scholarly journals Faculty Decisions on Serials Subscriptions Differ Significantly from Decisions Predicted by a Bibliometric Tool

2016 ◽  
Vol 11 (1) ◽  
pp. 63 ◽  
Author(s):  
Sue F Phelps
Keyword(s):  
Research University ◽  
Academic Research ◽  
The United States ◽  
Experimental Methodology ◽  
Quadratic Model ◽  
P Value ◽  
Journal Title ◽  
Binary Variable ◽  
Match Rate ◽  
Significant Difference

A Review of: Knowlton, S. A., Sales, A. C., & Merriman, K. W. (2014). A comparison of faculty and bibliometric valuation of serials subscriptions at an academic research library. Serials Review, 40(1), 28-39. http://dx.doi.org/10.1080/00987913.2014.897174 Abstract Objective – To compare faculty choices of serials subscription cancellations to the scores of a bibliometric tool. Design – Natural experiment. Data was collected about faculty valuations of serials. The California Digital Library Weighted Value Algorithm (CDL-WVA) was used to measure the value of journals to a particular library. These two sets of scores were then compared. Setting – A public research university in the United States of America. Subjects – Teaching and research faculty, as well as serials data. Methods – Experimental methodology was used to compare faculty valuations of serials (based on their journal cancellation choices) to bibliometric valuations of the same journal titles (determined by CDL-WVA scores) to identify the match rate between the faculty choices and the bibliographic data. Faculty were asked to select titles to cancel that totaled approximately 30% of the budget for their disciplinary fund code. This “keep” or “cancel” choice was the binary variable for the study. Usage data was gathered for articles downloaded through the link resolver for titles in each disciplinary dataset, and the CDL-WVA scores were determined for each journal title based on utility, quality, and cost effectiveness. Titles within each dataset were ranked highest to lowest using the CDL-WVA scores within each fund code, and then by subscription cost for titles with the same CDL-WVA score. The journal titles selected for comparison were those that ranked above the approximate 30% of titles chosen for cancellation by faculty and CDL-WVA scores. Researchers estimated an odds ratio of faculty choosing to keep a title and a CDL-WVA score that indicated the title should be kept. The p-value for that result was less than 0.0001, indicating that there was a negligible probability that the results were by chance. They also applied logistic regression to quantify the association between the numeric score of CDL-WVA and the binary variable of the faculty choices. The p-value for this relationship was less than 0.0001, also indicating that the result was not by chance. A quadratic model plotted alongside the previous linear model follows a similar pattern. The p-value of the comparison is 0.0002, which indicates the quadratic model’s fit cannot be explained by random chance. Main Results – The authors point out three outstanding findings. First, the match rate between faculty valuations and bibliometric scores for serials is 65%. This exceeds the 50% rate that would indicate random association, but also indicates a statistically significant difference between faculty and bibliometric valuations. Secondly, the match rate with the bibliometric scores for titles that faculty chose to keep (73%) was higher than those they chose to cancel (54%). Thirdly, the match rate increased with higher bibliometric scores. Conclusions – Though the authors identify only a modest degree of similarity between faculty and bibliometric valuations of serials, it is noted that there is more agreement in the higher valued serials than the lower valued serials. With that in mind, librarians might focus faculty review on the lower scoring titles in the future, taking into consideration that unique faculty interests may drive selection at that level and would need to be balanced with the mission of the library.

scholarly journals Disparities in Opioid Use Disorder Treatment Admissions in the United States

2020 ◽  
Vol 7 (1) ◽  
pp. 85-93
Author(s):  
Peter Mallow ◽  
Michael Mercado ◽  
Michael Topmiller
Keyword(s):  
United States ◽  
Wait Time ◽  
The United States ◽  
Opioid Use Disorder ◽  
P Value ◽  
Opioid Use ◽  
Data Set ◽  
Significant Difference ◽  
Receive Treatment ◽  
To Receive

Objectives: The Cincinnati region has been at the epicenter of the nation’s unfolding opioid epidemic. The objectives of this study were twofold: (1) to compare the Cincinnati region to the United States in length of time to obtain treatment and planned medication-assisted therapy for the treatment for opioid use disorder (OUD); and (2) to assess racial disparities within the Cincinnati region in wait time and type of treatment. Methods: The 2017 Treatment Episode Data Set: Admissions (TEDS-A) from the Substance Abuse and Mental Health Services Administration (SAMHSA) was used to identify a cohort of eligible individuals with a primary substance use of opioids, including opioid derivatives. Logistic regression models were performed to assess the differences for treatment wait time and type of planned treatment. Model covariates included patient demographics and socioeconomic characteristics. Three different models were performed to assess the influence of covariates of the outcomes. Results: There were 678 766 US and 3298 Cincinnati region individuals admitted for OUD treatment in 2017. The rate per 1000 for treatment admissions was 2.08 and 1.51 (P value < 0.0001) for the United States and Cincinnati, respectively. The fully saturated regression results found that the odds of Cincinnati individuals receiving planned medication-assisted therapy were 0.497 (95% CI, 0.451–0.546; P value < 0.001). The odds of waiting longer for treatment in Cincinnati were higher than in the United States as a whole: 2.33 (95% CI, 2.19–2.48; P value < 0.001). In Cincinnati, there were 3102 Caucasian, 123 African American, and 73 Other admissions. The fully saturated model results found that Caucasians and Other had an increased likelihood of receiving planned medication-assisted therapy (OR 1.89, P value 0.039; OR 7.07, P value 0.002, respectively) compared to African Americans. Within Cincinnati, there was not a statistically significant difference in the likelihood of waiting time to receive treatment by race. Conclusion: Individuals seeking treatment for OUD in Cincinnati were less likely to receive planned medication-assisted therapy and were more likely to wait longer than individuals in the United States as a whole. These results suggest that the demand for treatment is greater than the supply in Cincinnati. Within Cincinnati, there does not appear to be a racial disparity in treatment type or length of time to receive treatment for OUD.

scholarly journals Trends in Neisseria Gonorrheae Antimicrobial Susceptibility in California, 2005–2016

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S69-S69
Author(s):  
Juliet Stoltey ◽  
Emily Han ◽  
Nicole Burghardt ◽  
Joan Chow ◽  
Heidi Bauer
Keyword(s):  
Antimicrobial Susceptibility ◽  
The United States ◽  
P Value ◽  
Significant Difference ◽  
Chi Squared ◽  
Control And Prevention ◽  
Funded Project ◽  
Agar Dilution ◽  
Sex With Men ◽  
Recommended Therapy

Abstract Background Resistant Neisseria gonorrheae (NG) is a growing concern in California, nationally, and globally. Since 1987, California has participated in the Gonococcal Isolate Surveillance Project (GISP), a Centers for Disease Control and Prevention-funded project to monitor trends in antimicrobial susceptibility in sentinel STD clinic sites throughout the United States. We sought to describe trends in California NG susceptibility to ceftriaxone (CRO) and azithromycin (AZI), recommended therapy for NG, for 2005–2016. Methods Per GISP protocol, cultures are collected from the first 25 men presenting with NG urethritis each month at GISP clinic sites in California, and antimicrobial susceptibility testing (AST) is performed via agar dilution at GISP regional laboratories. Reduced susceptibility (RS) to CRO was defined as minimum inhibitory concentration (MIC) ≥0.125 µg/ml and AZI MIC ≥2 µg/ml. Demographics and MIC trends over time were examined. Results Between 2005 and 2016, there were 9,692 NG isolates submitted in California GISP clinics. There were 24 (0.25%) isolates with RS to CRO and 92 (0.96%) isolates with RS to AZI. There was a higher proportion of isolates from men who have sex with men with RS to AZI (but not CRO) compared with men who have sex with women (chi-squared P-values: AZI = 0.0015; CRO = 0.70). In 2016, the percent of isolates demonstrating RS to AZI increased to 3.69% (n = 32), compared with 0.69% of isolates with RS to AZI in 2005–2015 (chi-squared P-value &lt; .0001); there was no significant difference in the percent of isolates with RS to CRO in 2016 compared with prior years (Figure 1). Figures 2 and 3 demonstrate the distribution of AZI MICs and CRO MICs, respectively, from 2005–2016. There have been no isolates to date in California GISP with RS to both ceftriaxone and azithromycin. Conclusion Gonococcal surveillance data demonstrate an increase in the proportion of isolates with decreased susceptibility to azithromycin in 2016 in California compared with prior years. Although there has never been a documented treatment failure to the recommended therapy of CRO and AZI in California, clinicians should remain vigilant for treatment failures given these concerning increases. Disclosures All authors: No reported disclosures.

Survival trends among patients with advanced hepatocellular carcinoma in the United States.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 329-329
Author(s):  
Krishna Bilas Ghimire ◽  
Binay Kumar Shah ◽  
Barsha Nepal
Keyword(s):  
Survival Rates ◽  
Age Groups ◽  
Stage Iv ◽  
Relative Survival ◽  
The United States ◽  
P Value ◽  
Advanced Hepatocellular Carcinoma ◽  
Z Score ◽  
Significant Difference ◽  
End Results

329 Background: Sorafenib was approved by FDA for treatment of HCC in 2007. This study was conducted to evaluate survival outcome in advanced HCC during 2005-2006 and 2008-2009 using U.S. Surveillance, Epidemiology, and End Results (SEER) cancer registry database.Methods: We analyzed the Surveillance, Epidemiology, and End Results (SEER*Stat) database: Incidence - SEER 18 Regs Research Data + Hurricane Katrina Impacted Louisiana Cases, Nov 2011 Sub (1973-2009 varying) using MP-SIR session. We analysed 1 year relative survival rates among stage IV HCC patients between pre- sorafenib (2005- 2006) and post- sorafenib (2008- 2009) eras. We used seer Z test to compare relative survival rates among cohorts of patients categorized by gender and age groups (<50 and >50 years). Results: There were 2,497 (1,180 in pre-sorafenib era and 1,317 in post-sorafenib era) stage IV HCC patients reported in seer database. Overall 1 year relative survival rates ± standard error (SE) were: 12.5±0.7% (12.5±1% in pre sorafenib era vs 13.1±1.1% in post sorafenib era, Z score= 0.481, p value=0.63). Overall Relative survival rates among men and women were 12.9±0.8% (12.7±1.1% in pre vs 13.4±1.2 in post sorafenib era, Z score=0.254, p value=0.79) and 11.8±1.6% (11.7±2.2% in pre vs 11.5±2.5 post sorafenib era, Z score=0.469, p value=0.63) respectively. There was no significant differences between 1 year relative survival rates by age groups (<50 and >50 years). Conclusions: This study showed no significant difference in 1-year relative survival rates during 2008-2009 as compared to 2005-2006. More studies are required to find out why the findings of SHARP trial have not translated to population-based settings.[Table: see text]

scholarly journals Derajat Toksisitas Hemoglobin Pada Penderita Kanker Kolorektal Yang Mendapat Kemoterapi CapeOX

2020 ◽  
Vol 1 (4) ◽  
pp. 299-305
Author(s):  
Yusmaidi ◽  
Jordy Oktobiannobel ◽  
Muhammad Nur ◽  
Bella Sabila Dananda
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
The United States ◽  
Hematological Toxicity ◽  
P Value ◽  
Chemotherapy Drugs ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Difference ◽  
Colorectal Cancer Patients

Advances in the treatment and use of chemotherapy have been shown to improve the life expectancy rate for colorectal cancer patients. Studies conducted in China and Hongkong have shown that CapeOX combination chemotherapy regimens are more commonly used than in Europe and the United States. However, the use of chemotherapy drugs containing oxaliplatin and capecitabine can cause side effects such as hematological toxicity, which is one of them is anemia. This study aims to determine the difference in the form of a decrease in the average levels of hemoglobin and the degree of hemoglobin toxicity in colorectal cancer patients undergoing CapeOX chemotherapy. The Design in this study is a historical (retrospective) cohort. This study sample was 70 colorectal cancer patients who received CapeOX chemotherapy for 6 cycles at RSUD Dr. H. Abdul Moeloek in 2018-2019. Consecutive sampling is used in the sampling method. The statistical analysis is using Paired T-Test. There is a significant difference in the average hemoglobin level of colorectal cancer patients (p-value = <0.005), which receive CapeOX chemotherapy for 6 cycles.  Besides, there is an increase in the number of patients who get hemoglobin toxicity and the chemotherapy cycle. In the first cycle, 59 patients (84.3%) got hemoglobin toxicity after chemotherapy, and the number continued to increase to 69 patients (98.6%) in the sixth cycle. There was a decrease in hemoglobin levels in colorectal cancer patients who received CapeOX chemotherapy with p-value = <0.05 and increased patients who got hemoglobin toxicity.

Disparities in access to palliative care for patients treated for gynecologic oncology.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 136-136 ◽  
Author(s):  
Nora Flood ◽  
Colleen Rivard
Keyword(s):  
Palliative Care ◽  
Demographic Data ◽  
Minority Group ◽  
Gynecologic Oncology ◽  
Retrospective Chart Review ◽  
The United States ◽  
Minority Women ◽  
P Value ◽  
Significant Difference ◽  
Palliative Care Services

136 Background: Palliative care intends to improve quality of life for patients with life-threatening illness, but ethnic and linguistic minority patients have worse outcomes with palliative care. Methods: This is a single institution retrospective chart review of patients with an advanced stage or recurrent gynecologic malignancy who were seen in the clinic from 2010 to 2015. Women were defined as being from a minority group if they met one of the inclusion criteria including English not the primary language, race other than white, ethnically Hispanic/Latina, or their country of origin was not the United States. We then compared rates of referral to palliative care between those women who were deemed to be minority women as compared to those who were non-minority. We also compared the time to referral between these two groups. Results: Our study included 277 women of which 20% were categorized as minority. Demographic data between the two groups were well matched with the exception that minority women were diagnosed at a younger age and were more likely to have cervical cancer. Although not statistically significant, more minority women were referred to palliative care than non-minority (79% vs. 89%, p=0.08). In contrast, fewer minority patients were referred to palliative care at least 3 months prior to death when compared to non-minority patients (50% vs. 38%, p =0.10). There was no difference between referral location [inpatients (35% vs. 36%) and outpatients (65% vs. 64%, p=.92)] in minority versus non-minority patients. There was also no significant difference in those patients entering hospice while admitted to the hospital. Minority patients had significantly more cancer-related hospitalizations per year (0.6 vs 1.0, p value 0.02). Conclusions: Our study shows that there is a tendency towards later referral to palliative care for minority patients as compared to non-minority patients. Although more minority patients are referred to palliative care, they are hospitalized for cancer related symptoms at a significantly higher rate suggesting that perhaps their utilization of palliative care services is suboptimal.

scholarly journals Users of Virtual Reference Are More Satisfied with the Service They Receive than the Providers of that Service Think They Are

2011 ◽  
Vol 6 (2) ◽  
pp. 36
Author(s):  
Carol D. Howe
Keyword(s):  
Research University ◽  
Online Survey ◽  
Instant Messaging ◽  
The United States ◽  
Comparison Method ◽  
Ease Of Use ◽  
Library Science ◽  
Background Information ◽  
Matched Pairs ◽  
Significant Difference

Objective – To examine provider pessimism by comparing user and provider perception of the same instant messaging reference transaction. Design – Instant messaging users and providers completed post-reference transaction surveys which were analyzed using the pair perception comparison method. Setting – A large research university in the United States. Subjects – Two hundred undergraduate journalism students (users of the instant messaging service) and 51 Master of Library Science (MLS) students enrolled in a reference services class (providers of the instant messaging service). Methods – The authors created a research help webpage from which users could access the instant messaging service. Prior to service availability, providers received reference instruction and demonstrated reference aptitude through in-class activities. The authors briefed providers on the project and provided a wiki containing resources they might need during reference transactions. Providers worked in two-hour shifts, and two providers were available during each shift. The service was available for one week while potential users completed a journalism assignment. The authors asked both users and providers of the service to complete an online survey at the conclusion of the reference transaction. Users and providers completed different surveys, but both types included the following four elements: questions to aid in matching a user to a provider; questions about satisfaction with the service based on guidelines put forth by the Reference and User Services Association (RUSA); open-ended questions about the reference transaction; and questions regarding demographics, prior reference service usage, and knowledge of instant messaging. There were 55 valid reference transactions, and from those, the authors matched 26 pairs of user and provider surveys. The authors analyzed paired surveys to (a) compare the user’s perception of the reference transaction with the provider’s guess about the user’s perception and (b) compare the provider’s self-perception of the reference transaction with the provider’s guess about the user’s perception. The authors introduced the pair perception comparison method for the analysis using two-tailed paired t-tests and Wilcoxon signed-rank tests. Main Results – Analysis of background information showed that users were younger on average than providers and used instant messaging more frequently. Even so, most users and providers felt comfortable with instant messaging. When providers were asked to guess how satisfied overall they thought the user was with the reference transaction, they reported on average that the user was less satisfied than the user actually was. These results were statistically significant. The authors found no significant difference between the providers’ overall satisfaction with the service they provided and their guesses about the users’ overall satisfaction. The authors also analyzed the matched pairs on 14 specific aspects of satisfaction gathered from surveys. When comparing the users’ satisfaction with the service they received and the providers’ guesses about the users’ satisfaction, the providers underestimated the users’ satisfaction on average for all 14 dimensions. The authors found statistically significant differences with regard to 7 of the 14 dimensions: tempo, ease of use, friendliness, understanding, accuracy, follow up, and spelling. When comparing the providers’ satisfaction with a given reference transaction and their guesses about the users’ satisfaction with the same reference transaction, the authors found significant differences for 3 of the 14 dimensions: interest, resource type, and accuracy. Conclusion – This study has shown for instant messaging reference what other studies have shown for face-to-face reference—that provider pessimism exists. Whatever the environment, providers of reference tend to judge themselves more harshly than the people they are helping judge them. Based on a review of the literature, the authors further note that both expert and novice reference providers experience such pessimism. The authors are hopeful that providers will view these results as evidence of their own competence during instant messaging reference transactions. The results of this study provide valuable information for training instant messaging providers. For example, the fact that providers thought users were less satisfied with the tempo of the reference transaction than they really were suggested to the authors that instant messaging providers need not be so concerned about giving a quick answer. An accurate answer is more desirable. In the same vein, providers thought that users were more concerned with spelling than they really were. Both of these cases, and others gleaned from the results, provide insight into what aspects of the reference transaction providers should spend their time and effort on. Finally, the authors introduced the pair perception comparison method to compare feedback from matched pairs on individual reference transactions, a methodology not used in any earlier studies. They deemed this method to be an effective way to uncover biases and false assumptions.

scholarly journals Relationship between Hospital Volume and Inpatient Mortality Among Patients Diagnosed with Thrombotic Thrombocytopenic Purpura (TTP) in the United States

Blood ◽  
2017 ◽  
Vol 130 (Suppl_1) ◽  
pp. 675-675
Author(s):  
Smith Giri ◽  
Ranjan Pathak ◽  
Robert Franklin ◽  
Nikolai A. Podoltsev ◽  
Scott Huntington ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Hospital Volume ◽  
The United States ◽  
Secondary Outcome ◽  
P Value ◽  
Inpatient Mortality ◽  
Thrombocytopenic Purpura ◽  
Significant Difference ◽  
The Mean

Abstract Introduction: Thrombotic Thrombocytopenic Purpura (TTP) is a hematological emergency with high inpatient mortality that requires prompt diagnosis and treatment. Studies outside the setting of hematologic emergencies have established hospital volume as a factor associated with clinical outcomes. We tested whether hospital volume was associated with important inpatient outcomes among patients with TTP Methods: We utilized the Nationwide Inpatient Sample (NIS) to identify adult patients ≥18 years, diagnosed with TTP using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 446.6 from the years of 2010 to 2013. We only included patients who received therapeutic plasmapheresis (ICD-9-CM procedure code 99.71) during hospitalization to capture active cases of TTP and improve coding accuracy. Using unique hospital identifier, hospital volume was computed and defined as total hospitalizations for TTP per year. Hospital volume was then divided into four quartiles. The primary outcome of interest was inpatient mortality rate, with time to initiation of plasmapheresis as our secondary outcome. Baseline age, gender, race, demographics, insurance payer, hospital region, hospital type (rural versus urban, teaching versus non-teaching), and bed size were collected. All analyses were survey adjusted to account for the complex sampling nature of the database. Appropriate bivariate methods included ANOVA and tests of trend (nptrend). Mixed effects hierarchical logistic regression analysis was used to calculate adjusted odds ratio of in-hospital mortality adjusting for potential confounders at the patient level (age, race, comorbidity, gender, insurance status) and at the hospital level (hospital location, bedsize and teaching status). All p values were two sided and the level of significance was chose was 0.05. Results: A total of 1128 unique hospitalizations for TTP were identified during the study period. The mean age was 46.3 ± 16.6 years, out of which 66% were females (n=754) and 44% were whites (n=458). The overall inpatient mortality rate was 10.9%. The distribution of hospital volume by quartiles was as follows; 1st quartile, Q1 (2 or less hospitalizations of TTP per year), 2nd quartile, Q2 (3-5/year), 3rd quartile, Q3, (6-11/year), 4th quartile, Q4 (12 and above). The mean length of stay was 14.4 ± 11.5 days and the mean cost of hospitalization was $ 177546 ± 7736. Overall there was decreasing trend in inpatient mortality with increasing hospital volumes (14.4% vs 12.8% vs 9.8% vs 6.5% from Q1-Q4 respectively; p trend 0.002). This effect was also retained in multivariate analysis adjusting for potential confounders (aOR 0.50; 95% CI 0.26-0.98; p 0.04) (Table 1). Also there was a decreasing trend in the time to plasmapheresis with increasing hospital volume (3.02 vs 2.48 vs 2.27 vs 2.09 from Q1-Q4 respectively, ANOVA p value 0.04) with post hoc analysis significant difference between 4th versus 1st quartile (Tukey p value 0.04). Conclusion: In this retrospective cohort study using a large US inpatient database, we identified a significant association between hospital volume and inpatient mortality. Furthermore, plasmapheresis was initiated earlier in the hospital course at higher volume hospitals and provides a potential mechanism for the survival improvement. Disclosures Podoltsev: Ariad: Consultancy; Incyte: Consultancy; Alexion: Consultancy; CTI biopharma/Baxalta: Consultancy. Huntington: Janssen: Consultancy; Pharmacyclics: Honoraria; Celgene: Consultancy, Other: Travel. Zeidan: AbbVie, Otsuka, Pfizer, Gilead, Celgene, Ariad, Incyte: Consultancy, Honoraria; Takeda: Speakers Bureau; Otsuka: Consultancy.

scholarly journals INVESTOR PERLU MENGINDENTIFIKASI INDEKS SAHAM USA UNTUK MEMPREDIKSI FLUKTUASI IHSG: LINCOM ANALYSIS

2018 ◽  
Vol 16 (2) ◽  
pp. 9-17
Author(s):  
Tri Widianto ◽  
Yenni Khristiana ◽  
Nugroho Wisnu Murti
Keyword(s):  
United States ◽  
Stock Price ◽  
Composite Index ◽  
Sampling Technique ◽  
The United States ◽  
Stock Index ◽  
P Value ◽  
Stock Indices ◽  
Significant Difference ◽  
The Usa

First objective of this study is to identify the influence of the fluctuations in the entire United States stock index on the Indonesian Composite stock Index. The results of thisstudy be used to predict Indonesian Composite indexes in a certain period of timebase of USA indexes fluctuation. The second objective is to find out whether there was a significant difference between the influence of the United States stock indexes on the Indonesian composite index. We used time series secondary data of daily stock price index over in five years (January 1, 2013 to December 31, 2017). The sample selection method used non-probability sampling with purposive sampling technique. We used robust simple regressionto achieve the first goal is, while the second goal used the linear combination. The results analysis showed that all of types of United States stock indices are partially significant and positive to Indonesian Composite index fluctuations (P-Value <0.05). Several types of USA stock indices have a significantly different coefficient in influencing Indonesia's Composite index between the Dow Jones Composite and the NYSE Composite and Dow Jones Composite with OTCM ADR (P-Value <0.05). Thus, the results of this study provide advice to investors, especially the Swinger and Scalper types, that considering the fluctuations in the USA index as a stock investment decision in Indonesia, it does not only consider one type of index, which is currently the headline of the stock index in the USA for example (Dowjones 30). However, consider other indices both composite and specific composite.

scholarly journals The Choice of Induction Regimen Affects Post Remission Survival of Acute Myelogenous Leukemia (AML) Patients with Intermediate or Poor Risk Disease

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 82-82
Author(s):  
Melhem Solh ◽  
Scott R Solomon ◽  
Lawrence E Morris ◽  
H. Kent Holland ◽  
Xu Zhang ◽  
...  
Keyword(s):  
The United States ◽  
Myelogenous Leukemia ◽  
P Value ◽  
High Dose ◽  
Combination Regimen ◽  
Salvage Regimen ◽  
Factors Associated ◽  
Significant Difference ◽  
Induction Regimen ◽  
The Impact

Abstract The fludarabine, high dose cytarabine and G_CSF with or without idarubicin combination regimen, referred to as FLAG+/-Ida, is commonly used as a salvage regimen for relapsed/refractory AML but its use as initial induction therapy has been more limited. The MRC trial 15 compared 2 induction courses of FLAG-Ida regimen to 3+7 (anthracycline plus cytarabine) regimens with etoposide (ADE) and found a higher relapse free survival among patients receiving FLAG-Ida. The findings of the MRC AML 15 trial are not widely applied in the United States as many experts use one course of induction followed by consolidation if patients achieve remission. The impact of choice of induction regimen on post remission survival in non-favorable risk AML patients remains unclear. To address this question, we assessed outcomes of 306 consecutive AML patients between aged 18 to75 years, with non-favorable NCCN risk who were received initial treatment at our center between January of 2009 and July of 2017 with either 3+7 (n=88) or FLAG+/-Ida (n=218). Our center's algorithm is to offer allogeneic HSCT as a consolidative therapy to all AML patients with non-favorable risk in CR1 who are considered transplant candidates. Patient characteristics were as follows: Median age 58(19, 75), male 55%, FLT-3 ITD positive 12%, NCCN risk ( intermediate 49%, poor 51%) and normal cytogenetics 45%. Baseline characteristics were similar between the two treatment groups with FLAG+/-Ida being younger at time of diagnosis (59 vs 66 years, P<0.001). A total of 240 (78%) patients achieved CR 1 after 3+7 (n=67, 76%) or FLAG+/-Ida (n=167, 79%) with no difference in the rate of achieving remission between the two groups. Patients in the FLAG-Ida group were more likely to achieve remission after one course of induction (74% vs 62%, p<0.001) and had a faster time to get into CR (30 days vs 37.5, p<0.001) compared to 3+7. CR was achieved in 84% and 73% of patients with intermediate and poor NCCN risk disease respectively. HSCT was performed in 172 patients accounting for 72% of the 240 patients who achieved CR post induction without any significant difference in transplant rates between FLAG+/-Ida and 3+7. The time from diagnosis to transplant was significantly shorter among CR patients after FLAG+/-Ida compared to 3+7 (FLAG+/- Ida 115 days vs 144 days for 3+7, p<0.001). After a median follow up of 41 months for patients achieving CR, the 3 year post remission OS and DFS was significantly better for patients receiving FLAG-Ida at 54% and 49% compared to 39% and 32% for patients receiving 3+7 respectively( P= 0.01 for both endpoints). In multivariate analysis, we analyzed factors associated with OS and DFS since achieving CR1 including age at CR1 (≤49, 50-64, ≥65), gender, race, NCCN risk, induction regimen, number of cycles to CR1, HSCT (yes, no) and year of CR1. HSCT was modelled as a time dependent covariate. A forward stepwise algorithm was implemented and variables were selected if p value was less than 0.05. Factors associated with r post remission survival included age at CR1 (≤49 vs50-64, HR 0.59, p=.02; ≤49 vs ≥65 HR 0.46, p=0.001), NCCN risk (intermediate vs poor HR 0.54, p<0.001), induction regimen (FlAG+/-Ida vs 3+7 HR 0.62, p=0.01) and receiving HSCT (yes vs no HR 0.68, p=0.02). Factors affecting DFS from time of CR also included age, NCCN risk, induction regimen (FlAG+/-Ida vs 3+7 HR 0.68, p=0.028) and receiving HSCT. This single center analysis shows that among patients with non-favorable risk AML, achieving CR after FLAG+/-Ida has better post remission survival than 3+7. This may be partially explained by the faster time to achieve CR and faster time to HSCT in the FLAG+/- Ida group. Disclosures Solh: Amgen: Speakers Bureau; Celgene: Speakers Bureau; ADC Therapeutics: Research Funding.

Defining Outcomes in Hispanic Aggressive Non-Hodgkin Lymphoma Patients.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4542-4542
Author(s):  
Lara M Paraskos ◽  
Mariela A. Blum ◽  
Maricer Escalon ◽  
Annapoorna Ferrell ◽  
Erin Kobetz ◽  
...  
Keyword(s):  
Overall Survival ◽  
Hodgkin Lymphoma ◽  
Conflicts Of Interest ◽  
The United States ◽  
Treatment Modalities ◽  
P Value ◽  
Non Hodgkin Lymphoma ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Hispanic Patients

Abstract Abstract 4542 Background Multiple studies evaluating outcomes for oncology patients have demonstrated inferior overall survival rates among African-Americans. Hispanics comprise the largest ethnic minority in the United States. Surprisingly outcomes for Hispanic aggressive non-Hodgkin lymphoma (NHL) patients have not been evaluated and are therefore largely unknown. We aim to identify differences in epidemiology, treatment modalities and outcomes of Hispanic patients treated for aggressive NHL at our institution between the years 2000-2004. Methods We reviewed the medical records of 82 patients with aggressive type NHL who were identified using the tumor registry. Exclusion criteria include indolent and highly aggressive lymphomas per WHO classification as well as lymphomas related to AIDS or organ transplantation. Standard statistical analyses, including Kaplan-Meier survival estimates and Chi-squared analysis for group comparisons were used. P value of <0.05 was considered statistically significant. Results Of the 82 patients, 46 were self-reported Hispanic in origin; 36 were non-Hispanic. There were no significant differences with respect to age at diagnosis, LDH level, stage, or complete remission rate. Kaplan-Meier estimate of median overall survival (OS) of the cohort was 3.8 years with no statistically significant differences observed between the Hispanic and non-Hispanic ethnic groups. (P = 0.816). Conclusion Ethnic patterns of disease occurrences have been reported, but responses to treatment and outcome for Hispanic patients have not been established. Interestingly from our preliminary analysis, there appears to be no statistically significant difference in overall survival between Hispanic and non-Hispanic patients. Further evaluation is warranted. Disclosures: No relevant conflicts of interest to declare.

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