T-cell clonality in peripheral blood as a predictor of progression to systemic treatment in patients with stage IB mycosis fungoides (MF).

e19538 Background: A major unmet clinical need in the care of early-stage MF patients is the identification of those with a high risk of failing skin directed therapy or progressing to advanced disease. Herein, we inquired if the identification of a clonal T-cell receptor (TCR) gene rearrangement by PCR in peripheral blood could predict the clinical outcome, particularly the need for systemic treatment, in patients with stage IB MF. Methods: This is a retrospective cohort study of patients with stage IB MF who underwent peripheral blood TCR clonality analysis by PCR. The primary outcome of the study was time from diagnosis to initiation of systemic treatment. Secondary outcomes were: (1) time to progression to advanced-stage disease (stages IIB-IV) and (2) overall survival. Patients were censored at time of last clinical follow up. Log rank test was used to compare the survival distributions of the two groups; p value < 0.05 was considered significant. Results: From May 2014 to October 2019, 56 consecutive stage IB pts with > 6 months follow up were included in this analysis. Peripheral blood TCR clonality status was available in 42 patients: 18 pts had a positive TCR clone and 24 did not. Median follow up time was 36 months (range 8.5 – 198 months). At 3 years, 39% of patients with peripheral clone had progressed to systemic treatment versus 8% of those without a peripheral clone (log rank test, p-value = 0.003). For the secondary outcomes, at 3 years 17% of patients with peripheral clone had progressed to advanced stage versus 4% of those without (log rank test, p-value = 0.10); 5% of patients with peripheral clone had died versus 0% of those without (log rank test, p-value = 0.03). Conclusions: Detection of a predominant TCR clone by PCR in the peripheral blood is an important prognostic marker in the initial workup of MF, as its presence is highly correlated with subsequent progression to systemic treatment and death. If this finding is validated, it can be used to risk stratify and individualize therapy for MF patients.[Table: see text]

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Outcome of Diffuse Large B Cell Lymphoma in the United States: Review of SEER Data.

Blood ◽

10.1182/blood.v110.11.1567.1567 ◽

2007 ◽

Vol 110 (11) ◽

pp. 1567-1567

Author(s):

Rami S. Komrokji ◽

Najla H. Al Ali ◽

S.M. Beg ◽

Jeffrey A. Schrager ◽

Malek M. Safa

Keyword(s):

United States ◽

Early Stage ◽

B Cell Lymphoma ◽

The United States ◽

Rank Test ◽

P Value ◽

Advanced Stage ◽

Log Rank Test ◽

Black Patients ◽

Seer Data

Abstract Introduction: Diffuse large B cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL). Outcome data of DLBCL among a large population in the United States outside the context of clinical trials has not been reported. We examined survival trends of DLBCL patients among a large population based registry in the last four decades. Method: Surveillance, Epidemiology, and End Results (SEER) histology codes 9680, 9684, 9697 were used to identify all cases of DLBCL between 1973 and 2004. Kaplan-Meier estimates were used for median overall survival (OS). Variables analyzed included age, race, sex, stage, and year of diagnosis. SPSS statistical software was used for analysis. Results: Between 1973 and 2004, 59728 cases of DLBCL were recorded in the SEER data. The mean age of diagnosis was 63 years. 32505 (54.4%) were male and 27223 (45.6%) were female. The majority of patients, 51795 (86.7%), were white, 3733 (6.3%) were black, and 4200 (7%) were other races. Staging information was available in 57% of the cases, 18091 (30%) were early stage (I, II), 15862 (27%) were advanced stage (III, IV) and in 25775 (43%) the stage was unknown/missing. The overall median survival was 25 months. The 5 year OS was 36%. The relative 5 year OS was 47%. The median OS for females was 28 months compared to 21 months for males (log rank test, P value < 0.005). The median OS for white patients was 25 months compared to 16 months for black patients (log rank test, P value <0.005). The median OS improved over time. Specifically, for patients diagnosed between 1973–1979, 1980–1989,1990–1999, and 2000–2004 the median OS was 15, 18, 20, and 47 months, respectively (p value <0.005) (see Figure). The improvement in median OS was seen among both sexes, all ages and races. Also, the improvement in OS was seen in both early and advanced stages. For the period 2000–2004, 24,303 patients were identified. Of these 57% were males, 86% were white and 7% were black. Fifty percent were early stage and 44% were advanced stage; the stage was unknown in 6%. The median OS was 47 months. The 4 year overall survival was 46%. The median OS for early stage was not reached and was 19 months for patients with advanced stage (log rank test, p value <0.005). Outcome was better in white patients compared to black patients: 47 months compared to 29 months, respectively (log rank test, p value 0.001). No differences between males and females were noted. The median OS for patients <60 years old was not reached compared to 23 months for patients over the age of 60. In a Cox regression model all variables analyzed (age, sex, race, stage and year of diagnosis by decade) were statistically significant independent factors. Conclusion: This is the first report on outcome of DLBCL in the SEER data. The outcome of DLBCL in the United States has improved significantly in the era of monoclonal antibodies. Black patients had inferior outcome. No sex differences in outcome are noted in the recent years. The SEER data analysis has several limitations namely lack of accurate staging information, IPI scoring and treatment details. Figure Figure

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The Impact of Lymphocyte Subset Recovery At 3 Months on Progression-Free Survival After Myeloablative Allogeneic Stem Cell Transplantation,

Blood ◽

10.1182/blood.v118.21.4065.4065 ◽

2011 ◽

Vol 118 (21) ◽

pp. 4065-4065

Author(s):

Junya Kanda ◽

David A. Rizzieri ◽

Gwynn D. Long ◽

Cristina Gasparetto ◽

John P. Chute ◽

...

Keyword(s):

T Cells ◽

T Cell ◽

Complete Remission ◽

Progression Free Survival ◽

Myelogenous Leukemia ◽

Rank Test ◽

Free Survival ◽

Log Rank Test ◽

Standard Risk

Abstract Abstract 4065 Background: Opportunistic infection and disease relapse due to a delayed or impaired cellular immune reconstitution following allogeneic stem cell transplantation (SCT) is associated with significant morbidity and mortality. Various lymphoid subsets have been suggested to play an important role in immune function. However, it remains unknown which of these subsets directly impact survival after SCT. Therefore, we prospectively quantified multiple lymphoid subsets at 3 months following myeloablative allogeneic SCT and evaluated their impact on progression-free survival (PFS). Methods: Quantitative recovery of 13 lymphoid subsets was prospectively characterized in a consecutive cohort of adult patients undergoing T-cell replete myeloablative SCT using peripheral blood stem cells (PBSCs) from a matched sibling donor (MSD) or a matched unrelated donor (MUD), or dual umbilical cord blood (DUCB) grafts. CD3+, CD4+, CD8+, regulatory (Treg) (CD4+, CD25+, CD62L+), cytotoxic (CTL) (CD8+, CD57+, CD28-), and activated T cells (CD8+, HLA-DR+), naïve CD4+ T cells with L-selectin expression (CD4+, CD45RA+/CD45RO-, CD62L+), NK (CD3-, CD16+/CD56+) and NKT cells (CD3+, CD16+/CD56+), B cells (CD19+, CD3-, CD16-, CD56-), plasmacytoid dendritic cells (DCs) (CD123+, CD11c-), and myeloid DCs (CD123-, CD11c+) were analyzed by flow cytometry on fresh peripheral blood. We included 69 patients (MSD, n = 23; MUD, n = 24; DUCB, n = 22) with standard-risk hematologic malignancies who survived at least 3 month (landmark day) following transplantation to evaluate the prognostic impact of lymphoid subset recovery at 3 months on PFS. Standard-risk diseases were defined as acute myelogenous leukemia (AML) in 1st or 2nd complete remission, acute lymphoblastic leukemia (ALL) in 1st or 2nd complete remission, myelodysplastic syndrome (MDS) with blasts <5%, malignant lymphoma (ML) in any complete remission, chronic myelogenous leukemia (CML) in 1st or 2nd chronic phase, and myelofibrosis (MF). PFS was defined as period from the 3 month after transplantation to disease progression or death, whichever occurred first and censored at time of last follow-up. The probability of PFS was estimated according to the Kaplan-Meier method, and groups were compared using the log-rank test. Cox proportional hazards multivariate regression modeling was used to predict PFS. Each lymphocyte subset was dichotomized at the median value and analyzed in a bivariate model adjusted for donor type (MSD/MUD or CBT) as well as in a univariate model in the MSD/MUD group. A parallel analysis was not performed in the CBT group due to few events. Results: Median age (range) of recipients was 40 (19–65) years. Primary diseases were AML (n = 42), ALL (n = 12), MDS (n = 8), CML (n = 4), ML (n = 2), and MF (n = 1). Tacrolimus-based GVHD prophylaxis was used in 83% of recipients. Median follow-up of survivors after transplantation was 21.1 (range, 3.9–53.6) months. PFS rate at 1 year among DUCB, MSD, and MUD recipients was 0.85 (95% confidence interval, 0.61–0.95), 0.64 (0.40–0.80), and 0.73 (0.49–0.86), respectively, without significant difference between the 3 groups (log-rank test, P = 0.164). Patient characteristics were not associated with PFS in the univariate analysis. In the bivariate analysis controlling for donor type, higher numbers of T cells (P = 0.016), Treg (P = 0.015), CTL (P = 0.041), and myeloid DC (P = 0.028) were significantly associated with improved PFS. In the MSD/MUD group, myeloid DC was the only significant variable (hazard ratio 0.25, 95% confidence interval, 0.07–0.89, P = 0.032) (Figure 1). Conclusion: Total T cell, regulatory T cell, cytotoxic T cell and myeloid DC recovery at 3 months post transplant is predictive of PFS. Given the unique properties of the DUCB graft, the predictive potential of lymphocyte subsets on PFS may differ from that of MSD/MUD transplant recipients and a larger cohort of DUCB recipients is needed to perform such an analysis. However, among recipients of MSD/MUD grafts, poor myeloid DC recovery at 3 months following transplantation predicted for worse PFS. These data allow for identification of a population at high risk for poor outcome who may be appropriate targets for intervention to augment post-transplant immune recovery using novel techniques. Disclosures: No relevant conflicts of interest to declare.

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P4698Survival outcomes in patients with Eisenmenger syndrome after heart-lung or bilateral sequential lung transplantation

European Heart Journal ◽

10.1093/eurheartj/ehz745.1079 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

K Kearney ◽

N Bart ◽

K Khush ◽

D Hayes ◽

A Keogh

Keyword(s):

Lung Transplantation ◽

Septal Defect ◽

Cardiac Repair ◽

Rank Test ◽

P Value ◽

Eisenmenger Syndrome ◽

Post Transplant ◽

Log Rank Test ◽

Significant Difference

Abstract Background Eisenmenger syndrome (ES) is defined as pulmonary hypertension secondary to a right to left intracardiac shunt, commonly an atrial septal defect (ASD) or ventricular septal defect (VSD). Heart-lung (HLTx) or bilateral sequential lung transplantation (BSLT) are both treatment options for some candidates. The choice between these two procedures has varied historically and according to transplant centre preference and donor availability. We completed a retrospective study to determine if BSLT with cardiac repair was associated with better outcomes compared to HLTx. Aim This study compared post-transplant survival in patients with ES undergoing HLTx or BSLT. Method Using the International Society Heart and Lung Transplantation Registry data, we identified all patients with ES between October 1, 1987 and March 31, 2018. Results A total of 177 patients underwent HLTx for ES ASD and 101 who underwent BSLT with cardiac repair. Median follow up was 890 days (range 0–9888 days) for the entire post-transplant cohort. 126 HLTx and 66 BSLT patients died in the follow up period. A total of 173 ES VSD patients underwent HLTx in the database, and 52 underwent BSLT with cardiac repair. Median follow up was 460 days (range 0–8406 days) for the entire post-transplant cohort. 116 HLTx and 36 BSLT patients died during the follow up period. Figure 1 demonstratres the comparative Kaplan-Meier survival curves following BSLT or HLTx for Eisenmenger's ASD and VSD patients. No statistically significant difference in Eisenmenger survival between combined heart-lung transplantation or bilateral sequential lung transplantation group (ASD log rank test p value = 0.99, VSD log rank test p value = 0.1 performed for the first 6 year). Figure 1 Conclusions Our analysis determined that patients with ES and either VSD or ASD had similar long-term survival comparing HLTx with BSLT and cardiac repair.

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Higher Titer of Anti-EBV Nuclear Antigen Antibodies Might be a Marker of Poorer Prognosis in Patients with Peripheral T-Cell Lymphoma, Not Otherwise Specified

Blood ◽

10.1182/blood.v126.23.5016.5016 ◽

2015 ◽

Vol 126 (23) ◽

pp. 5016-5016

Author(s):

Yoshiharu Kusano ◽

Yasuhito Terui ◽

Kyoko Ueda ◽

Yuko Mishima ◽

Noriko Nishimura ◽

...

Keyword(s):

T Cell ◽

Response Rate ◽

Cell Lymphoma ◽

T Cell Lymphoma ◽

Nuclear Antigen ◽

Rank Test ◽

P Value ◽

Not Otherwise Specified ◽

Log Rank Test ◽

Therapeutic Outcomes

Abstract Background Epstein-Barr virus (EBV) nuclear antigen 1 (EBNA) is the only viral protein consistently expressed by EBV. Anti-EBNA-1 antibodies (EBNA-Ab) status has long been the method to diagnose the latent EBV infection to date. Both positivity of EBV-encoded small RNA in situ hybridization using lymph node and positivity of EBV-DNA using peripheral blood meant that poor therapeutic outcomes in patients with peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) and with NK/T-cell lymphoma, respectively. It has been unknown whether EBNA-Ab status has another clinical implication except knowing latent EBV infection. Methods This is an observational trial in single cancer institute. EBNA-Ab has routinely measured before the treatment in patients with PTCL-NOS, who were diagnosed or treated in our hospital from July 2001 to December 2014. Then, we analyzed that whether these patients attributed their therapeutic outcomes to the each value of their pretreatment EBNA-Ab titer. Primary objective was to evaluate a prognostic value of EBNA-Ab titer for one-year overall survival (OS). Secondary objective was response rate. Results In total of 30 cases, 24 showed EBNA-Ab positive (titer ≥ 10). Baseline patients characteristics run as follows; median age was 63 (26-83), 22 were men, 18 were Ann Arbor stage ≥ 3, 11 were IPI ≥ 3, 9 showed elevated LDH. All patients were given six cycles of CHOP except one patient (CHOEP). Overall response rate (ORR) was 40% and complete response rate (CRR) was 27%. 40% showed progression disease. The median OS was 51.4 months. At the median follow-up of 12 months, the pretreatment EBNA-Ab level demonstrated significant correlation with prognosis. OS was 52.7% (95% confidential index [CI]: 30-71) and 100% (95%CI: 100-100) in cases that EBNA-Ab positive and EBNA-Ab negative, respectively (Figure 1, p value of log-rank test = 0.013). Furthermore, we compared outcomes in the three groups: EBNA-Ab < 10, 10 ≤ EBNA-Ab ≤ 60, and EBNA-Ab > 60. Each group has same proportion of age > 60 (p value of fisher exact test = 0.26), sex (p = 0.51), IPI ≥ 3 (p = 0.85), stage ≥ 3 (p = 0.09), and elevated LDH (p = 0.64). ORR was 33% vs. 44% vs. 33% and CRR was 33% vs. 28% vs. 17% in cases that EBNA-Ab < 10, 10 ≤ EBNA-Ab ≤ 60, and EBNA-Ab > 60. In terms of OS, 100%, 63%, and 20% in cases that EBNA-Ab < 10, 10 ≤ EBNA-Ab ≤ 60, and EBNA-Ab > 60, respectively (Figure 2, p value of log-rank test = 0.0007). Conclusion As these results demonstrated, in this study, patients with high-level titer of EBNA-Ab demonstrated shorter OS. Especially, EBNA-Ab titer > 60 cases showed the worst outcome. By contrast, EBNA-Ab negativity demonstrated significantly longer OS. Higher EBNA-Ab might be an independent marker that associated with poorer outcomes in patients with PTCL-NOS. Figure 1. OS between EBNA-Ab < 10 and ≥ 10 arms (p = 0.01) Figure 1. OS between EBNA-Ab < 10 and ≥ 10 arms (p = 0.01) Figure 2. OS between EBNA-Ab < 10, 10 ≤ EBNA-Ab ≤ 60, and EBNA-Ab > 60 arms (p = 0.0007) Figure 2. OS between EBNA-Ab < 10, 10 ≤ EBNA-Ab ≤ 60, and EBNA-Ab > 60 arms (p = 0.0007) Disclosures Mishima: Chugai Pharmaceutical CO., LTD.: Consultancy. Nishimura:Chugai Pharmaceutical CO., LTD.: Consultancy. Yokoyama:Chugai Pharmaceutical CO., LTD.: Consultancy. Hatake:Chugai Pharmaceutical CO., LTD.: Other: lecture speaking.

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Monitoring ctDNA in r/r DLBCL patients following the CAR T-cell therapy axicabtagene ciloleucel: Day 28 landmark analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.7552 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 7552-7552 ◽

Cited By ~ 2

Author(s):

Matthew Joshua Frank ◽

Nasheed M. Hossain ◽

Ali Abbas Bukhari ◽

Erin Dean ◽

Jay Y. Spiegel ◽

...

Keyword(s):

T Cell ◽

Cell Therapy ◽

Rank Test ◽

T Cell Therapy ◽

Landmark Analysis ◽

Car T Cell ◽

Log Rank Test ◽

Car T Cell Therapy ◽

Car T

7552 Background: Axicabtagene Ciloleucel (Axi-cel) is an autologous anti-CD19 CAR T-cell therapy approved for the treatment of relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL). Long‐term analysis of the Zuma‐1 clinical trial showed ~40% of patients remained progression-free at 2 years (Locke, Lancet Oncology 2018). Early identification of patients who will later progress after CAR T cell therapy may improve clinical care and patient outcomes. Methods: As of 2/1/2019, we enrolled 50 patients on a multi-institutional, prospective study measuring circulating tumor DNA(ctDNA) minimal residual disease (MRD) in r/r DLBCL patients undergoing treatment with Axi-cel. Using an next generation sequencing-MRD assay (Adaptive Biotechnologies; Seattle WA), ctDNA levels were measured pre, 0, 7, 14, 21, 28, 56, 90, 180, 270, and 365 days following Axi-cel infusion. A pre-planned comparison between EDTA, Streck, and CFD tubes for the initial 10 enrolled patients determined the CFD tube provided optimal analyte stability over 144 hours following sample collection. CFD tubes are being used to collect all study samples. Results: 24 subjects have 3 or more months clinical follow up and their treatment ctDNA MRD significantly associated with clinical outcomes. A day 28 landmark analysis shows 12 patients were MRD negative and 12 patients were MRD positive as defined by detection of none or any tumor-associated ctDNA, respectively. 10 of 12 MRD+ patients subsequently developed progressive disease. In contrast, only 2 MRD- patients subsequently progressed and the 10 other patients remain in a CR. (p = 0.0033, Fisher's exact test). With a median follow up of 237 days, median PFS after Axi-cel infusion for day 28 MRD+ vs. MRD- patients is 93 days vs. not reach, p = 0.0010 by Log-rank test. Median OS for day 28 MRD+ vs. MRD- patients is 281 days after Axi-cel infusion vs. not reach, p = 0.0399 by Log-rank test. Conclusions: After Axi-cel infusion, day 28 ctDNA-based MRD significantly associates with PFS and OS and identified early at-risk patients prior to progression. These results provide a rationale for designing MRD-based risk-adaptive CAR T-cell clinical trials.

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Colorectal Liver Metastases - Does the Number of Lesions Determine the Sensibility of Resection?

Swiss Surgery ◽

10.1024/1023-9332.6.1.6 ◽

2000 ◽

Vol 6 (1) ◽

pp. 6-10

Author(s):

Knoefel ◽

Brunken ◽

Neumann ◽

Gundlach ◽

Rogiers ◽

...

Keyword(s):

Liver Metastases ◽

Colorectal Liver Metastases ◽

Rank Test ◽

Log Rank Test ◽

Kaplan Meier ◽

Chirurgische Entfernung

Die komplette chirurgische Entfernung von Lebermetastasen bietet Patienten nach kolorektalem Karzinom die einzige kurative Chance. Es gibt jedoch eine, anscheinend unbegrenzte, Anzahl an Parametern, die die Prognose dieser Patienten bestimmen und damit den Sinn dieser Therapie vorhersagen können. Zu den am häufigsten diskutierten und am einfachsten zu bestimmenden Parametern gehört die Anzahl der Metastasen. Ziel dieser Studie war es daher die Wertigkeit dieses Parameters in der Literatur zu reflektieren und unsere eigenen Patientendaten zu evaluieren. Insgesamt konnte von 302 Patienten ein komplettes Follow-up erhoben werden. Die gebildeten Patientengruppen wurden mit Hilfe einer Kaplan Meier Analyse und konsekutivem log rank Test untersucht. Die Literatur wurde bis Dezember 1998 revidiert. Die Anzahl der Metastasen bestätigte sich als ein prognostisches Kriterium. Lagen drei oder mehr Metastasen vor, so war nicht nur die Wahrscheinlichkeit einer R0 Resektion deutlich geringer (17.8% versus 67.2%) sondern auch das Überleben der Patienten nach einer R0 Resektion tendenziell unwahrscheinlicher. Das 5-Jahres Überleben betrug bei > 2 Metastasen 9% bei > 2 Metastasen 36%. Das 10-Jahres Überleben beträgt bislang bei > 2 Metastasen 0% bei > 2 Metastasen 18% (p < 0.07). Die Anzahl der Metastasen spielt in der Prognose der Patienten mit kolorektalen Lebermetastasen eine Rolle. Selbst bei mehr als vier Metastasen ist jedoch gelegentlich eine R0 Resektion möglich. In diesen Fällen kann der Patient auch langfristig von einer Operation profitieren. Das wichtigere Kriterium einer onkologisch sinnvollen Resektabilität ist die Frage ob technisch und funktionell eine R0 Resektion durchführbar ist. Ist das der Fall, so sollte auch einem Patienten mit mehreren Metastasen die einzige kurative Chance einer Resektion nicht vorenthalten bleiben.

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CLINICO-PATHOLOGICAL AND RADIOLOGICAL PROGNOSTIC FACTORS IN CANCER CERVIX TREATED WITH CONCURRENT CHEMORADIATION

SRMS Journal of Medical Science ◽

10.21761/jms.v1i1.10940 ◽

2016 ◽

Vol 1 (1) ◽

Author(s):

Manraj S. Kang ◽

Kamal Sahni ◽

Piyush Kumar ◽

Rajneesh Madhok ◽

Ratna Saxena ◽

...

Keyword(s):

Prognostic Factors ◽

Mitotic Index ◽

Univariate Analysis ◽

Disease Free Survival ◽

Concurrent Chemoradiation ◽

P Value ◽

Publication Date ◽

Cancer Cervix ◽

Stage Ib

<bold>Introduction:</bold> Cervical cancer is most common cancer in the rural and second most common in urban areas of our country. It accounts for 16% of all cancers. There are various clinical, Paper Submission Datepathological and radiological factors which dictate the prognosis of these cancer cervix patients. The present study evaluates clinical, pathological and radiological prognostic factors in cancer cervix treated with concurrent chemoradiation. <bold>Material and Methods:</bold> A total of 32 patients seen between 2012 and 2014 patients planned concurrent chemoradiation were evaluated in terms of clinical (age, stage, Hb% and HPV Paper Publication Date infection), pathological (histopathology type and subtype, grade, mitotic index, lymph-July 2016 vascular invasion and necrosis) and radiological (parametrial extension, disease dimension, lymph node, hydronephrosis and vascularity of tumour) prognostic factors. After pre-DOI treatment evaluation patient was planned for 3 Dimentional-Conformal Radiotherapy (50Gy/25#/5 weeks) with concurrent chemotherapy (Cisplatin 35mg/m<sup>2</sup>) followed by 3 applications of Intracavitary radiotherapy (6Gy/fraction) with 6 months follow up. Response was accessed according to WHO response criteria and univariate analysis was done using chi-square test. <bold>Results:</bold> Clinical factors: Age – better disease free survival in older patients (p value=0.003), stage - Lower stage had better survival (for stage Ib-IIa vs stage IIb p value = 0.003 and for stage Ib vs. IIIb p value = 0.0005), Hb% - 57% patients with Hb <10g/dl had recurrence at end of 6 months (p value=0.00001), HPV – High recurrence with HPV presence. Pathological factors like high Mitotic Index had more residual disease (p=0.0009), grade - No statistical significance. Radiological factors- volume of disease - 35 % patients with volume of disease > 6 cm had disease at end of 6 months, hydronephrosis - 40 % patient with hydronephrosis had recurrence (p value = 0.0005) at end of 6 months follow up and vascularity of tumour showed statistically no difference. <bold>Conclusion:</bold> Hb <10%, HPV infection, Mitotic index (3-5/HPF), stage IIIB, pelvic nodes were concluded as the independent poor prognostic factors.

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Oncological and functional outcomes of supratotal resection of IDH1 wild-type glioblastoma based on 11C-methionine PET: a retrospective, single-center study

Scientific Reports ◽

10.1038/s41598-021-93986-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Seiichiro Hirono ◽

Ko Ozaki ◽

Masayoshi Kobayashi ◽

Ayaka Hara ◽

Tomohiro Yamaki ◽

...

Keyword(s):

Functional Outcomes ◽

Awake Craniotomy ◽

Rank Test ◽

Wild Type ◽

Log Rank Test ◽

Positron Emission ◽

Single Center Study ◽

Supratotal Resection ◽

Subcortical Mapping

AbstractThe oncological and functional outcomes in glioblastoma (GBM) patients following supratotal resection (SupTR), involving complete resection of contrast-enhancing enhanced (CE) tumors and areas of methionine (Met) uptake on 11C-met positron emission tomography (Met-PET), are unknown. We conducted a retrospective review in newly diagnosed, IDH1 wild-type GBM patients, comparing SupTR with gross total resection (GTR), in which only CE tumor tissue was resected. All patients underwent standard radiotherapy and temozolomide treatment, and were followed for tumor recurrence and overall survival (OS). Among the 30 patients included in this study, 7 underwent SupTR and 23 underwent GTR. Awake craniotomy with cortical and subcortical mapping was more frequently performed in the SupTR group than in the GTR group. During the follow-up period, significantly different patterns of disease progression were observed between groups. Although more than 80% of recurrences were local in the GTR group, all recurrences in the SupTR group were distant. Median OS in the GTR and SupTR groups was 18.5 months (95% confidence interval [CI] 14.2–35.1) and not reached (95% CI 30.5-not estimable), respectively; this difference was statistically significant (p = 0.03 by log-rank test). No postoperative neurocognitive decline was evident in patients who underwent SupTR. Compared to GTR alone, aggressive resection of both CE tumors and areas with Met uptake (SupTR) under awake craniotomy with functional mapping results in a survival benefit associated with better local control and neurocognitive preservation.

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Interim Serum Soluble Interleukin-2 Receptor Levels Are Strongly Associated with Prognosis in Newly Diagnosis DLBCL Patients

Blood ◽

10.1182/blood-2019-122375 ◽

2019 ◽

Vol 134 (Supplement_1) ◽

pp. 4118-4118

Author(s):

Haruya Okamoto ◽

Akihiro Miyashita ◽

Hiroaki Nagata ◽

Yasuhiko Tsutsumi ◽

Yuri Kamitsuji ◽

...

Keyword(s):

Poor Prognosis ◽

Interleukin 2 ◽

B Cell Lymphoma ◽

Clinical Variable ◽

Rank Test ◽

Prognostic Impact ◽

Interleukin 2 Receptor ◽

Log Rank Test ◽

Soluble Interleukin 2 Receptor

<Background> Serum soluble interleukin-2 receptor (sIL2R) levels are often measured to evaluate the state of lymphoma. The serum sIL2R level at diagnosis has been reported to be correlated with the prognosis of diffuse large B cell lymphoma (DLBCL) patients treated with the R-CHOP regimen. However, it is unclear whether interim sIL2R levels are associated with prognosis in DLBCL. Here, we analyzed the prognostic impact of interim serum sIL2R levels in DLBCL. <Patients and Methods> We retrospectively examined data for DLBCL patients who started receiving chemotherapy at the Japanese Red Cross Society Kyoto Daini Hospital between January 2012 and December 2018. All of the patients received R-CHOP-like regimens (rituximab plus pirarubicin or adriamycin, cyclophosphamide, vincristine, and prednisolone). The interim sIL2R level (I-IL2R) was defined as the value measured after the third chemotherapy cycle. I-IL2R levels of >700 U/ml were regarded as positive. The primary endpoints of this study were progression-free survival (PFS) and overall survival (OS). The unadjusted probabilities of PFS and OS were estimated using the Kaplan-Meier method. The log-rank test and multivariate Cox regression analysis were used to assess the prognostic value of each clinical variable. <Results> In total, 102 patients were enrolled. The patients' median age was 73.5 years (range, 35-88), 58 patients (56.9%) were male, and 52 (51.0%) had poor revised International Prognostic Index scores. The median follow-up time was 25.2 months (range, 3.7-88.6). Twenty-three patients (22.5%) were I-IL2R-positive (>700 U/ml). Univariate analysis revealed that I-IL2R-positivity was associated with a poor prognosis. The 3-y PFS rates of the I-IL2R-negative (<700 U/ml) and I- IL2R-positive (>700 U/ml) patients were 60.4% (95% confidence interval [95%CI], 46.2-71.9) and 37.5% (95%CI, 15.7-59.4; p<0.001, log-rank test), respectively, and their 3-y OS rates were 82.2% (95%CI, 69.7-89.9) and 37.4% (95%CI, 13.8-61.4; p<0.001, log-rank test), respectively. Multivariate analysis confirmed that the I-IL2R level is independently associated with prognosis. <Conclusion> The I-IL2R level of >700 U/ml patients had poor prognosis. The I-IL2R level can be used to predict the outcomes of DLBCL patients. IL2R levels should be measured during chemotherapy, and I-IL2R-positive patients could be targeted with high-dose or novel therapies. As this study was based on a retrospective analysis and involved a small cohort and a limited follow-up period, further studies are needed to confirm the prognostic impact of I-IL2R. Figure Disclosures No relevant conflicts of interest to declare.

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