% for PR, 73.5% for p16, and 94% for E2F1. Good prognosis was predicted by the strength of staining for E2F1 (HR 0.757, CI 0.216/0.902, p = 0.025) and poor prognosis by p16 (HR 1.470, CI 1.040/2.077, p = 0.029). Conclusions: Positive staining for ERα and PR was of similar frequency to previous studies of early stage endometrial cancer and did not significantly influence prognosis. Good prognosis correlated with E2F1 expression and poor prognosis with p16. A greater proportion of patients had serous morphology compared to published series of early stage endometrial cancer. Further study of prognostic factors in larger numbers of patients and built into prospective randomised trials may allow the creation of a prognostic model and guide the development of future clinical trials of targeted therapy. No significant financial relationships to disclose.

scholarly journals Benefit of Two Additional Cycles of Bortezomib/Thalidomide/Dexamethasone (VTD) Induction Therapy Compared to Four Cycles of VTD for Newly Diagnosed Multiple Myeloma

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3252-3252
Author(s):  
Yoojin Lee ◽  
Kihyun Kim ◽  
Sang Kyun Sohn ◽  
Dongwon Back ◽  
Joon Ho Moon ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Induction Therapy ◽  
Conflicts Of Interest ◽  
Stage I ◽  
High Dose ◽  
Newly Diagnosed ◽  
Favorable Prognostic Factor

Abstract Introduction Four cycles of bortezomib/thalidomide/dexamethasone (VTD) induction therapy followed by autologous stem cell transplantation (ASCT) is one of the standard therapy for patients aged less than 65 years with newly diagnosed multiple myeloma (NDMM). Complete remission (CR) status before ASCT is an important prognostic factor for progression-free survival (PFS). We analyzed whether two additional cycles of VTD improved the pre- and post-transplant responses as well as PFS compared to the four cycles of VTD induction therapy. Methods A total of 222 patients with NDMM between September 2014 and August 2016 from eleven hospitals in South Korea were included in the current study. The patients received at least four or more cycles of VTD induction therapy before administration of high-dose therapy (HDT, melphalan 200mg/m2) followed by ASCT. VTD regimen was consisted of bortezomib subcutaneous infusion (1.3 mg/m2 on days 1, 4, 8, and 11), thalidomide (100 mg daily), and dexamethasone (40 mg on days 1-4, 8-11), which was administered every 4 weeks. Results The median age was 57 years (range 30−64 years), and 120 patients (61.9%) were male. Revised international scoring system (R-ISS) classified 59 (30.4%), 86 (44.3%), and 49 patients (25.3%) as stage I, II, and III, respectively. VTD induction was administered 4 cycles in 194 patients (VTD4, 67.5%) and more than 4 cycles in 63 (VTD6, 32.5%) before HDT. Patient characteristics at diagnosis did not differ between VTD4 and VTD6. CR rate before HDT was significantly higher in VTD6 than VTD4 (31.7% vs 13.0%, P = 0.003). However, CR rate after HDT/ASCT was similar between VTD4 and VTD6 (69.0% vs 65.5%, P = 0.726). There was no difference in the incidence of peripheral neuropathy (PN) (≥ grade 2 or that required dose reduction) between two groups. The median follow-up duration was 18.0 months (range 7.0-43.8 months). The 2-year PFS did not differ between the two groups (51.7 ±5.7% in VTD4 and 62.1±8.6% in VTD6, P = 0.240). Multivariate analysis revealed that the achievement of CR was a favorable prognostic factor for PFS (HR 0.27 [0.08−0.90], P = 0.034). Deletion 17p (HR 2.87 [1.01−7.92], P = 0.048) and t(4;14) (HR 3.38 [1.76−6.48], P < 0.001) in FISH were adverse prognostic factors for PFS. Patients with stage I/II by R-ISS receiving additional two cycles of VTD showed prolonged PFS (median PFS not reached vs. 27.6 months, P = 0.034). In the multivariate analysis, VTD6 was a favorable prognostic factor for PFS for patients with stage I/II by R-ISS, (HR 0.11 [0.02−0.52], P = 0.005). Conclusion CR rates increased with additional cycles of VTD induction therapy for NDMM. However, the PFS benefit was observed only in patients with R-ISS stage I/II. For patients with high-risk MM, intensive induction therapy that overcome poor prognostic factors should be administered to improve long-term outcomes. Figure. Figure. Disclosures No relevant conflicts of interest to declare.

Expression of Smad Proteins as a Potential Prognostic Factor in Chronic Lymphocytic Leukemia

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1957-1957
Author(s):  
Magdalena Witkowska ◽  
Barbara Cebula-Obrzut ◽  
Agata Majchrzak ◽  
Aleksandra Medra ◽  
Tadeusz Robak ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Growth Factor ◽  
Prognostic Factor ◽  
Clinical Stage ◽  
Apoptotic Index ◽  
Lymphocytic Leukemia ◽  
Vegf Receptors ◽  
Smad Proteins ◽  
Smad 3 ◽  
Low Expression

Abstract Background: The Smad family proteins are crucial element of one of the most versatile cytokine signaling pathways- the transforming growth factor beta (TGF- ß). TGF-ß is a multipotent cytokine that participates in a wide range of cellular processes in the human body both in physiology and pathology. TGF-ß is involved in angiogenesis, regulates apoptosis, stimulates differentiation and divisions of several target cells and exhibits effects on the cell cycle by G1 phase arrest. This strongly suggests that disruption of Smad signaling pathway could be involved in cancerogenesis. The Smad proteins are unique group of particles, that after receiving a signal from activated TGF-β, act on transcription factors in the nucleus, leading directly to the expression of the corresponding genes. Based on the differences in their function, the Smad family is divided into three classes: receptor-associated Smads including Smad 1, Smad 2, Smad 3, Smad 5 and Smad 8, co-operating Smads (Smad 4), and inhibitory Smads (Smad 6, Smad 7). Smad 1 and Smad 5 are prefentially involved in the BMP (bone morphogenetic protein) dependent pathway, while Smad 2 , Smad 3 are associated with activin (Act) pathway. According to current knowledge, disturbances in the functioning of Smad proteins are present in a numerous solid tumors. Low expression of Smad 4 protein correlates with progressive outcome and promote metastasis of many solid tumors including pancreatic cancer, colorectal and breast cancer. However, overexpression of Smad 1/8 and Smad 2/3 protein was observed in both patients with colorectal cancer and lung cancer So far, studies in hematological malignances are limited, with no data published in chronic lymphocytic leukemia (CLL) patients. The aim: This is the first study assessing the expression of Smad 1/8, Smad 2/3, Smad4 and Smad 7 proteins in CLL cells in an aspect of their clinical significance and potential prognostic value in this disease. Material and Methods: CLL cells isolated from peripheral blood of overall 214 previously untreated CLL patients were examined on the expression of Smad1/8, Smad 2/3, Smad4 and Smad 7 proteins. Results were compared with data obtained from 42 healthy volunteers. Moreover, expression of Smad proteins was correlated with stable/progression status of the disease, as well as with several prognostic factors known for CLL, including clinical stage according to Rai system, lymphocyte doubling time (LTD), cytogenetics, ZAP-70 and CD38 expression, lactate dehydrogenase (LDH) activity or beta-2-migroglobulin (β2-M) expression. Additionally, Smad protein expression was correlated with the level of spontaneous in vivo apoptosis of CLL cell and expression of three vascular endothelial growth factor (VEGF) receptors – R1, R2 or R3. All measurement were made using flow cytometry methods. Apoptotic index (AI) was calculated as a percentage of Annexin-V-positive cells. Results: Significantly lower expression of Smad 4 was showed in CLL cells than in healthy lymphocytes in controls (p<0.001). Overexpression of Smad 1/8 and low expression of Smad 4 was found in CLL patients with more progressive compared to stable course of the disease (p<0.005). Moreover, high level of Smad 1/8 and low expression of Smad 4 correlated with other well establish prognostic factors, such as clinical stage according to Rai (p<0.001), LDT (p<0.015), LDH (p<0.001), β2-M (p<0.010) and CD38 (p<0.003). In a multivariate analysis low expression of Smad 4 was independent negative prognosic factor. In contrast, there were no statistical differences observed according to ZAP-70 and cytogenetics. Moreover, we did not find differences in expression Smad 2/3 and inhibitory Smad 7 expression was not related to all investigated prognostic factors among CLL patients. Low expression of Smad 4 correlated with lower apoptotic index of CLL cells and higher expression of R1 and R2 VEGF receptors. Conclusions: Our study demonstrated significant correlation between expression of Smad 1/8 and Smad 4 proteins and progressive outcome of disease and poor prognosis. The data presented provides supporting evidence that expression of Smad family proteins may be a valuable prognostic factor for CLL patients. Disclosures No relevant conflicts of interest to declare.

scholarly journals Prognostic factors of chest CT findings for ICU admission and mortality in patients with COVID-19 pneumonia

2020 ◽  
Author(s):  
Mohammad Ali Kazemi ◽  
Hossein Ghanaati ◽  
Behnaz Moradi ◽  
Mohammadreza Chavoshi ◽  
Hassan Hashemi ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Poor Prognosis ◽  
Underlying Disease ◽  
Good Prognosis ◽  
Chest Ct ◽  
Icu Admission ◽  
Ct Findings ◽  
Pattern Distribution ◽  
Ct Features

AbstractBackgroundStudies have shown that CT could be valuable for prognostic issues in COVID-19Objectiveto investigate the prognostic factors of early chest CT findings in COVID-19 patients.Materials and MethodsThis retrospective study included 91 patients (34 women, and 57 men) of RT-PCR positive COVID-19 from 3 hospitals in Iran between February 25, 2020, to march 15, 2020. Patients were divided into two groups as good prognosis, discharged from the hospital and alive without symptoms (48 patients), and poor prognosis, died or needed ICU care (43 patients). The first CT images of both groups that were obtained during the first 8 days of the disease presentation were evaluated considering the pattern, distribution, and underlying disease. The total CT-score was calculated for each patient. Univariate and multivariate analysis with IBM SPSS Statistics v.26 was used to find the prognostic factors.ResultsThere was a significant correlation between poor prognosis and older ages, dyspnea, presence of comorbidities, especially cardiovascular and pulmonary. Considering CT features, peripheral and diffuse distribution, anterior and paracardiac involvement, crazy paving pattern, and pleural effusion were correlated with poor prognosis. There was a correlation between total CT-score and prognosis and an 11.5 score was suggested as a cut-off with 67.4% sensitivity and 68.7% specificity in differentiation of poor prognosis patients (patients who needed ICU admission or died. Multivariate analysis revealed that a model consisting of age, male gender, underlying comorbidity, diffused lesions, total CT-score, and dyspnea would predict the prognosis better.ConclusionTotal chest CT-score and chest CT features can be used as prognostic factors in COVID-19 patients. A multidisciplinary approach would be more accurate in predicting the prognosis.

Lack of CD34 Expression in Acute Myeloid Leukemia (AML) Is a Favorable Prognostic Factor in Patients Treated with Stem Cell Transplant Irrespective of the Cytogenetic Risk

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1894-1894
Author(s):  
Fahed Almhareb ◽  
Claudia Ulrike Walter ◽  
Randa Nounou ◽  
Salem Khalil ◽  
Nasir Bakshi ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Myeloid Leukemia ◽  
Mutation Status ◽  
Allogeneic Hsct ◽  
Predicting Outcome ◽  
Favorable Prognostic Factor ◽  
Cd34 Expression ◽  
Acute Myeloid

Abstract Abstract 1894 Background: Most of the studies of prognostic factors in acute myeloid leukemia (AML) are focused on predicting outcome after standard chemotherapy treatment. The studies that looked at the importance of these prognostic variables in predicting outcome after hematopoietic stem cell transplantation (HSCT) are very limited. Considering post-HSCT prognostic factors in stratifying AML patients may add a new level of confidence in any risk stratification of these patients. Toward this goal, we investigated the clinical relevance of CD34 expression in the primary leukemic cells on the outcome of allogeneic HSCT. Methods: Data collected from immunophenotyping of 110 patients with AML who were treated with HSCT was reviewed and the expression of CD34 on the blast population as determined by flow cytometry was correlated with clinical behavior and outcome. All the patients were treated with allogeneic HSCT. The median age of these patients was 24 (range: 14–57) and included 88 patients in the intermediate cytogenetic group and 22 in the adverse cytogenetic group. Of the 110 patients 71, (64.5%) were treated with HSCT in first remission (CR1). Results: Twenty-eight (25%) of all AML patients studied did not express CD34 on the surface of the blasts at diagnosis. Patients with CD34 negative blasts had significantly longer overall survival (OS) (P=0.003) as well as longer event free survival (EFS) (P=0.01) when all patients were considered. In the subgroup of patients who received HSCT in CR1, OS and EFS were significantly longer (P=0.017 and P=0.027, respectively) in the CD34-negative patients (N=20). Furthermore, if we consider only patients in the intermediate cytogenetic group at diagnosis, patients with CD34-negative blasts had significantly longer OS (P=0.007) and EFS (P=0.026). Even in patients with adverse cytogenetic abnormalities, OS and EFS were also significantly longer in the CD34-negative patients (P=0.01 for both). This was true when all patients were considered. The same was true when only patients transplanted in CR1 (P=0.05 for EFS in intermediate cytogenetics and P=0.05 for EFS in patients with adverse cytogenetic) were evaluated. Multivariate analysis including CD34 expression and FLT3 mutation status was carried out on a subset of patients (N=63) and showed CD34 expression was an independent prognostic factor for survival and EFS, while FLT3 mutation status became no longer a predictor. Conclusion: Our data suggests that CD34 expression on the blast cells at the time of AML diagnosis may have an adverse prognostic impact even after allogeneic HSCT. Lack of CD34 expression is a powerful independent favorable prognostic factor for AML patients if these patients are treated with HSCT after induction chemotherapy, irrespective if they were in CR1 or in CR2, and irrespective of their cytogenetic risk at diagnosis. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Prognostic Factors of Initial Chest CT Findings for ICU Admission and Mortality in Patients with COVID-19 Pneumonia

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mohammad Ali Kazemi ◽  
Hossein Ghanaati ◽  
Behnaz Moradi ◽  
Mohammadreza Chavoshi ◽  
Hassan Hashemi ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Poor Prognosis ◽  
Underlying Disease ◽  
Good Prognosis ◽  
Chest Ct ◽  
Icu Admission ◽  
Ct Findings ◽  
Pattern Distribution ◽  
Ct Features

Background: Studies have shown that CT could be valuable for prognostic issues in COVID-19. Objectives: To investigate the prognostic factors of early chest CT findings in COVID-19 patients. Methods: This retrospective study included 91 patients (34 women, and 57 men) of real-time reverse transcription polymerase chain reaction (RT-PCR) positive COVID-19 from three hospitals in Iran between February 25, 2020, to March 15, 2020. Patients were divided into two groups as good prognosis, discharged from the hospital and alive without symptoms (48 patients), and poor prognosis, died or needed ICU care (43 patients). The first CT images of both groups that were obtained during the first 8 days of the disease presentation were evaluated considering the pattern, distribution, and underlying disease. The total CT-score was calculated for each patient. Univariate and multivariate analysis with IBM SPSS Statistics v.26 was used to find the prognostic factors. Results: There was a significant correlation between poor prognosis and older ages, dyspnea, presence of comorbidities, especially cardiovascular and comorbidities. Considering CT features, peripheral and diffuse distribution, anterior and paracardiac involvement, crazy paving pattern, and pleural effusion were correlated with poor prognosis. There was a correlation between total CT-score and prognosis and an 11.5 score was suggested as a cut-off with 67.4% sensitivity and 68.7% specificity in differentiation of poor prognosis patients (patients who needed ICU admission or died). Multivariate analysis revealed that a model consisting of age, male gender, underlying comorbidity, diffused lesions, total CT-score, and dyspnea would predict the prognosis better. Conclusions: Total chest CT-score and chest CT features can be used as prognostic factors in COVID-19 patients. A multidisciplinary approach would be more accurate in predicting the prognosis.

scholarly journals Prognostic factors of chronic pulmonary aspergillosis: A retrospective cohort of 264 patients from Japan

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249455
Author(s):  
Yuya Kimura ◽  
Yuka Sasaki ◽  
Junko Suzuki ◽  
Jun Suzuki ◽  
Hiroshi Igei ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Retrospective Cohort ◽  
Poor Prognosis ◽  
Survival Rates ◽  
Pulmonary Aspergillosis ◽  
Lower Serum ◽  
Proportional Analysis ◽  
The Poor ◽  
Chronic Pulmonary Aspergillosis ◽  
Male Sex

Background Chronic pulmonary aspergillosis (CPA) develops in various underlying pulmonary conditions. There is scarce data evaluating interstitial lung disease (ILD)/abnormalities (ILA) as such conditions, and it has not been explored much whether non-tuberculous mycobacterial pulmonary disease (NTM-PD) is a prognostic factor for mortality in CPA patients. Few reports had investigated prognostic factors of CPA including underlying pulmonary conditions. Objectives To explore prognostic factors of CPA including pulmonary conditions. Methods We conducted a retrospective cohort study of 264 CPA patients from a center for pulmonary aspergillosis in Japan. Results Survival rates were 78.7%, 61.0%, and 47.4% at 1, 3, and 5 years, respectively. Of 264 patients, 53 (20.1%) and 87 (33.1%) were complicated with ILA and NTM-PD. Several independent prognostic factors were identified by multivariate Cox proportional analysis: ILA (HR 1.76, 95%CI 1.06–2.92, p = 0.029), age (1.05, 1.02–1.08, p<0.001), male sex (2.48, 1.34–4.59, p = 0.004), body mass index of <18.5 kg/m2 (1,87, 1.20–2.90, p = 0.005), presence of aspergilloma (1.59, 1.04–2.45, p = 0.033), and lower serum albumin (0.56, 0.38–0.83, p = 0.004). NTM-PD was not associated with higher mortality (0.85, 0.52–1.38, p = 0.51). Conclusions The poor prognosis of CPA and several prognostic factors were revealed. Early diagnosis and intervention is required with reference to such factors.

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