Distinct Treatment Response and Liver Transplant-Free Survival of Autoimmune Hepatitis in the Elderly

2014 ◽  
Vol 109 ◽  
pp. S156-S157
Author(s):  
Dasha Moza ◽  
Thara Kumar ◽  
Andrew Mason ◽  
Aldo Montano-Loza
Keyword(s):  
Liver Transplant ◽  
Autoimmune Hepatitis ◽  
Treatment Response ◽  
The Elderly ◽  
Free Survival

Evaluation of R-CHOP and R-CVP in the treatment of elderly patient with non-Hodgkin lymphoma

MedPharmRes ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 1-6
Author(s):  
Truc Phan ◽  
Tram Huynh ◽  
Tuan Q. Tran ◽  
Dung Co ◽  
Khoi M. Tran
Keyword(s):  
Elderly Patients ◽  
Hodgkin Lymphoma ◽  
B Cell Lymphoma ◽  
Complete Response ◽  
The Elderly ◽  
Free Survival ◽  
Non Hodgkin Lymphoma ◽  
Common Sign ◽  
Related Mortality

Introduction: Little information is available on the outcomes of R-CHOP (rituximab with cyclophosphamide, doxorubicin, vincristine and prednisone) and R-CVP (rituximab with cyclophosphamide, vincristine and prednisone) in treatment of the elderly patients with non-Hodgkin lymphoma (NHL), especially in Vietnam. Material and methods: All patients were newly diagnosed with CD20-positive non-Hodgkin lymphoma (NHL) at Blood Transfusion and Hematology Hospital, Ho Chi Minh city (BTH) between 01/2013 and 01/2018 who were age 60 years or older at diagnosis. A retrospective analysis of these patients was perfomed. Results: Twenty-one Vietnamese patients (6 males and 15 females) were identified and the median age was 68.9 (range 60-80). Most of patients have comorbidities and intermediate-risk. The most common sign was lymphadenopathy (over 95%). The proportion of diffuse large B cell lymphoma (DLBCL) was highest (71%). The percentage of patients reaching complete response (CR) after six cycle of chemotherapy was 76.2%. The median follow-up was 26 months, event-free survival (EFS) was 60% and overall survival (OS) was 75%. Adverse effects of rituximab were unremarkable, treatment-related mortality accounted for less than 10%. There was no difference in drug toxicity between two regimens. Conclusions: R-CHOP, R-CVP yielded a good result and acceptable toxicity in treatment of elderly patients with non-Hodgkin lymphoma. In patients with known cardiac history, omission of anthracyclines is reasonable and R-CVP provides a competitive complete response rate.

scholarly journals Interest in Immunosuppression Withdrawal among Liver Transplant and Autoimmune Hepatitis Patients

2021 ◽  
Vol 12 (2) ◽  
pp. 147-154
Author(s):  
Eden Sharabi ◽  
Allison Carroll ◽  
Peter Cummings ◽  
Josh Levitsky
Keyword(s):  
Decision Making ◽  
Liver Transplant ◽  
Autoimmune Hepatitis ◽  
Immunological Tolerance ◽  
Side Effect Profile ◽  
Transplant Recipients ◽  
Single Center ◽  
Patient Reported ◽  
Liver Transplant Recipients ◽  
Mean Time

Immunosuppression withdrawal (ISW) is considered in liver transplant recipients (LTRs) and autoimmune hepatitis patients (AIHPs). Immunosuppressive therapy (IST) can be burdensome both financially and due to its side effect profile, making ISW an important intervention to consider. Data on patient interest in ISW would be helpful to providers in ISW decision-making. We conducted independent single-center surveys of LTR and AIHP attitudes on IST and withdrawal interest. Of 325 LTRs screened, 120 completed the survey (50% female, mean age 58 ± 14 years, mean time since transplant 8 ± 10.5 years and 79.5% Caucasian). Of 100 AIHPs screened, 45 completed the survey (77.8% female, mean age 54 ± 2 and 82.2% Caucasian). A higher percentage of AIHPs expressed concern with their IST and were interested in ISW compared with LTRs. However, over a third of LTRs were interested in ISW, particularly those with knowledge of this potential intervention. LTRs who discussed ISW with a physician were more likely to desire withdrawal (p = 0.02; OR = 2.781 (95% CI = 1.125, 6.872)). As patient interest in ISW is of growing interest, investigators should continue to assess patient-reported desires and outcomes and pursue strategies to achieve immunological tolerance.

scholarly journals Development and validation of a prognostic score for long‐term transplant‐free survival in autoimmune hepatitis type 1

2021 ◽  
Author(s):  
Maaike Biewenga ◽  
Xavier P.D.M.J. Verhelst ◽  
Martine A.M.C. Baven‐Pronk ◽  
Hein Putter ◽  
Aad P. Berg ◽  
...  
Keyword(s):  
Autoimmune Hepatitis ◽  
Prognostic Score ◽  
Free Survival ◽  
Development And Validation ◽  
Autoimmune Hepatitis Type 1

scholarly journals P22 Are Elderly Patients at Increased Perioperative Morbidity and Mortality from Oesophagectomy for Oesophageal Cancer? A Systematic Mapping Review and Meta-Analysis

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Rohan R Gujjuri ◽  
Muhammed Elhadi ◽  
Hamza Umar ◽  
Manjunath S Subramanya ◽  
Richard P T Evans ◽  
...  
Keyword(s):  
Elderly Population ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
The Elderly ◽  
Pulmonary Complications ◽  
Cardiac Complications ◽  
Anastomotic Leaks ◽  
Free Survival ◽  
Younger Patients ◽  
Disease Free

Abstract Introduction Oesophagectomy is being increasingly performed in an ageing population that is observing a concomitant growth in the life expectancy. However, the risks are poorly quantified, and this study aims to review current evidence to further quantify the postoperative of oesophagectomy in the elderly population compared to younger patients. Methods A systematic electronic search was conducted for studies reporting oesophagectomy in the elderly population. Meta-analysis was performed using random-effects modelling to compute odds ratios (OR) and 95% confidence intervals (CI). Primary outcome was overall complications and secondary outcomes included anastomotic leaks, cardiac complications, pulmonary complications, overall and disease-free survival. Meta-regression was performed to identify study-, hospital- and patient-level factors confounding study findings. Results This review included 37 eligible studies involving 61,723 patients. Increasing age was significantly associated with increased rates of overall complications (OR: 1.67, CI 95%: 1.42 – 1.97), cardiac complications (OR: 1.62, CI 95%: 1.10 – 2.40), pulmonary complications (OR: 1.44, CI 95%: 1.11 – 1.87) and decreased 5-year overall survival (OR: 1.36, CI 95%: 1.11 – 1.66) and 5-year disease-free survival (OR: 1.66, CI 95%: 1.40 – 1.97). Rates of anastomotic leaks showed no difference between elderly and younger patients (OR: 1.06, CI 95%: 0.71 – 1.59). Conclusion Postoperative outcomes such as overall complications, 5-year overall survival and disease-free survival appear to significantly worse in all age cut-offs in this meta-analysis. Sarcopenia and frailty act as better predictors of postoperative outcomes than chronological age. This study confirms the preconceived suspicions of increased risks in elderly patients following oesophagectomy and will aid future pre-operative counselling and informed consent.

scholarly journals Recurrence of primary biliary cirrhosis and development of autoimmune hepatitis after liver transplant: A blind histologic study

2009 ◽  
Vol 39 (6) ◽  
pp. 577-584 ◽  
Author(s):  
Prodromos Hytiroglou ◽  
Julio A. Gutierrez ◽  
Maria Freni ◽  
Joseph A. Odin ◽  
Carmen M. Stanca ◽  
...  
Keyword(s):  
Primary Biliary Cirrhosis ◽  
Liver Transplant ◽  
Autoimmune Hepatitis ◽  
Biliary Cirrhosis ◽  
Histologic Study

Characteristics and long-term outcome of patients with autoimmune hepatitis related to the initial treatment response

2010 ◽  
Vol 45 (4) ◽  
pp. 457-467 ◽  
Author(s):  
Mårten Werner ◽  
Sven Wallerstedt ◽  
Stefan Lindgren ◽  
Sven Almer ◽  
Einar Björnsson ◽  
...  
Keyword(s):  
Autoimmune Hepatitis ◽  
Treatment Response ◽  
Initial Treatment ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals THE ASPREE STUDY: DISABILITY-FREE SURVIVAL, UPDATED RESULTS, SUB-STUDIES, AND IMPLICATIONS FOR ASPIRIN USE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S632-S633
Author(s):  
Anne M Murray ◽  
John McNeil ◽  
Basil Eldadah
Keyword(s):  
The Elderly ◽  
Secondary Outcome ◽  
The Novel ◽  
Free Survival ◽  
Incident Cancer ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Observational Cohort ◽  
The Rich ◽  
And Performance

Abstract The NIA/NCI ASPREE (ASPirin in Reducing Events in the Elderly) Study was a landmark RCT of 19,114 healthy adults aged 70 (whites) and 65 (US minorities) in Australia and the US that demonstrated lack of effect of low dose aspirin (LDA:100 mg/d) on the novel primary end point of Disability- Free Survival (life free of disability and dementia) over a mean treatment of 4.7 years. Surprisingly, LDA was associated with a trend toward increased all cause mortality, driven by cancer deaths (results published NEJM September 2018). After the LDA intervention was halted in June 2017, ASPREE was extended as an observational cohort follow-on study, ASPREE-XT, to measure potential delayed LDA effects on ASPREE outcomes. The ASPREE study primary results will be summarized, and the rationale for and performance of the novel DFS geriatric outcome discussed. New results of the analysis of dementia as a secondary outcome will also be presented (both for overall dementia and Alzheimer’s disease). We will also examine the unexpected increased all-cause mortality attributed to cancer deaths, despite no significant difference between groups for all incident cancer, and effects of LDA on incident metastatic disease. The important implications of the ASPREE results for prescribing LDA for primary prevention in health elderly will be discussed, and the ASPREE-XT study design and progress described. Lastly, the breadth of the ASPREE sub-studies including the Biobank, Brain Imaging studies and Genomics, and opportunities to access the rich ASPREE data and collaborate with ASPREE investigators will be reviewed.

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