scholarly journals Timing of chemotherapy-induced neutropenia is a prognostic factor in patients with diffuse large B-cell lymphoma: a retrospective study

2021 ◽  
Author(s):  
Juan Qiu ◽  
Baoxuan Zhang ◽  
Bing Bu ◽  
Shu Fang ◽  
Lihua Song
Keyword(s):  
Early Onset ◽  
Cell Lymphoma ◽  
Late Onset ◽  
Independent Predictor ◽  
B Cell Lymphoma ◽  
Short Term ◽  
Term Efficacy ◽  
Large B Cell Lymphoma ◽  
Onset Group ◽  
Early Onset Group

Abstract Background Chemotherapy-induced neutropenia (CIN) has been shown to be associated with improved clinical outcomes in patients with various solid tumors. The aim of this study was to investigate the relationship between the timing and degree of chemo-induced neutropenia (CIN) and short-term efficacy and survival in newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL).Methods A retrospective study was conducted on 236 newly diagnosed DLBCL patients who received at least 6 cycles of R-CHOP (like) or CHOP (like) between January 2012 and December 2018. According to the occurrence time of CIN, subjects were divided into CIN-absent group, early-onset CIN group and late-onset CIN group. According to the degree of CIN, they were divided into CIN-absent group, mild (grade 1-2) CIN group, and severe (grade 3-4) CIN group. Short-term efficacy was evaluated after 4 cycles of treatment. The Kaplan-Meier method was used to draw the survival curve, and the Cox proportional hazards model was applied to determine the correlation between the timing and extent of CIN and clinical features, short-term efficacy, progression-free survival (PFS) and overall survival (OS).Results After 4 treatment cycles, the objective response rate (ORR) of the early-onset group was higher than that of in the late-onset group and CIN absent group (95.7% VS 88.4% VS 81.0%). Multivariate analysis, Ann Arbor staging, choice of treatment plan and CIN timing were the independent prognostic factors for OS and PFS. OS and PFS in the early-onset group were longer than those of in the absent group [OS (HR:0.241; 95%CI: 0.110-0.530; P < 0.001), PFS (HR: 0.313; 95%CI: 0.169-0.579; P < 0.001)] and late-onset group [OS (HR: 0.332; 95%CI: 0.161- 0.685; P = 0.003), PFS (HR: 0.376; 95%CI: 0.204-0.693; P = 0.002)].Conclusions The timing of CIN is an independent predictor of prognosis in DLBCL patients treated with R-CHOP (like) or CHOP (like) regimens, and patients with early-onset CIN have longer survival times. The degree of CIN is not an independent predictor of prognosis in patients with DLBCL.

scholarly journals Differences in Clinical and Dietary Characteristics, Serum Adipokine Levels, and Metabolomic Profiles between Early- and Late-Onset Gout

Metabolites ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 399
Author(s):  
Young Sun Suh ◽  
Hae Sook Noh ◽  
Hyun-Jin Kim ◽  
Yun-Hong Cheon ◽  
Mingyo Kim ◽  
...  
Keyword(s):  
Early Onset ◽  
Late Onset ◽  
Clinical Information ◽  
Plasminogen Activator Inhibitor ◽  
Ultra Performance Liquid Chromatography ◽  
Plasminogen Activator Inhibitor 1 ◽  
Baseline Serum ◽  
Onset Group ◽  
Early Onset Group ◽  
Pai 1

This study aimed to identify differences in clinical and dietary characteristics, serum adipokine levels, and metabolomic profiles between early- and late-onset gout. Eighty-three men with gout were divided into an early-onset group (n = 38, aged < 40 years) and a late-onset group (n = 45, aged ≥ 40 years). Dietary and clinical information was obtained at baseline. Serum adipokines, including adiponectin, resistin, leptin, and plasminogen activator inhibitor-1 (PAI-1), were quantified by a Luminex multiplex immunoassay. Metabolite expression levels in plasma were measured in 22 representative samples using metabolomics analysis based on ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. Average body mass index, rate of consumption of sugar-sweetened beverages, and serum uric acid levels were significantly higher in the early-onset group (p < 0.05), as was the PAI-I concentration (105.01 ± 42.45 ng/mL vs. 83.76 ± 31.16 ng/mL, p = 0.013). Changes in levels of metabolites mostly involved those related to lipid metabolism. In the early-onset group, acylcarnitine analog and propylparaben levels were downregulated and negatively correlated with the PAI-1 concentration whereas LPC (22:6) and LPC (18:0) levels were upregulated and positively correlated with the PAI-1 concentration. Dietary and clinical features, serum adipokine concentrations, and metabolites differed according to whether the gout is early-onset or late-onset. The mechanisms of gout may differ between these groups and require different treatment approaches.

The Evolution of Dementia in Idiopathic Parkinson's Disease: Neuropsychological and Clinical Evidence in Support of Subtypes

1992 ◽  
Vol 4 (4) ◽  
pp. 147-160 ◽  
Author(s):  
Wayne G. J. Reid
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Early Onset ◽  
Late Onset ◽  
Age At Onset ◽  
Critical Determinant ◽  
Drug Study ◽  
Baseline Phase ◽  
Onset Group ◽  
Early Onset Group

One hundred and seven newly diagnosed, untreated patients with Parkinson's disease (PD) were divided into two groups according to their age at reported onset of symptoms. Of these, 79 patients were under age 70 (early-onset) and 28 patients were age 70 and over (late-onset). The group of 50 control subjects comprised spouses, friends of the PD patients, and community volunteers. The patients were participants in a multicenter drug study of Parkinson's disease. Each had received a detailed neurological and neuropsychological assessment in the baseline placebo phases of the study. Thirty-4 patients with early-onset and 12 patients with late-onset were reassessed 3 years after treatment with low-dose levodopa, with bromocriptine, or with a combination of the two drugs. The results of the baseline phase of the study revealed that 8% of the early-onset group and 32% of the late-onset group were classified as demented. The 3-year follow-up revealed that the prevalence of dementia had increased to 17% in the early-onset group and to 83% in the late-onset group. This study confirms that at least two distinct subtypes of Parkinson's disease exist. The subtypes differ both clinically and neuropsychologically. The age at onset of symptoms is a critical determinant of the rate and type of cognitive decline in Parkinson's disease.

Long-term efficacy of the combination of lenalidomide and rituximab in elderly relapsed/refractory diffuse large B-cell lymphoma patients

2013 ◽  
Vol 31 (4) ◽  
pp. 223-224 ◽  
Author(s):  
Pier Luigi Zinzani ◽  
Cinzia Pellegrini ◽  
Enrico Derenzini ◽  
Lisa Argnani ◽  
Stefano Pileri
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Term Efficacy ◽  
Large B Cell Lymphoma ◽  
Large B Cell

The Genotype of MLH1 Is An Independent Predictor of Outcome In Diffuse Large B-Cell Lymphoma Treated with R-CHOP: a Training-Validation Study

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 992-992
Author(s):  
Davide Rossi ◽  
Silvia Rasi ◽  
Alice Di Rocco ◽  
Alberto Fabbri ◽  
Francesco Forconi ◽  
...  
Keyword(s):  
Cell Lymphoma ◽  
Independent Predictor ◽  
Excision Repair ◽  
B Cell Lymphoma ◽  
Salvage Treatment ◽  
Genotype 4 ◽  
Bulky Disease ◽  
Clinical Endpoints ◽  
Large B Cell Lymphoma ◽  
Validation Series

Abstract Abstract 992 Several drugs utilized in diffuse large B cell lymphoma (DLBCL) rely on DNA damage for tumor killing. This study aimed at verifying whether single nucleotide polymorphisms (SNPs) of genes involved in DNA repair may contribute to prognostication of DLBCL treated with R-CHOP. The study utilized a training-validation design. The training cohort (n=163) was a mono-institutional, prospectively collected, consecutive series of DLBCL homogeneously treated with the same chemotherapeutic regimen both at diagnosis (R-CHOP21) and at relapse/progression (R-DHAP ± BEAM conditioned autologous stem cell transplant, ASCT). The validation cohort (n=156) was a multi-institutional retrospective series of DLBCL treated with R-CHOP at diagnosis. Candidate SNPs (n=35) were selected by an educated guess approach, and included SNPs belonging to genes involved in: i) mismatch repair (MLH1); ii) base excision repair (XRCC1, OGG1); iii) nucleotide excision repair (ERCC1, ERCC2, ERCC4, ERCC5, ERCC6, XPA, XPC); iv) double strand break repair (BRCA1, BRCA2, LIG4, XRCC2, XRCC3, XRCC4, XRCC6); and v) direct reversal (MGMT). Clinical endpoints were progression free survival (PFS) after R-CHOP, overall survival (OS) from diagnosis, and OS from salvage treatment. Univariate analysis controlled for multiple comparisons identified MLH1 rs1799977 as the sole SNP predicting DLBCL OS in the training series (AG/GG genotype: HR: 3.23; 4-year OS: 55.5% vs AA genotype: 4-year OS: 80.9%; p<.001; q=.009) (Fig. 1A). Multivariate analysis identified the MLH1 rs1799977 AG/GG genotype (HR: 3.14; p<.001) as an independent predictor of OS, along with IPI score (HR: 1.38; p=.037) and bulky disease (HR: 2.56; p=.004). The prognostic relevance of MLH1 rs1799977 in the DLBCL training series was due to the impact on risk of failing both R-CHOP21 (AG/GG genotype; HR: 2.02; 4-year PFS: 47.5%; AA genotype: 4-year PFS: 65.6%; p=.007) (Fig. 1B) and second line treatment (AG/GG genotype: HR: 3.04; 2-year OS from salvage: 16.0%; AA genotype: 2-year OS from salvage: 57.3%; p=.007) (Fig. 1C). Multivariate analysis identified the MLH1 rs1799977 AG/GG genotype (HR: 1.96; p=.010) as an independent predictor of PFS after R-CHOP21, along with IPI score (HR: 1.41; p=.002) and bulky disease (HR: 1.96; p=.012). By bivariate analysis, MLH1 predicted OS from salvage treatment independent of having (p=.002) or having not (p=.049) consolidated with ASCT. The DLBCL validation series did not differ from the training series in terms of clinical features at presentation, median follow-up (p=.429), OS (p=.331), PFS (p=.416), OS from salvage (p=.987), and prevalence of MLH1 rs1799977 genotypes (p=.378). The MLH1 rs1799977 AG/GG genotype was confirmed as a predictor of poor outcome in the DLBCL validation series when considering all clinical endpoints, including: i) OS (unadjusted HR: 3.22, p=.001; adjusted HR: 3.15; p=.001); ii) PFS (unadjusted HR: 1.98, p=.017; adjusted HR: 1.86, p=.018); and iii) OS from salvage treatment (unadjusted HR: 2.95, p=.027). Pooling of the training and validation series (n=319) revealed that MLH1 AG/GG predicts DLBCL OS within subgroups defined by IPI. The biologic plausibility of the association between MLH1rs1799977 genotype and DLBCL outcome is supported by four lines evidence: i) MLH1rs1799977 is a nonsynonymous SNP causing the I219V amino acidic substitution in MLH1, a gene of the mismatch repair pathway; ii) in silico, MLH1rs1799977 is predicted to have deleterious consequences; iii) in vitro, the G variant allele of MLH1rs1799977 associates with reduced MLH1 protein expression; iv) loss of MLH1 expression in tumor cells is known to induce refractoriness to doxorubicin and platinum compounds. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Differences Ratio Level Soluble FMS-Like Tyrosine Kinase-1 and Placental Growth Factor Early And Late Onset on Preeclampsia and Normal Pregnancy

2018 ◽  
Vol 3 (1) ◽  
pp. 83
Author(s):  
Ria Andina ◽  
Yanwirasti Yanwirasti ◽  
Defrin Defrin
Keyword(s):  
Growth Factor ◽  
Tyrosine Kinase ◽  
Early Onset ◽  
Late Onset ◽  
Normal Pregnancy ◽  
Elisa Test ◽  
Placental Growth Factor ◽  
Cross Sectional ◽  
Onset Group ◽  
Early Onset Group

Preeclampsia is a major maternal morbidity and mortality worldwide including in Indonesia. PIGF concentrations were found to be lower and sFlt-1 to be higher in patients with preeclampsia than normal pregnancy. Futher, this factor has been proposed as a parameter that can help identify women with potentially preeclampsia.This study aims todeterminethe differences ratio level soluble rate fms-like tyrosine kinase-1 and placental growth factor early and late onset on preeclampsia and normal pregnancy. The cross sectional study design was conducted in RSUP M.Djamil, Rasidin Hospital, Reksodiwiryo Hospital and Biomedical Laboratory of Andalas University from July 2017 until January 2018. The sample of this study was pregnant women>20-42 weeks pregnancy totalling 80 people by consecutive sampling.Sample was divided into 3 groups. SFlt-1 and PlGF levels tested using ELISA test. Test the normality of data by Kolmogrov-Smirnov test by using unpaired T test.The results showed median sFLT-1 levels in the early onset group with normal pregnancy with p= 0,88, median sFLT-1 levels in the late onset group with normal pregnancy with p= 0,01 and median levels of sFLT-1 in the early onset group with late onset with p= 0.34. Mean of PlGF in the early onset group with normal pregnancy with p=0,30, mean of PlGF in the late onset group with normal pregnancy with p= 0.63, and mean of PlGF in the early onset group with late onset with p = 0.27. The conclusion of this study was that there was a difference ratio level Soluble Fms-Like Tyrosine Kinase-1 late onset in preeclampsia and normal pregnancy.

scholarly journals Age trajectories of disability in instrumental activities of daily living and disability-free life expectancy among middle-aged and older adults in Taiwan: an 11-year longitudinal study

2020 ◽  
Author(s):  
Wen-Ling Liao ◽  
Yu-Hung Chang
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Life Expectancy ◽  
Early Onset ◽  
Late Onset ◽  
Remaining Life ◽  
Iadl Disability ◽  
Disability Free Life Expectancy ◽  
Onset Group ◽  
Early Onset Group

Abstract Objectives: This study aims to identify the age trajectories of disability in instrumental activities of daily life (IADLs) over 11 years and their correlates, and to estimate disability-free life expectancy for identified trajectory groups in middle-aged and older adults.Methods: We included 3,118 participants aged 50 and over without IADL limitations at baseline from the Taiwan Longitudinal Study in Aging, followed across 1996-2007. We used group-based trajectory models to identify age trajectories of IADL disability, and multiple logistic regressions to examine their correlates. Sullivan method was used to compute IADL disability-free life expectancy for trajectory groups at different ages.Results: We identified two trajectories groups: 67.7% of participants classified as the late-onset group and 32.3% as the early-onset group. Female (adjusted odds ratio [aOR]: 1.93, 95% confidence interval [95% CI]: 1.54, 2.41), not being employed (aOR: 1.30, 95% CI: 1,08, 1,56), poor/fair self-rated health (aOR: 1.31, 95% CI:1.09, 1.58), hypertension (aOR: 1.32, 95% CI: 1.07, 1.63) , diabetes mellitus (aOR: 2.29, 95% CI: 1.72, 3.07), arthritis (aOR: 1.42, 95% CI: 1.11, 1.81), stroke (aOR: 2.21, 95% CI: 1.04, 4.70), and one-point increase in a 10-item depression scale (aOR: 1.04, 95% CI: 1.02, 1.06) were associated with early-onset of disability, whereas higher education (aOR: 0.59, 95% CI: 0.42, 0.81), regular exercise (aOR: 0.76, 95% CI: 0.62, 0.93), and participating voluntary or club activities (aOR: 0.78, 95% CI: 0.65, 0.93) related to the late-onset. IADL disability-free life expectancies at 65 years old in the late-onset group were 15.6 years for women and 14.4 for men, respectively, comprising 56.6% and 64.2% of their remaining life, whereas those of the early-onset group were 4.8 and 4.6 years for women and men respectively, comprising 22.5% and 27.2% of remaining life.Conclusions: Early-onset of IADLs disability may correlate to chronic conditions, and engagement in employment, exercise, and social participation were associated with a reduced risk of early disability in IADLs.

scholarly journals Clinical characteristics of patients under 40 years old with early-onset hyperuricaemia: a retrospective monocentric study in China

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e025528
Author(s):  
Yi Zhang ◽  
Yong Yang ◽  
Leixi Xue ◽  
Jian Wen ◽  
Lin Bo ◽  
...  
Keyword(s):  
Fatty Liver ◽  
Early Onset ◽  
Clinical Characteristics ◽  
Liver Enzymes ◽  
Late Onset ◽  
Density Lipoprotein ◽  
Control Group ◽  
And Control ◽  
Onset Group ◽  
Early Onset Group

ObjectiveTo investigate the clinical characteristics of patients with early-onset hyperuricaemia (HUC).MethodsA retrospective study using data from the Second Affiliated Hospital of Soochow University was conducted. 623 patients with HUC were divided into early-onset group and late-onset group. Another 201 healthy subjects ≤40 years old were regarded as control group. The data of physical measurements and biochemistry test were collected. Clinical data of early-onset group were compared with late-onset group and control group by analysis of variance (ANOVA) and χ2test. Principal component analysis (PCA) was applied. Logistic regression was used to identify the clinical factors correlated with patients with early-onset HUC.ResultsThe patients of early-onset group had different body mass index (BMI), serum albumin, alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AKP), gamma-glutamyltransferase (GGT), creatinine (Cr), triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL), TG/high density lipoprotein (HDL) ratio, HDL and percentage of males, hypertension (HBP) as well as fatty liver compared with healthy people in the control group. Early-onset group patients had different albumin, ALT, fasting blood glucose, Cr, percentage of males and HBP compared with late-onset group patients. PCA identified four significant patterns including PC1 (labelled ‘TG and HDL’), PC2 (labelled ‘fatty liver and liver enzymes’), PC3 (labelled ‘TC and LDL’) and PC4 (labelled ‘AKP’). The results of univariate and multivariate logistic regression analysis showed that BMI, HBP and albumin were correlative factors for early onset of HUC when the patients with early-onset and late-onset HUC were involved, while gender, BMI, PC1, PC2 and PC4 were correlative factors for early-onset HUC when the early-onset and control groups were involved.ConclusionThis study described a group of patients with early-onset HUC with distinct clinical features. Gender, BMI, ‘TG and HDL’, ‘fatty liver and liver enzymes’ and ‘AKP’ have higher values than HBP, type 2 diabetes mellitus and ‘TC and LDL’ in patients under 40 years old with early-onset HUC.

Clinical and Laboratory Differences Between Early-Onset and Late-Onset Adult Atopic Dermatitis

2020 ◽  
Vol 24 (4) ◽  
pp. 360-366
Author(s):  
Dae-Lyong Ha ◽  
Geun-Hwi Park ◽  
Hoon-Soo Kim ◽  
Hyun-Chang Ko ◽  
Moon-Bum Kim ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Early Onset ◽  
Age Of Onset ◽  
Late Onset ◽  
Severity Index ◽  
Total Serum ◽  
Significant Difference ◽  
First Onset ◽  
Onset Group ◽  
Early Onset Group

Background Atopic dermatitis (AD) in adults is not uncommon, and its prevalence has been increasing in the recent decades. However, there is a paucity of data about the differences between early-onset and late-onset adult AD. Objective The objective of this study is to investigate the clinical and laboratory characteristics of adult AD, focusing on the differences between early-onset and late-onset adult AD. Methods We retrospectively reviewed the medical records and clinical photos of 214 adult AD patients (≥18 years of age) over a 3-year period. We classified the patients into 2 groups: early-onset (first onset of AD before 12 years of age) and late-onset (first onset of AD at 12 years of age or later). Results Among 214 patients, 151 patients (70.6%) belonged to the early-onset group (mean age 24.5 years), while 63 patients belonged to the late-onset group (mean age 29.5 years). An association with allergic asthma or rhinitis, a family history of atopic disease, elevated total serum IgE, and sensitivity to food allergens were more commonly seen in the early-onset group. The late-onset group had a significant likelihood of nonflexural involvement (38.1% vs 13.2%). There was no significant difference in the mean eczema area severity index score, eosinophil count, and sensitivity to aeroallergens between 2 groups. Conclusion Adult AD shows different clinical and laboratory characteristics depending on the age of onset. This study could help to create awareness about the heterogeneity of AD in adulthood and encourage further studies on clinical outcomes and different therapeutic methods depending on the age of onset.

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