scholarly journals Education Level as a Predictor of Survival in Patients with Multiple Myeloma

2020 ◽  
Author(s):  
Limei Xu ◽  
Xiuju Wang ◽  
Xueyi Pan ◽  
Xiaotao Wang ◽  
Qing Wang ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
High Education ◽  
Rural Areas ◽  
Survival Rates ◽  
Multivariable Analysis ◽  
Progression Free Survival ◽  
Education Level ◽  
Low Education ◽  
Education Levels ◽  
Better Than

Abstract Background: Disparities in multiple myeloma (MM) prognosis based on sociodemographic factors may exist. We investigated whether education level at diagnosis influenced Chinese MM patient outcomes.Methods: We performed a multicenter retrospective analysis of data from 773 MM patients across 9 centers in China from 2006 to 2019. Sociodemographic and clinical factors at diagnosis and treatment regimens were recorded, and univariate and multivariate analyses were performed.Results: Overall, 69.2% of patients had low education levels. Patients with low education levels differed from those with high education levels in that they were more likely to be older, and a higher proportion lived in rural areas, were unemployed, had lower annual incomes and lacked insurance. Additionally, compared to patients with high education levels, patients with low education levels had a higher proportion of international staging system (ISS) stage III classification and elevated lactate dehydrogenase (LDH) levels and underwent transplantation less often. Patients with high education levels had a median progression-free survival (PFS) of 67.50 (95% confidence interval (CI): 51.66-83.39) months, which was better than that of patients with low education levels (30.60 months, 95% CI: 27.38-33.82, p<0.001). Similarly, patients with high education levels had a median overall survival (OS) of 122.27 (95% CI: 117.05-127.49) months, which was also better than that of patients with low education levels (58.83 months, 95% CI: 48.87-62.79, p<0.001). In the multivariable analysis, patients with high education levels had lower relapse rates and higher survival rates than did those with low education level in terms of PFS and OS (hazard ratio (HR)=0.50 [95% CI: 0.34-0.72], p<0.001; HR=0.32 [0.19-0.56], p<0.001, respectively).Conclusions: Low education levels may independently predict poor survival in MM patients in China.

scholarly journals Education Level as a Predictor of Survival in Patients with Multiple Myeloma

2020 ◽  
Author(s):  
Limei Xu ◽  
Xiuju Wang ◽  
Xueyi Pan ◽  
Xiaotao Wang ◽  
Qing Wang ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
High Education ◽  
Rural Areas ◽  
Multivariable Analysis ◽  
Progression Free Survival ◽  
Staging System ◽  
Education Level ◽  
Rank Test ◽  
Low Education ◽  
Education Levels

Abstract Background Disparities in multiple myeloma (MM) prognosis based on sociodemographic factors may exist. We investigated whether education level at diagnosis influenced Chinese MM patient outcomes.Methods We performed a multicenter retrospective analysis of data from 773 MM patients across 9 centers in China from 2006 to 2019. Sociodemographic and clinical factors at diagnosis and treatment regimens were recorded, and univariate and multivariate analyses were performed. Results Overall, 69.21% of patients had low education levels. Patients with low education levels differed from those with high education levels in that they were more likely to be older, and a higher proportion lived in rural areas, were unemployed, had lower annual incomes and lacked insurance. Additionally, compared to patients with high education levels, patients with low education levels had a higher proportion of international staging system (ISS) stage III classification and elevated lactate dehydrogenase (LDH) levels and underwent transplantation less often. Patients with high education levels had better progression-free survival (PFS) and overall survival (OS) than did patients with low education levels (67.50±8.10 versus 30.60±1.64 months; 122.27±0 versus 55.83±3.55 months, log-rank test, p<0.001; respectively). In the multivariable analysis, patients with high education levels had lower relapse and mortality rates than did those with low education level in terms of PFS and OS (hazard ratio (HR)=0.50 [95% confidence interval (CI): 0.34-0.72], p<0.001; HR=0.31 [0.18-0.53], p<0.001, respectively). Conclusions Low education levels may independently predict poor survival in MM patients in China. To reduce healthcare disparities for universal healthcare reform, it is critical to improve citizens’ education levels.

scholarly journals Disaggregation of official demographic projections in sub-groups by education level: the neglected “composition effect” in the future path of life expectancy

Genus ◽  
2021 ◽  
Vol 77 (1) ◽  
Author(s):  
Sergio Ginebri ◽  
Carlo Lallo
Keyword(s):  
High Education ◽  
Life Expectancy ◽  
Education Level ◽  
Retirement Age ◽  
Composition Effect ◽  
Education Group ◽  
Population Forecasts ◽  
Low Education ◽  
Mortality Differential ◽  
Education Groups

AbstractWe developed an innovative method to break down official population forecasts by educational level. The mortality rates of the high education group and low education group were projected using an iterative procedure, whose starting point was the life tables by education level for Italy, based on the year 2012. We provide a set of different scenarios on the convergence/divergence of the mortality differential between the high and low education groups. In each scenario, the demographic size and the life expectancy of the two sub-groups were projected annually over the period 2018–2065. We compared the life expectancy paths in the whole population and in the sub-groups. We found that in all of our projections, population life expectancy converges to the life expectancy of the high education group. We call this feature of our outcomes the “composition effect”, and we show how highly persistent it is, even in scenarios where the mortality differential between social groups is assumed to decrease over time. In a midway scenario, where the mortality differential is assumed to follow an intermediate path between complete disappearance in year 2065 and stability at the 2012 level, and in all the scenarios with a milder convergence hypothesis, our “composition effect” prevails over the effect of convergence for men and women. For instance, assuming stability in the mortality differential, we estimated a life expectancy increase at age 65 of 2.9 and 2.6 years for men, and 3.2 and 3.1 for women, in the low and high education groups, respectively, over the whole projection period. Over the same period, Italian official projections estimate an increase of 3.7 years in life expectancy at age 65 for the whole population. Our results have relevant implications for retirement and ageing policies, in particular for those European countries that have linked statutory retirement age to variations in population life expectancies. In all the scenarios where the composition effect is not offset by a strong convergence of mortality differentials, we show that the statutory retirement age increases faster than the group-specific life expectancies, and this finding implies that the expected time spent in retirement will shrink for the whole population. This potential future outcome seems to be an unintended consequence of the indexation rule.

LMCE3 Treatment Strategy: Results in 99 Consecutively Diagnosed Stage 4 Neuroblastomas in Children Older Than 1 Year at Diagnosis

2000 ◽  
Vol 18 (3) ◽  
pp. 468-468 ◽  
Author(s):  
D. Frappaz ◽  
J. Michon ◽  
C. Coze ◽  
C. Berger ◽  
E. Plouvier ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Complete Remission ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Consolidation Therapy ◽  
French Society ◽  
Free Survival ◽  
Stage 4 ◽  
Total Body ◽  
Better Than

PURPOSE: To tailor postinduction therapy for stage 4 neuroblastoma in children who are older than 1 year at diagnosis according to status after induction. PATIENTS AND METHODS: From March 1987 to December 1992, 99 patients who were consecutively admitted were included in the Lyon-Marseille-Curie East of France (LMCE)3 strategy. After induction with the French Society of Pediatric Oncology NB87 regimen and surgery, patients who were in complete remission immediately proceeded to consolidation therapy with vincristine, melphalan, and fractionated total-body irradiation (VMT). All other patients underwent a postinduction strategy before VMT, either an additional megatherapy regimen or further chemotherapy with etoposide/carboplatin. RESULTS: The progression-free survival (PFS) is 29% at 7 years from diagnosis, which compares favorably with that of a similar cohort of 72 patients previously reported by our group (LMCE1; PFS of 20% at 5 years and 8% at 14 years, P = .004). In the multivariate analysis, only age younger than 3 years at diagnosis (P = .0085) and achievement of complete or very good partial remission after NB87 and surgery (P = .00024) remained significant. The PFS of the 87 patients who were included in the postinduction strategy was significantly better than that of the comparable 62 patients on the LMCE1 study (32% v 11% at 7 years; P = .005). CONCLUSION: The progressive improvements in the LMCE results over the last 10 years suggest that improvements in supportive care measures and increases in each component of this strategy (induction, postinduction, consolidation) may all contribute to increased survival rates.

Hypofractionated therapy versus conventional fractionated radiotherapy in elderly patients with glioblastoma multiforme

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 12529-12529
Author(s):  
H. Elshenshawy ◽  
A. Abd El-Razek ◽  
H. Bader
Keyword(s):  
Glioblastoma Multiforme ◽  
Elderly Patients ◽  
Performance Status ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Fractionated Radiotherapy ◽  
Treatment Groups ◽  
Short Course ◽  
Short Course Radiotherapy ◽  
Better Than

12529 Background: To evaluate efficacy of short- course radiotherapy(RT) in elderly (>60years) patients with glioblastoma multiforme(GBM), and compare this biological similar short -course radiotherapy with a standard radiotherapy Methods: Forty-four elderly patients with GBM were randomly assigned after surgery to receive either a short-course of radiotherapy (45 Gy in 15 fractions over 3 weeks ) or standard radiotherapy (60 Gy in 30 fractions over 6weeks) to a target volume described as tumor visible on CT scan and a 2- cm margin . The primary end point was overall survival. Results: The overall response rate and median duration of response were 60%and 8.5 months in short- course RT versus 65% and 8 months in standard RT . Improvement in pretreatment performance status and increase in post- treatment corticosteroid dosage were observed in 50% and 25% in short- course RT versus 40% and 50% in standard RT (P=0.09, P=0.031) respectively. Median survival time was 5.9 months in short-course RT versus 5.6 months in standard RT . Six months, 1-year survival and progression-free survival rates were 40%, 15% and 30% ,10% in short- course RT versus 45%, 10% and 35% , 5% in standard RT , respectively. In both treatment groups, females did significantly better than males, patients with KPS 60–70 did significantly better than those with KPS 50 , patients having tumors 4–5 cm did significantly better than those with tumors 6–8 cm as well as did those with more radical surgery when compared to those with biopsy only. On multivariate analysis , only tumor size and extent of surgery were found to independently influence survival. Acute toxicity was generally assessed as mild in the two treatment groups. While RT -induced brain necrosis appeared only in one patient received short- course RT, but this patient died from tumor recurrence. Conclusions: Hypofractionated RT is feasible and safe treatment for elderly patients with GBM. No significant financial relationships to disclose.

scholarly journals Epidemiological Aspect of Dog Bite and Response of The Dog Bite Victims Attending Vaccination Centre of Sadar Hospital, Sirajganj

KYAMC Journal ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 148-152
Author(s):  
Ahmed Nawsher Alam ◽  
Mahmuda Siddiqua ◽  
Asma Siddiqua ◽  
Nasreen Akther ◽  
Moushumi Sarker ◽  
...  
Keyword(s):  
Rural Areas ◽  
Public Health Problem ◽  
Education Level ◽  
Post Exposure Prophylaxis ◽  
Dog Bite ◽  
Primary Level ◽  
Epidemiological Aspect ◽  
Low Education ◽  
Knowledge And Attitude ◽  
Exposure Prophylaxis

Background: Rabies is a public health problem in Bangladesh, with poorer people and children being mainly affected. Objectives: The aim of this study was to investigate the behaviours of dog bite victims following a bite and to assess the knowledge and attitude about rabies among dog bite victims. Materials and Methods: A crosssectional type of descriptive study was designed where individual people who came to the vaccination centre from the month of April 2015 to July 2015 for post-exposure prophylaxis were considered. They were interviewed and followed during subsequent visits until they had received their final dose of vaccination. Result: Among the victims, males 60.9% were more common than females 39.1% and most of them were children aged below 20 years 51 %, mostly from rural areas 69.3%, had very little primary 46.1% or no education 24.7%. Victims were bitten mostly at their legs 89.3%. In response to question regarding what happens following dog bite, 49% couldn't say anything, and 46% mentioned hydrophobia. Most of them (87%) know that rabies can be transmitted from dogs to humans; 68.4% had no idea that rabies can be prevented in dogs. Though 82.3% bite victims didn't know that rabies in humans can be prevented before a dog bite, 77.7% knew that rabies can be prevented after a dog bite. Use of soap and water was found lowest 13.1% among those who had education upto primary level and highest 53.9% in graduates. Conclusion: This study showed that most victims didn't take any washing measures before visiting to hospital which is one of the most important measures recommended by WHO and it was found mostly who had low education level. It also observed that knowledge gap about rabies among the dog bite victims decreased with increased education level. KYAMC Journal Vol. 9, No.-4, January 2019, Page 148-152

Novel therapy with 2-methoxyestradiol (2ME2) for the treatment of relapsed and plateau phase multiple myeloma

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 8108-8108 ◽  
Author(s):  
M. Lacy ◽  
P. Richardson ◽  
M. Gertz ◽  
A. Dispenzieri ◽  
P. Greipp ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stable Disease ◽  
Survival Rates ◽  
Eastern Cooperative Oncology Group ◽  
Progression Free Survival ◽  
Pharmacokinetic Data ◽  
Cell Transplant ◽  
Upper Respiratory Tract ◽  
Plateau Phase ◽  
Novel Therapy

8108 Background: 2-methoxyestradiol (2ME2) is a natural endogenous product of estradiol metabolism with anti-angiogenic and anti-neoplastic properties that has demonstrated activity against multiple myeloma cell lines and xenografts in immunocompromised mice. We report results of the first phase II clinical trial of 2ME2 in pts with relapsed and plateau phase myeloma. Methods: This trial was designed with a one-stage design to accrue 60 pts in the setting of relapsed and plateau phase myeloma. 2ME2 was administered orally at a dose of 1000 mg daily. After the first 39 pts were accrued, based on the results of ongoing phase I trials, the dose of 2ME2 was increased to 800 mg twice daily for the remaining patients. Pts who were already on study at that point were also allowed to escalate their dose to 800 mg twice daily. The primary endpoint was overall response rate. Responses were assessed using Eastern Cooperative Oncology Group criteria. Results: Sixty patients were treated at Mayo Clinic and Dana Farber Cancer Institute. Median age was 60 years (range, 28–99). Thirty-one patients had relapsed/refractory myeloma and 29 patients had plateau phase myeloma. Median number of prior therapies was 4 including stem cell transplant (48%), thalidomide (62%), bortezomib (6%) and lenalidomide (3%). Therapy was well tolerated. Adverse events were anemia (35%), fatigue (35%), nausea (25%), diarrhea (20%), hot flashes (20%), headache (17%), muscle cramps (15%), and upper respiratory tract infection (15%). Most toxicities were mild (grade 1–2). Estimated progression-free survival rates for all pts at one, two, and three years are 24%, 16%, and 9% respectively. Three pts with plateau phase disease, have been on study for over 4 years without progression at 50, 60, and 63 months. Response assessment is ongoing; so far, whilst no partial responses have been seen, prolonged stable disease has been observed in 3 pts (5%). Conclusions: 2ME2 is a novel agent that appears to be safe and well tolerated. Although no responses have been seen, prolonged stable disease in some pts is promising. Preliminary pharmacokinetic data indicate that the dose of 2ME2 used in this study may be inadequate, and a new formulation with significantly better bioavailability will be tested soon in this patient population. No significant financial relationships to disclose.

scholarly journals A Phase 2 Study to Assess the Feasibility and Tolerance of the Combination of Elotuzumab, Lenalidomide, and Dexamethasone (ERd) in the Induction, Consolidation, and Maintenance Treatment of Transplant-Eligible Patients Newly Diagnosed with Multiple Myeloma (MM)

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 603-603 ◽  
Author(s):  
Jesus G. Berdeja ◽  
Tara K. Gregory ◽  
Suman Kambhampati ◽  
Bertrand M. Anz ◽  
Stefano R. Tarantolo ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
High Risk ◽  
Research Funding ◽  
Maintenance Treatment ◽  
Overall Response Rate ◽  
Response Rate ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Newly Diagnosed ◽  
Overall Response

Background: The introduction of novel agents such as proteasome inhibitors (PI) and immunomodulatory drugs (IMiDs) with and without corticosteroids has revolutionized treatment (tx) and improved survival rates for MM. IMID/PI triplets such as VRD (bortezomib, lenalidomide, dexamethasone), VTD (bortezomib, thalidomide, dexamethasone), or KRD (carfilzomib, lenalidomide, dexamethasone) are preferred inductions for transplant-eligible patients (pts). Unfortunately, the PI often has unique safety events such as peripheral neuropathy (PN) or cardiac issues that can impact the quality of life. Elotuzumab is a mAb with a dual mechanism of action (tagging MM cells and activating NK cells by binding SLAMF7). The combination of elotuzumab, lenalidomide, and dexamethasone (ERd), is active, well-tolerated, and approved by the FDA for pts with relapsed MM. In this study, we will determine the feasibility of incorporating ERd into a transplant-eligible pt population. Methods: Pts with newly diagnosed MM requiring chemotherapy planning to undergo autologous stem cell transplantation (ASCT) were enrolled. Induction of elotuzumab at 10 mg/kg was administered IV on days (D) 1, 8, 15, 22 of the 1st 2 28-day cycles and days 1, 15 of the third and fourth 28-day cycles. Lenalidomide was dosed at 25 mg orally on D 1-21 of each 28 day induction cycle. Dexamethasone was administered IV concurrent with elotuzumab (28mg orally 3-24 hours prior to infusion and 8 mg IV with elotuzumab), with 40 mg orally administered on D 8 and 22 of cycles 3 and 4. After completion of the 4 induction cycles, pts proceeded to mobilization and ASCT though pts who refused transplantation were allowed to proceed directly to consolidation and maintenance if the investigator believed the pt was deriving benefit. 70-120 days after ASCT, 4 cycles of consolidation were administered (dosing similar to cycles 3-4 of induction but with lenalidomide at 15mg). Pts then went on to maintenance with elotuzumab 20 mg/kg IV on D 1, oral lenalidomide 10mg +/- 5 mg D 1-21 and dexamethasone 28mg oral/8 mg IV prior to elotuzumab infusion were dosed in 28-day cycles for up to 24 months. The primary endpoint was the induction feasibility rate (IFR) defined as the percentage of pts successfully completing 4 cycles of induction tx with ERd and able to start ASCT. Secondary end points were complete response rate (≥nCR), overall response rate (≥PR), progression-free survival (PFS) and overall survival (OS). AEs were assessed according to CTCAE V4 and responses were assessed using the revised IMWG criteria. Results: 52 pts were enrolled: 56% male, median age 61 ys, 12% RISS III, 21% high-risk cytogenetics [17p del, t(4;14), and/or t(14;16)]. To date, 26 (50%) pts remain on active tx. 4 pts refused transplantation despite being eligible and were excluded from the IFR calculation. The IFR was 69% and the best overall response rate (ORR) was 92% (69% ≥ VGPR). With a median follow up of 20 mos, median PFS and OS for all pts were not reached. The 18 mo PFS and OS were 83% and 89% respectively. The most common AEs were fatigue (59.6%), diarrhea (42.3%) and nausea (42.3%). PN was seen in 29%, and all events were ≤ G2. There were 28 SAEs in 20 pts, including 12 tx-related SAEs. There was 1 tx-related death due to heart failure in a pt with no history of prior cardiac issues who had subsequent therapy. 29% of pts met the high-risk (HR) criteria (defined as RISS III or high risk cytogenetics) and 29% of pts were considered standard-risk (RISS I and no high-risk cytogenetics). The best ORR was 87% (67% ≥ VGPR) for HR pts and 93% (53% ≥ VGPR) for SR pts and the IFR was 57% for HR pts and 64% for SR pts. The median PFS and OS were 20.5 mos and 22.0 mos respectively for HR pts and have not been reached for SR pts. Conclusions: ERd induction, consolidation and maintenance was feasible and well tolerated in conjunction with ASCT in transplant-eligible pts. Despite high ORR for all pts, HR patients had inferior PFS and OS. This study supports the continued evaluation of this regimen in SR pts. Disclosures Berdeja: Amgen Inc, BioClinica, Celgene Corporation, CRISPR Therapeutics, Bristol-Myers Squibb Company, Janssen Biotech Inc, Karyopharm Therapeutics, Kite Pharma Inc, Prothena, Servier, Takeda Oncology: Consultancy; Poseida: Research Funding; AbbVie Inc, Amgen Inc, Acetylon Pharmaceuticals Inc, Bluebird Bio, Bristol-Myers Squibb Company, Celgene Corporation, Constellation Pharma, Curis Inc, Genentech, Glenmark Pharmaceuticals, Janssen Biotech Inc, Kesios Therapeutics, Lilly, Novartis, Poseida: Research Funding. Gregory:Takeda: Speakers Bureau; Celgene: Speakers Bureau; Poseida: Research Funding; Amgen: Speakers Bureau. OffLabel Disclosure: Yes, this was an investigational clinical study of the combination of elotuzumab, lenalidomide, and dexamethasone in the induction, consolidation, and maintenance treatment of transplant-eligible patients newly diagnosed with multiple myeloma.

scholarly journals Survival of Patients with Multiple Myeloma That Is Refractory to Both Bortezomib and Lenalidomide: A Retrospective Study

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 2020-2020
Author(s):  
Kanji Miyazaki ◽  
Kenshi Suzuki
Keyword(s):  
Multiple Myeloma ◽  
Retrospective Study ◽  
Autologous Transplantation ◽  
Survival Rates ◽  
Allogeneic Transplantation ◽  
New Drugs ◽  
Rank Test ◽  
Refractory Multiple Myeloma ◽  
Kaplan Meier ◽  
Better Than

Abstract Introduction: Patients with multiple myeloma that is refractory to both bortezomib and lenalidomide show poor survival. This resistant myeloma is called double-refractory multiple myeloma. Several new drugs, such as pomalidomide, panobinostat, carfilzomib, ixazomib, elotuzumab, and daratumumab, have become available in recent years. These new drugs could prolong the survival of patients with double-refractory multiple myeloma in prospective clinical trials. The present study aimed to evaluate the survival of such patients and assess the effectiveness of the new drugs, autologous transplantation, and allogeneic transplantation in real clinical settings. Methods: This retrospective study reviewed the medical records of patients with multiple myeloma who received treatment between February 2002 and January 2018 at our institution. Patients with myeloma refractory to both bortezomib and lenalidomide were selected. Those with coexisting amyloidosis were excluded. The primary outcome was overall survival (OS). Survival analyses were performed using the Kaplan-Meier method, and survival rates were compared using the log-rank test. Results: The study included 103 patients. New drugs were used in 71 (68.9%) patients, and their OS was significantly better than that of the remaining 32 (31.1%) patients who did not receive those agents (median OS, not reached versus 5 months, p < 0.001) (Figure 1). Total 20 patients underwent autologous transplantation. Their OS was similar to that of those who did not undergo autologous transplantation (median OS, 21 months versus 17 months, p = 0.503). Total 10 patients underwent allogeneic transplantation. Their OS was similar to that of those who did not undergo allogeneic transplantation (median OS, 24 months versus 18 months, p = 0.517). In the 71 patients who were treated using new drugs, pomalidomide and panobinostat-based therapies were not associated with better survival, whereas carfilzomib, ixazomib, elotuzumab, and daratumumab-based therapies were associated with significantly better OS. Carfilzomib was administered to 45.1% (32/71) of patients, and their OS was significantly better than that of the remaining 54.9% (31/71) patients (median OS, not reached versus 19 months, p = 0.032). Although carfilzomib, lenalidomide, and dexamethasone (KRd) therapy was not associated with better OS among the 71 patients, carfilzomib and dexamethasone (Kd) therapy was associated with better OS (median OS, not reached versus 21 months, p = 0.040). Ixazomib was administered to 14.1% (10/71) of patients, and their OS was 100%, which was significantly better than that of the remaining 85.9% (61/71) of patients (median OS, 20 months, p = 0.037). Elotuzumab was administered in 15.5% (11/71) of patients, and their OS was also 100% and was significantly better than that in the remaining 84.5% (60/71) of patients (median OS, 20 months, p = 0.011). Daratumumab was administered in 25.4% (18/53) of patients, and their OS was significantly better than that of the remaining 74.6% of patients (median OS, not reached versus 20 months, p = 0.025). The OS of patients administered only 1 new drug was worse than that of patients administered 2 new drugs (median OS, 17 months versus not reached, p = 0.003). However, the OS of patients administered 2 new drugs was comparable with that of patients administered 3 or more new drugs (p = 0.477) (Figure 2). Conclusions: New drugs, particularly carfilzomib, ixazomib, elotuzumab, and daratumumab, are associated with improved survival in patients with multiple myeloma refractory to both bortezomib and lenalidomide. Autologous and allogeneic transplantation are not associated with improved survival. Figure 1. Figure 1. Disclosures Suzuki: SRL.Inc: Employment; Sanofi Aventis: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Celgene: Consultancy, Honoraria; Novartis: Consultancy, Honoraria; Bristol-Myers Squibb: Consultancy, Honoraria; Ono: Consultancy, Honoraria; Takeda: Consultancy, Honoraria.

Diagnostic accuracy of CERAD total score in a Colombian cohort with mild cognitive impairment and Alzheimer's disease affected by E280A mutation on presenilin-1 gene

2015 ◽  
Vol 28 (3) ◽  
pp. 503-510 ◽  
Author(s):  
Daniel Camilo Aguirre-Acevedo ◽  
Fabian Jaimes-Barragán ◽  
Eliana Henao ◽  
Victoria Tirado ◽  
Claudia Muñoz ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
High Education ◽  
Mild Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Education Level ◽  
Presenilin 1 ◽  
Education Group ◽  
Low Education

ABSTRACTBackground:This study aimed to determine Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Neuropsychological Assessment Battery total score diagnostic accuracy in the diagnosis of mild cognitive impairment (MCI) and dementia in familial Alzheimer's disease (FAD) with E280A mutation on presenilin-1 gene (PSEN1).Methods:A cross-sectional study was conducted in a cohort of PSEN1 E280A carriers and non-carriers assessed between January 1995 and February 2013. During the first neuropsychological assessment, 76 were having dementia, 46 had MCI, and 1,576 were asymptomatic. CERAD cut-off points were established for MCI and dementia using a Receiver Operating Characteristics (ROC) analysis, and were further analyzed according to education level in two groups: low education level (eight years or less), and high education level (over eight years).Results:The area under curve–ROC CERAD total score for dementia was 0.994 (95% CI = 0.989–0.999), and that for MCI was 0.862 (95% CI = 0.816–0.908). The dementia diagnosis cut-off point for the low education group was 54, (98.4% sensitivity, 92.6% specificity), and that for the high education group was 67 (100% sensitivity, 94.1% specificity). The MCI diagnosis cut-off point for the low education group was 66 (91.2% sensitivity, 56.4% specificity), and that for the high education group was 72 (91.7% sensitivity, 76.3% specificity).Conclusions:The CERAD total score is a useful screening tool for dementia and MCI in a population at risk of FAD.

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