scholarly journals Patterns of seroconversion for SARS-CoV2-IgG in patients with malignant disease and association with anti-cancer therapy

2020 ◽  
Author(s):  
Astha Thakkar ◽  
Kith Pradhan ◽  
Shawn Jindal ◽  
Zhu Cui ◽  
Bradley Rockwell ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Cellular Therapy ◽  
Antibody Therapy ◽  
Hematologic Malignancies ◽  
High Rate ◽  
Cell Transplant ◽  
Specific Patient ◽  
Patients With Cancer ◽  
Anti Cancer ◽  
Patient Groups

Abstract Patients with cancer have been identified in several studies to be at high risk of developing severe COVID-19; however, rates of SARS-CoV-2 IgG seroconversion and its association with cancer types and anti-cancer therapy remain obscure. We conducted a retrospective cohort study in patients with cancer that underwent SARS-CoV-2 IgG testing. Two hundred and sixty-one cancer patients underwent SARS-CoV-2 IgG testing and demonstrated a high rate of seroconversion (92%). However, significantly lower seroconversion was observed in patients with hematologic malignancies (82%), patients that received anti-CD-20 antibody therapy (59%), CAR-T/cellular therapy (33%) and stem cell transplant (60%). Interestingly, all 17 patients that received immunotherapy, including 16 that received anti-PD-1/PD-L1 monoclonal antibodies, developed SARS-Cov-2 IgG antibodies (100% seroconversion). These data show differential rates of seroconversion in specific patient groups and bear importance for clinical monitoring and vaccination strategies that are being developed to mitigate the COVID-19 pandemic

scholarly journals Cancer History and Systemic Anti-Cancer Therapy Independently Predict COVID-19 Mortality: A UK Tertiary Hospital Experience

2020 ◽  
Vol 10 ◽  
Author(s):  
Christopher C. T. Sng ◽  
Yien Ning Sophia Wong ◽  
Anjui Wu ◽  
Diego Ottaviani ◽  
Neha Chopra ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Tertiary Hospital ◽  
Solid Cancer ◽  
Cancer History ◽  
Asian Ethnicity ◽  
Patients With Cancer ◽  
Anti Cancer ◽  
South Asian Ethnicity ◽  
History Of ◽  
Second Peak

BackgroundThe COVID-19 pandemic remains a pressing concern to patients with cancer as countries enter the second peak of the pandemic and beyond. It remains unclear whether cancer and its treatment contribute an independent risk for mortality in COVID-19.MethodsWe included patients at a London tertiary hospital with laboratory confirmed SARS-CoV-2 infection. All patients with a history of solid cancer were included. Age- and sex-matched patients without cancer were randomly selected. Patients with hematological malignancies were excluded.ResultsWe identified 94 patients with cancer, matched to 226 patients without cancer. After adjusting for age, ethnicity, and co-morbidities, patients with cancer had increased mortality following COVID-19 (HR 1.57, 95% CI:1.04–2.4, p = 0.03). Increasing age (HR 1.49 every 10 years, 95% CI:1.25–1.8, p < 0.001), South Asian ethnicity (HR 2.92, 95% CI:1.73–4.9, p < 0.001), and cerebrovascular disease (HR 1.93, 95% CI:1.18–3.2, p = 0.008) also predicted mortality. Within the cancer cohort, systemic anti-cancer therapy (SACT) within 60 days of COVID-19 diagnosis was an independent risk factor for mortality (HR 2.30, 95% CI: 1.16–4.6, p = 0.02).ConclusionsAlong with known risk factors, cancer and SACT confer an independent risk for mortality following COVID-19. Further studies are needed to understand the socio-economic influences and pathophysiology of these associations.

scholarly journals Endovascular Therapy for the Management of Acute Ilio-femoral Deep Vein Thrombosis

Phlebologie ◽  
2021 ◽  
Author(s):  
Mert Dumantepe
Keyword(s):  
Deep Vein Thrombosis ◽  
Endovascular Therapy ◽  
High Rate ◽  
Bleeding Complications ◽  
Postthrombotic Syndrome ◽  
Specific Patient ◽  
Acute Thrombosis ◽  
Vein Thrombosis ◽  
Patient Groups ◽  
Deep Vein

AbstractIlio-femoral deep vein thrombosis (DVT) has a high rate of long-term morbidity in the form of the postthrombotic syndrome (PTS). Therefore, management of acute thrombosis should not only focus on the prevention of acute complications such as propagation or embolisation of the initial clot but also on preventing recurrent thrombosis and PTS. Contemporary catheter-based treatments of deep vein thrombosis have proven to be safe and effective in selected patients. Current guidelines recommend medical therapy with anticoagulation alone for all but the most severe, limb-threatening thrombosis. They additionally allow for consideration of endovascular catheter-based treatment in selected patients with acute proximal ilio-femoral DVT and low risk of bleeding complications to prevent PTS. Imaging-guided, catheter-based endovascular therapy has been used in selected patients to alleviate these sequelae, but important questions remain about their optimal use. In this article, we review the available evidence and summarize the rationale for use of catheter-based therapy in specific patient groups with acute iliofemoral DVT.

scholarly journals SARS-CoV-2 in Childhood Cancer in 2020: A Disease of Disparities

2021 ◽  
Author(s):  
Emily E. Johnston ◽  
Isaac Martinez ◽  
Elizabeth S. Davis ◽  
Caroline Caudill ◽  
Joshua Richman ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Pediatric Oncology ◽  
Antibody Therapy ◽  
Population Level ◽  
Patient Characteristics ◽  
Hematologic Malignancies ◽  
Children With Cancer ◽  
Adjusted Risk ◽  
Icu Admission ◽  
Publicly Insured

PURPOSE The Pediatric Oncology COVID-19 Case Report registry supplies pediatric oncologists with data surrounding the clinical course and outcomes in children with cancer and SARS-CoV-2. METHODS This observational study captured clinical and sociodemographic characteristics for children (≤ 21 years) receiving cancer therapy and infected with SARS-CoV-2 from the pandemic onset through February 19, 2021. The demographic and clinical characteristics of the cohort were compared with population-level pediatric oncology data (SEER). Multivariable binomial regression models evaluated patient characteristics associated with hospitalization, intensive care unit (ICU) admission, and changes in cancer therapy. RESULTS Ninety-four institutions contributed details on 917 children with cancer and SARS-CoV-2. Median age at SARS-CoV-2 infection was 11 years (range, 0-21 years). Compared with SEER, there was an over-representation of Hispanics (43.6% v 29.7%, P < .01), publicly insured (59.3% v 33.5%, P < .01), and patients with hematologic malignancies (65.8% v 38.3%, P < .01) in our cohort. The majority (64.1%) were symptomatic; 31.2% were hospitalized, 10.9% required respiratory support, 9.2% were admitted to the ICU, and 1.6% died because of SARS-CoV-2. Cancer therapy was modified in 44.9%. Hispanic ethnicity was associated with changes in cancer-directed therapy (adjusted risk ratio [aRR] = 1.3; 95% CI, 1.1 to 1.6]). Presence of comorbidities was associated with hospitalization (aRR = 1.3; 95% CI, 1.1 to 1.6) and ICU admission (aRR = 2.3; 95% CI, 1.5 to 3.6). Hematologic malignancies were associated with hospitalization (aRR = 1.6; 95% CI, 1.3 to 2.1). CONCLUSION These findings provide critical information for decision making among pediatric oncologists, including inpatient versus outpatient management, cancer therapy modifications, consideration of monoclonal antibody therapy, and counseling families on infection risks in the setting of the SARS-CoV-2 pandemic. The over-representation of Hispanic and publicly insured patients in this national cohort suggests disparities that require attention.

scholarly journals Impact of the timing of hepatitis B virus (HBV) identification and anti-HBV therapy initiation on the risk of adverse liver outcomes in patients receiving cancer therapy.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6503-6503
Author(s):  
Jessica Hwang ◽  
Maria E. Suarez-Almazor ◽  
Scott B. Cantor ◽  
Andrea G. Barbo ◽  
Heather Y. Lin ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Cancer Therapy ◽  
Hepatitis B ◽  
Liver Failure ◽  
Solid Tumors ◽  
Hematologic Malignancies ◽  
Patients With Cancer ◽  
Therapy Initiation ◽  
B Virus ◽  
Chronic Hbv

6503 Background: Patients with cancer and hepatitis B virus (HBV) infection receiving cancer therapy are at risk for HBV reactivation. We aimed to determine the impact of early vs. late HBV identification and early vs. late/no anti-HBV therapy on adverse liver outcomes of patients with cancer with chronic (HBsAg+/anti-HBc+) or past (HBsAg-/anti-HBc+) HBV infection. Methods: We retrospectively studied adult patients with solid or hematologic malignancies who received chemotherapy during 2004-2011. Adverse liver-related events included hepatitis flares, liver failure, and death. Time-to-event analysis was used to determine incidence, and multivariable hazard models to determine predictors of outcomes. Early was defined as at the initiation of cancer therapy and late as after therapy initiation. Results: There were 18,688 study patients (80.4% had solid tumors). Among patients with hematologic malignancies, 89.6% had HBV testing of which 90.4% was early. Among patients with solid tumors, 10.8% had HBV testing of which 46.4% was early. Prevalence of chronic HBV was 1.1% (52/4905) and past HBV was 7.1% (350/4905). Among patients with chronic HBV with hematologic or solid malignancy, those identified late had 2.95 times (1.45-6.01) higher risk of liver failure than those identified early. Among chronic HBV patients, 59% (23/39) with early testing had early initiation of anti-HBV therapy, while all of those tested late had late/no initiation of anti-HBV therapy. Predictors of liver failure were male sex, chronic HBV, and late HBV identification for patients with solid tumors, and allogeneic SCT for patients with hematologic malignancies. Conclusions: Early HBV identification correlated with early anti-HBV therapy initiation and reduced risk of liver failure after chemotherapy in chronic HBV patients with solid tumors or hematologic malignancies as well as patients with past HBV and solid tumors.

scholarly journals Immunogenicity of SARS-CoV-2 mRNA Vaccines in Patients with Cancer: Findings from an International Collaborative Cohort Study

2021 ◽  
Author(s):  
Alfredo Addeo ◽  
Pankil Shah ◽  
Natacha Bordry ◽  
Robert Hudson ◽  
Brenna Albracht ◽  
...  
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
General Population ◽  
Antibody Therapy ◽  
Vulnerable Groups ◽  
Cell Mediated Immunity ◽  
Plasma Therapy ◽  
Patients With Cancer ◽  
Anti Cancer ◽  
Antibody Titers

Abstract Patients with cancer experience higher burden of SARS-CoV-2 infection, disease severity, complications, and mortality, compared to the general population. SARS-CoV-2 mRNA vaccines have shown to be highly effective in clinical trials; however, few data are available on the efficacy of SARS-CoV-2 vaccines in patients with cancer. Using a prospective cohort study design, we assessed the seroconversion rates and anti-SARS-CoV-2 S antibody titers following the 1st and 2nd dose of BNT162b2 and mRNA-1273 SARS-CoV-2 vaccines in patients with cancer at centers in U.S. and Europe from January 2021 to April 2021. Among 131 patients included in the immunogenicity analysis, most (94%) developed antibody levels; however, 6% showed no seroconversion after completing the mRNA vaccination series. No differences in seroconversion rates were observed between BNT162b2 and mRNA-1273 vaccine groups. Patients with solid tumors (98%) were much more likely to seroconvert and develop higher antibody titers than those with hematological malignancy (77%). Although seroconversion rates were consistently high in patients receiving different types of anti-cancer therapy except anti-CD-20 antibody; the antibody titers were much lower in patients who received cytotoxic chemotherapy, immunotherapy, or monoclonal antibody compared to those on clinical surveillance or receiving endocrine therapy within six months prior to vaccination. None of the patients on anti-CD-20 antibody therapy developed an antibody response, even after receiving 2 doses of the vaccines. After correlating with cell-mediated immunity in a subset of patients at high-risk for antibody non-response, we propose exploring the addition of a second booster, or convalescent plasma therapy, or postpone vaccination until after completion of their specific anti-cancer treatment. Although encouraging results, we suggest high-risk vaccinated patients with cancer to continue taking safety precautions until their immune response is confirmed at 4 weeks after 2nd dose of mRNA vaccines. We also highly encourage all eligible individuals in the general population to get vaccinated to ensure the protection of the most vulnerable groups, such as those with cancer.

scholarly journals Participation of MicroRNAs in the Treatment of Cancer with Phytochemicals

Molecules ◽  
2020 ◽  
Vol 25 (20) ◽  
pp. 4701 ◽  
Author(s):  
Seung Wan Son ◽  
Han Yeoung Lee ◽  
Sokviseth Moeng ◽  
Hyo Jeong Kuh ◽  
Soo Young Choi ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Health Concern ◽  
Promising Candidate ◽  
Medical Treatments ◽  
Patients With Cancer ◽  
Anti Cancer ◽  
Causes Of Disease ◽  
The Relationship ◽  
Effective Cancer Therapy

Cancer is a global health concern and one of the main causes of disease-related death. Even with considerable progress in investigations on cancer therapy, effective anti-cancer agents and regimens have thus far been insufficient. There has been compelling evidence that natural phytochemicals and their derivatives have potent anti-cancer activities. Plant-based anti-cancer agents, such as etoposide, irinotecan, paclitaxel, and vincristine, are currently being applied in medical treatments for patients with cancer. Further, the efficacy of plenty of phytochemicals has been evaluated to discover a promising candidate for cancer therapy. For developing more effective cancer therapy, it is required to apprehend the molecular mechanism deployed by natural compounds. MicroRNAs (miRNAs) have been realized to play a pivotal role in regulating cellular signaling pathways, affecting the efficacy of therapeutic agents in cancer. This review presents a feature of phytochemicals with anti-cancer activity, focusing mainly on the relationship between phytochemicals and miRNAs, with insights into the role of miRNAs as the mediators and the regulators of anti-cancer effects of phytochemicals.

scholarly journals Microbiological and Clinical Studies of Legionellosis in 33 Patients with Cancer

2015 ◽  
Vol 53 (7) ◽  
pp. 2180-2187 ◽  
Author(s):  
Xiang Y. Han ◽  
Andrea Ihegword ◽  
Scott E. Evans ◽  
Jiaqi Zhang ◽  
Li Li ◽  
...  
Keyword(s):  
Asymptomatic Carrier ◽  
Hematologic Malignancies ◽  
Human Infection ◽  
Cancer Center ◽  
Rrna Gene ◽  
Cell Transplant ◽  
Sequencing Analysis ◽  
Hematopoietic Stem ◽  
Content Type ◽  
Patients With Cancer

Legionella, a large group of environmental Gram-negative bacteria, represents an occasional cause of pneumonia. We analyzed the microbiological and clinical features of 33 consecutive cases ofLegionellainfections that occurred at the University of Texas MD Anderson Cancer Center, Houston, TX, from 2002 to 2014. TheLegionellastrains were isolated from bronchoscopy specimens (32 strains) and a blood culture (1 strain) and were identified by sequencing analysis of the full-length 16S rRNA gene. The 33 strains involved 12Legionellaspecies or subspecies: 15 strains ofL. pneumophilasubsp.pneumophila, 3 strains ofL. pneumophilasubsp.fraseriorL. pneumophilasubsp.pascullei, 4 strains of “L. donaldsonii,” 3 strains ofL. micdadei, and one each ofL. bozemanae,L. feeleii,L. gormanii,L. longbeachae,L. maceachernii,L. parisiensis,L. sainthelensi, andLegionellasp. strain D5382. All patients except one asymptomatic carrier showed pneumonia, including one with concurrent bacteremia. Nine patients died, with this infection being the immediate cause of death in six. Twenty-seven patients had underlying hematologic malignancies. Twenty-three patients were leukopenic. Six patients were recipients of allogeneic hematopoietic stem cell transplant, with their infections caused by fiveLegionellaspecies. Together, these results suggest that diverseLegionellaspecies infect patients with cancer in the Houston area and its vicinity. The five cases of pneumonia due toL. donaldsoniiandLegionellasp. D5382 are likely the first reports of human infection with these organisms.

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