scholarly journals Contribution of intraoperative stimulation mapping to glioblastoma surgery within or adjacent to descending motor pathways: survival analysis and functional outcome comparison between two series in a single institution

2021 ◽  
Author(s):  
Jimmy Ming-Jung Chuang ◽  
Li-Han Lin ◽  
Meng-Hsiang Chen ◽  
Wei-Che Lin ◽  
Cheng-Hsien Lu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Time ◽  
Neurological Outcome ◽  
Median Overall Survival ◽  
Extent Of Resection ◽  
Rank Test ◽  
Positive Effects ◽  
Overall Survival Time ◽  
Significant Difference ◽  
Median Overall Survival Time

Abstract Purpose Extensive resection probably confers a modest survival advantage in patients with glioblastoma. Studies have revealed the positive effects of intraoperative stimulation mapping (ISM) on the extent of resection, but no consensus for contribution of intraoperative stimulation mapping is reached. Methods This retrospective study enrolled two groups of patients who underwent surgery for motor-eloquent glioblastoma: the non-ISM group of 57 patients (surgery in 2008–2013) and ISM group of 13 patients (surgery in 2014–2015). The two groups and subgroups based on resection extent and postoperative additional neurological deficit were compared using Kaplan–Meier analysis and the log-rank test. Results Gross or near total resection (≥ 90% resection quality) was significantly more common in the ISM group than the non-ISM group (76.9% versus 24.6%; p = 0.001). The extent of resection was also significantly greater (90.5% ± 15.6% versus 64.6% ± 29.2%; p = 0.002). The neurological outcome in the ISM group was thus superior, but the two differences were not significant. The median progression-free survival time was significantly longer in the ISM group (22.0 ± 5.1 months vs 8.0 ± 1.0 months; p = 0.037) but a significant difference was not indicated in median overall survival time (22.0 ± 8.4 months vs 16.0 ± 2.2 months; p = 0.167). Conclusion ISM was discovered to lead to higher quality of resection and delayed recurrence. The neurological outcome and median overall survival time in the ISM group was thus superior, but the two differences were not significant. Trial registration number (for clinical trials) Nil

Caspase 3 Expression in Mantle Cell Lymphoma: An Immunohistochemical Study of 84 Patients.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4676-4676
Author(s):  
Carsten Schrader ◽  
Wolfram Klapper ◽  
Paul Riis ◽  
Peter Meusers ◽  
Guenter Brittinger ◽  
...  
Keyword(s):  
Overall Survival ◽  
Mantle Cell Lymphoma ◽  
Survival Time ◽  
Median Overall Survival ◽  
Caspase 3 ◽  
Clinical Course ◽  
Cell Lymphoma ◽  
Overall Survival Time ◽  
Mantle Cell ◽  
Median Overall Survival Time

Abstract Mantle cell lymphoma (MCL) is a malignant lymphoma associated with a relatively aggressive clinical course and a median overall survival time of 3–4 years. We investigated immunohistochemically the expression of the apoptotic marker caspase 3 in relation to the clinical course. Biopsy specimen from 84 untreated patients enrolled in two multicenter prospective trials were investigated immunohistochemically with monoclonal antibodies against CD20, CD5, CD3, CD23, cyclin D1, Caspase3. The Caspase3 expression was analyzed in three groups: less than 1 positive cell per high power field (HPF), more than 1 positive cell per HPF and more than 2 positive cells per HPF. The expression was compared with the overall survival data analysed according to Kaplan and Meier. In 75 cases the caspase 3 staining could be analyzed. The caspase 3 expression had a range of 0.1–4.7 positive cells per HPF (median value:1.1, mean:1.3). Patients with mantle cell lymphoma that had less than 1 caspase 3 positive cell per HPF (33 cases) had a median overall survival time of 48 months compared to 27 months for patients with more than 1 positive cell per HPF (24 cases) and 15 months for more than 2 positive cells per HPF (18). The Kaplan-Meier analysis showed a significant difference in the overall survival time between these groups (p<0.0001). The immunohistochemical detection of caspase 3 in mantle cell lymphoma is a predictor for survival in MCL.

Apoptosis Regulating Proteins bax and p53 in Mantle Cell Lymphoma.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4710-4710
Author(s):  
Carsten Schrader ◽  
Wolfram Klapper ◽  
Dirk Janssen ◽  
Paul Riis ◽  
Peter Meusers ◽  
...  
Keyword(s):  
Overall Survival ◽  
Clinical Outcome ◽  
Mantle Cell Lymphoma ◽  
Survival Time ◽  
Median Overall Survival ◽  
Cell Lymphoma ◽  
P53 Expression ◽  
Overall Survival Time ◽  
Mantle Cell ◽  
Median Overall Survival Time

Abstract In malignant tumors beside cell proliferation also cell death plays role for cell survival. Apoptosis regulating genes can be divided into two groups: death antagonists and death agonists such as bax. The ratio of death agonists and antagonists determines if a cell goes into apoptosis. We investigated in a large collective the immunohistochemical expression of the apoptotic marker p53 and bax in relation to the clinical course. Biopsies were stained immunohistochemically with monoclonal antibodies against bax and p53 and the expression was subdivided in three groups: negative, weak positive and strong positive. The expression profiles were analyzed with the overall survival data according to Kaplan and Meier. Patients with mantle cell lymphoma that had negative p53 expression had a median overall survival time of 38.1 months compared to 22.3 months for patients with a weak and 11.3 months for a strong p53 expression (0<0.0001). The bax expression was in the majority of cases positive. Only one case showed a negative staining. Patients with weak and strong bax expression showed no differences in clinical outcome (median overall survival time: 23 vs 33 months, p=0.6051). The immunohistochemical detection of p53 in mantle cell lymphoma is a good predictor for the clinical outcome.

Subcutaneous Alemtuzumab (MabCampath) in Fludarabine-Refractory CLL (CLL2H Trial of the GCLLSG).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3120-3120 ◽  
Author(s):  
Stephan Stilgenbauer ◽  
Dirk Winkler ◽  
Andreas Bühler ◽  
Thorsten Zenz ◽  
Silja Groner ◽  
...  
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Survival Time ◽  
Median Overall Survival ◽  
Progression Free Survival ◽  
Outpatient Basis ◽  
Free Survival ◽  
Overall Survival Time ◽  
Median Overall Survival Time ◽  
Grade Iii

Abstract Fludarabine-refractory CLL has a poor prognosis with a median overall survival time of less than 12 months despite salvage chemotherapy and intravenous alemtuzumab (Campath-1H) is the approved treatment based on a remission rate of 33% and a median survival time of 16 months (Keating et al., Blood 2002). The CLL2H trial of the GCLLSG was initiated to evaluate the subcutaneous application of 3 × 30 mg alemtuzumab weekly in fludarabine refractory CLL. The current analysis is based on 109 consecutive patients enrolled until completion of the trial in April 2006. Median age was 63 (36–81) years, 71% were male. A median number of 3 (1–9) prior lines of therapy had been given. Subcutaneous treatment was performed on an outpatient basis in all cases and had to be temporarily interrupted in 68 patients due to neutropenia (43%), anemia (6%), thrombocytopenia (3%), infections (40%, CMV reactivations 30%), and was stopped early in 63 cases due to insufficient response (44%), hematotoxicity (16%), infection (17%), and CMV reactivation (13%). The median alemtuzumab dose given was 722 (3–2203) mg. Toxicity was mostly grade I/II apart from hematotoxicity (grade III/IV anemia: 42%, thrombocytopenia: 52%, neutropenia: 54%) and grade III/IV infections (25%). After a median follow up time of 21.4 months, 56 deaths have occurred (due to progression 52%, infections 39%, not CLL related 9%). The overall response rate was 33% (CR 4%, PR 27%), the median progression free survival time was 7.7 months, and median overall survival time was 19.1 months. Genetic high-risk factors were present in the vast majority of cases (unmutated VH 66%, 17p–29%, 11q–19%, TP53 mutation 39%). Responses (CR or PR) were observed in 22% of VH unmutated, 24% of 11q-, 39% of 17p-, and 33% of TP53 mutated cases. Progression free survival and overall survival were not significantly different when comparing the genetic subgroups, particularly TP53 mutated, 11q-, and 17p- (see figure). In conclusion, subcutaneous alemtuzumab is feasible in an outpatient setting in a high-risk population of fludarabine-refractory CLL and appears to be of similar efficacy as by intravenous administration. Most importantly, genetic high risk subgroups with unmutated VH, 11q- or 17p- appear to respond to alemtuzumab. Figure Figure

Modified Topotecan Combination with Cyclophosphamide and Ara-C (CAT) for Patients with Refractory/Relapsed Leukemia.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4357-4357
Author(s):  
Sui-jing Wu ◽  
Xin Du ◽  
Wei Lin ◽  
Zi-lun Huang ◽  
Xiao-li Zhou ◽  
...  
Keyword(s):  
Overall Survival ◽  
Complete Remission ◽  
Survival Time ◽  
Median Time ◽  
Topoisomerase I ◽  
Median Overall Survival ◽  
Blast Phase ◽  
Platelet Recovery ◽  
Overall Survival Time ◽  
Median Overall Survival Time

Abstract The prognosis of patients with leukemia has improved significantly. With combination chemotherapy, 60%–80% of adult patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia(ALL) achieve complete remission(CR). But most patients eventually relapse and do not response to current induction regimens based on cytarabine and anthracyclines any more. This emphasize the need to discover new agents for the treatment of leukemia to improve long-term prognosis. Topotecan is a semisynthetic analogue of the alkaloid camptothecin which acts as a specific inhibitor of topoisomerase I,by stabilization of the topoisomerase I DNA complex which leads to cell death.It also appears to be active against leukemias which have acquired the multi-drug resistant phenotype.[ Ulukan et al. Drug, 2000; Weihrauch et al. Leuk Lymphoma, 2004].It also could go through blood brain barrier[Kollmannsberger et al. Oncology, 1999].Here we observe the effect and side-effects of cyclophosphamide, cytanthetic analogue of rabine and topotecan (Modified CAT) combination regimen for treatment of refractory or relapsed leukemia. The study population comprise 26 patients with relapsed/refractory leukemia,including 12 with AML, 9 with ALL, 2 with myeloid blast phase of CML, 3 with lymphoma. Median age was 35 years.Patients received cyclophosphamide 300mg/m2 every 12 hours for 6 doses on day1 to 3.On day 2, topotecan was given at a dose of 1.5mg/m2/day for 5 days on days 2 to 6, and cytarabine 1.0 g/m2 /day for 5 days on days 2 to 6.The regimen (cytarabine reduced to 0.5g/m2 /day) could be repeated one or two cycles after remission. The total response rate of one course was 57%, eleven patients (42%) achived complete remission(CR). Responses occurred in 7of 12 AML (57%), including 5 CR(41%); in 6 of 9 patients with ALL (67%), including 5 CR(56%); and in 1 of 2 myeloid blast phase of CML(CR 50%). The median overall survival time after treatment was 2+ months, and the median overall survival time after CR was 4+ months. Severe myelosuppression was universal (100% Grade 4 neutropenia and thrombocytopenia), the median time to recovery of neutrophils to ≥0.5×109/L was 18 days,and the median time to platelet recovery to ≥ 20×109/L was 26 days.Infection developed in 96% cases, the most frequent events were oral mucositis(77%, 20/26), sepedogenesis(46%, 12/26),anusitis(38%,10/26),pneumonia(31%, 8/26), two patients died of infection complications(8%). Non-hematologic toxicity was seen frequently in gastrointestinal but it was mild. Nausea and/or vomiting occurred in 13 patients(50%)with gradeI-II in all of them.Two patients(8%) had diarrhea and grade 1–2 in them. In summary, Modified CAT regimen is well tolerated and has significant anti-leukemia activity as salvage therapy for relapsed/refractory leukemia.

Elevated preoperative levels of CA 19-9 and CA 125 predicts overall survival time in the pancreatic adenocarcinoma. Single institution series.

2020 ◽  
Vol 92 (3) ◽  
pp. 1-5
Author(s):  
Piotr Hogendorf ◽  
Aleksander Skulimowski ◽  
Adam Durczyński ◽  
Anna Kumor ◽  
Grażyna Poznańska ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Survival Time ◽  
Univariate Analysis ◽  
Ca 125 ◽  
Rank Test ◽  
Multiple Cancer ◽  
Overall Survival Time ◽  
Pancreatic Body

Background: Pancreatic cancer is a devastating disease, being the fourth cause of cancer-related death worldwide. Several studies have investigated the use of multiple cancer biomarkers, such as C 19-9, CA 125, and CEA, as prognostic factors for overall survival in pancreatic cancer. CA 125 seems to have superior predictive utility in selected groups of PDAC patients. Material and methods: We retrospectively analyzed data collected from 129 patients admitted to our Department due to diagnosis with pancreatic cancer. Prior to the survival analysis, the preliminary assessment of pre-treatment levels of biomarkers was carried out. The overall survival time was defined as that elapsing from the admission date to the date of death. Results: The patients mean age was 62 +/- 9.5 years, while the median overall survival (OS) was 7mo 12d. As for tumor localization, most of the patients had PDAC within the head of the pancreas (n=93), followed by PDAC of the pancreatic body (n=15), pancreatic tail (n=14) and both pancreatic body and tail (n=7). Ninety-five patients had an unresectable tumor and 34 were diagnosed with a resectable tumor (tab.1). The statistically significant correlation was found for CA 125 (ρ=-0.355 p<0.001) and CA 19-9 (ρ=-0.225 p=0.012). We chose the following cut-off points: CA 125>=20 IU/mL was considered as high, and CA 19-9>=200 IU/mL as significantly elevated. In the univariate analysis in the Kaplan-Meier survival model, adjusted for age, both elevated biomarkers were statistically significant prognostic factors of OS (CA 125<20 median OS- 10mo 3d vs. CA 125>=20- 4mo 17d p=0.001) and (CA19-9<200 median OS- 8mo 3d vs. CA 19-9>=200- 4mo 20d p=0.001). Patients’ gender and, PDAC resectability and its localization were not statistically significant prognostic factors (log rank test p=0.8; p=0.108 and p=0.578 respectively). In the age-adjusted multivariate analysis, both biomarkers remained significant- CA 125>=20 (HR: 1.73 95%CI 1.27-2.58 p=0.006) CA 19-9>=200 (HR: 1.78 95%CI 1.19-2.66 p=0.005) Conclusions: Our study proves the utility of the pretreatment assessment of CA 125 because its level is tightly correlated with OS. It may be hypothesized that the pretreatment measurement of both CA 19-9 and CA 125 can provide the valuable information about patients’ prognosis.

Efficacy and Safety of Gemtuzumab-Based Regimens in Patients with CD33-Positive Refractory Leukemia.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4358-4358
Author(s):  
Suijing Wu ◽  
Xin Du ◽  
Wei Lin ◽  
Jianyu Weng ◽  
Jianjun Zhang ◽  
...  
Keyword(s):  
Stem Cells ◽  
Overall Survival ◽  
Survival Time ◽  
Myeloid Leukemia ◽  
Median Overall Survival ◽  
Response Rate ◽  
Single Agent ◽  
Efficacy And Safety ◽  
Blast Phase ◽  
Median Overall Survival Time

Abstract Patients with relapsed or refractory leukemia have less chances of obtaining remission than patients with newly diagnosed.It is reported that more than 80% of acute myeloid leukemia(AML) patients have myeloid blast cells that express the CD33 surface antigen. This antigen also is present on the leukemic stem cells at least some patients with chronic myeloid leukemia(CML)and acute lymphoblastic leukemia(ALL). It is absent from normal hematopoietic stem cells and nonhematopoietic cells and tissues. Gemtuzumab is a humanized anti-CD33 antibody conjugated to calicheamicin, a potent anti tumor antibiotic derived from a bacterium. It is conditionally approved in the US for treatment of CD33+ AML in first relapse in patients over 60 years[Sievers et al.Journal of Clinical Oncology,2001]. Here we evaluate the efficacy and safety of Gemtuzumab -based regimens. The study population comprise 11 patients with CD33-positive refractory leukemia (determined as CD33-antigen expression in over 50% of leukemic blasts by bone marrow aspirates and immunophenotyping), including two with myeloid blast phase of CML, one with refractory ALL, two relapsed after Auto-stem cell transplantation(Auto-SCT). The median age was 47 years. Four cases who were over 60 years or after Auto-SCT treated with single agent. The other seven cases treated with mylotarg and cytotoxic agents, including mylotarg plus idarubine (MI); Gemtuzumab plus fludarabine, cytarabine, CsA(MFAC); or plus mitoxantrone, Ara-C (MMA).The overall response rate was 54% (6/11), with 36%(4/11) patients obtaining complete remission (CR) and 18% (2/11) achieving CRp.The median overall survival time after treatment was 4.8 months, and the median overall survival time after CR was 8.2 months.Two patients with myeloid blast phase of CML achieved CR with BCR/ABL(−), the survival time after CR was 5+months and 20+months respectively, but failed in second relapse. One patient received Allo-SCT after CR with refractory ALL is still alive at present (21months) with disease free. The median time to ANC recovery of 0.5×109/L was 15 days.The common adverse events was myelosuppression (100% Grade 4 neutropenia and thrombocytopenia).Significant non-hematologic toxicitics included infection(96%), infusion-related chills and fever (55%).Although hepatic dysfunction and mucositis were observed,they were generally infrequent and not severe(Grade 1–2).Six patients (55%) developed Hepatic veno-occlusive disease(VOD), four of them were either over 60 years old or received Auto-SCT before although they received only single agent mylotarg therapy, but it was transient and no one died from it. In conclusion, patients with CD33-positive refractory leukemia, Gemtuzumab -based regimens have a comparable response rate and offer a more favorable toxicity profile, expecially for the patients with myeloid blast phase of CML. It is also effective for the patient with refractory ALL. In the treatment, we should pay attention to the hepatic condition of ones who are over 60 years old or after stem cell transplantation, attemps to avoid and treat VOD are warranted. Above all, When patients with refractory leukemia got remission, allogenic-SCT should be done as soon as possible

scholarly journals Comparison of Two Different Vinblastine Dosages for Treatment of Cutaneous Mast Cell Tumor in Dogs

2020 ◽  
Vol 48 ◽  
Author(s):  
Lucas Cavalli Kluthcovsky ◽  
Bruna Fernanda Firmo ◽  
Pedro Carvalho Cassino ◽  
Andrigo Barboza De Nardi ◽  
Jorge Luiz Costa Castro ◽  
...  
Keyword(s):  
Overall Survival ◽  
Mast Cell ◽  
Survival Time ◽  
Dose Intensity ◽  
Control Group ◽  
Histopathological Diagnosis ◽  
Clinical Variables ◽  
Overall Survival Time ◽  
Significant Difference ◽  
The Impact

Background: Mast cell tumors (MCT) are among the most common malignant cutaneous neoplasm in dogs with variable biologic behavior and remain a therapeutic challenge in high-grade cases. Surgery remains the primary treatment for canine MCT; however, chemotherapy and radiation therapy are commonly used to treat aggressive cases. The combination of vinblastine (VBL) at a dose of 2 mg/m² and prednisone is the classically described protocol for MCT treatment. Studies have shown the safety of higher VBL doses for dogs with MCT, but there is a lack of information regarding dose intensity and outcome as a goal after chemotherapy.   This study aimed to evaluate the impact of a higher dose of VBL on MCT treatment outcome.Materials, Methods & Results: This was an observational and comparative study conducted in two different Veterinary Teaching Hospitals. Client-owned dogs with histopathological diagnosis of grade II or III MCT were selected and underwent at least four chemotherapy sessions with VBL and prednisone. The experimental group (EG) consisted of 18 dogs that received a dose of 3 mg/m² VBL treated in one institution. The control group (CG) included 31 dogs that received a dose of 2 mg/m² VBL treated at the other institution. All dogs treated in both groups had a clinical and complete blood count (CBC) evaluation performed previous the start of chemotherapy (T0) and before each weekly treatment (T1, T2, T3, and T4). After treatment, dogs in both groups were followed-up for the recurrence rate and overall survival time after diagnosis. There was no significant difference in clinical variables between EG and CG. During treatment, dogs of EG showed a significant reduction in erythrocyte, hemoglobin, and hematocrit values between T0 and T1, T2, T3, and T4 (P < 0.001). Comparatively, the CG showed significant reduction in hemoglobin (P = 0.02) and total leucocytes (P = 0.001) values in the same period. Despite these findings, these hematological parameters did not exceed the lower limit for the species in both groups. There was a higher-grade neutropenia one week after the first VBL application (T2) in both groups, with no statistical difference in neutrophil counts at T2 or during the whole treatment. There were discrete and self-limited episodes of anorexia, vomiting, and diarrhea in both groups. After chemotherapy, dogs in EG showed a significantly lower rate of recurrence than dogs in CG (P = 0.02). There was no significant difference in the overall survival time between groups.Discussion: The absence of significant differences in clinical variables (e.g. sex, age, histological grading, and tumor location) between EG and CG suggests that the groups may be similar regarding these parameters. All dogs included in this study had a recommendation for MCT post-operative chemotherapy treatment. VBL action is non-selective and anemia is not a commonly described adverse effect associated with its administration. Despite that, EG dogs exhibited a reduction in erythrocytes, hematocrit, and hemoglobin, and CG dogs in hemoglobin throughout T0 to T4. The highest number of neutropenia episodes occurred during T2, after the first VBL application in both groups with a trend of stabilization after T2, which is compatible with findings described in the literature. Any dog of EG or CG had to interrupt the treatment due to hematological or gastrointestinal toxicity or died during treatment. The role of VBL dose intensity in outcome is still debatable for dogs with MCT, once it is a multifactorial disease with variable presentation. In this study, there was no difference in overall survival time after diagnosis between groups, and EG dogs treated with a higher VBL dose showed significantly less tumor recurrence than CG.

Immunohistochemical Detection of CD95L (Fas Ligand) in Mantle Cell Lymphoma: A Prognostic Factor for Clinical Outcome.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4566-4566
Author(s):  
Carsten Schrader ◽  
Peter Meusers ◽  
Guenter Brittinger ◽  
Dirk Janssen ◽  
Reza Parwaresch ◽  
...  
Keyword(s):  
Overall Survival ◽  
Mantle Cell Lymphoma ◽  
Survival Time ◽  
Median Overall Survival ◽  
Fas Ligand ◽  
Clinical Course ◽  
Cell Lymphoma ◽  
Immunohistochemical Detection ◽  
Overall Survival Time ◽  
Mantle Cell

Abstract Mantle cell lymphoma is a malignant lymphoma associated with a relatively aggressive clinical course and a median overall survival time of 3–4 years. Proliferation indices are important prognostic factors in the clinical outcome. We investigated immunohistochemically the expression of the apoptotic marker CD95L (Fas Ligand) in relation to the clinical course. Biopsy specimen from 69 untreated patients enrolled in two multicenter prospective trials were investigated immunohistochemically with monoclonal antibodies against CD20, CD5, CD3, CD23, cyclin D1, CD95L. The CD95L expression was analyzed into three groups: negative, weak positive and strong positive. The expression was compared with the overall survival data analysed according to Kaplan and Meier. Patients with mantle cell lymphoma that had negative and weak positive CD95L expression had a median overall survival time of 32.0 months compared to 18.3 months for patients with a strong CD95L expression. The Kaplan-Meier analysis showed a significant difference in the overall survival time between the patients with strong CD95L expression and the group of patients with negative or weak positive tumor cells (p&lt;0.0038). Based on these findings, the immunohistochemical detection of CD95L in mantle cell lymphoma is a prognostic factor.

The Incidence of Corrected Hypercalcemia and Its Relationship with Prognosis for Chinese Multiply Myeloma.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4903-4903
Author(s):  
Xi Zhang ◽  
Chunkang Chang ◽  
Xiao Li ◽  
Jiying Su ◽  
Lingyun Wu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Serum Creatinine ◽  
Serum Albumin ◽  
Survival Time ◽  
Serum Calcium ◽  
Staging System ◽  
P Value ◽  
Overall Survival Time ◽  
Significant Difference ◽  
Before And After

Abstract Abstract 4903 Purpose This paper is to study and analze the serum calcium level after corrected for serum albumin and its effect on prognosis in Chinese multiple myeloma (MM). Methods Serum calcium levels before and after corrected by serum albumin were retrospectively analyzed in 165 Chinese multiple myeloma patients. Corrected serum calcium (mmol/L)=serum calcium (mmol/L) – 0.025 x serum albumin (g/L)+1.0 (mmol/L). We also analyzed the relationship of serum calcium, serum creatinine and disease categories in Durie-Salmon (DS) staging system with patients' long-term overall survival rate. Results In 165 patients, the incidences of before and after corrected hypercalcemia were 8.7% and 40.6%, which were statistically significantly different (p=0.0245). Based on DS staging, the before and after corrected serum calcium levels of sixteen MM patients in I stage were 2.316±0.082 mmol/L and 2.344±0.073 mmol/L with a p value equal to 0.3236; the before and after correccted serum calcium levels of fifty MM patients in II stage were 2.314±0.17 and 2.407±0.235 mmol/L with a p value equal to 0.0251; the before and after corrected serum calcium levels of ninety-nine MM patients in II stage were 2.428±0.32 and 2.671±0.309 mmol/L with a p value equal to 0.0000. There is no significant difference in overall survival time between normal serum calcium group and elevated serum calcium group, p=0.8929. There is significant difference in overall survival time between normal serum creatinine patients and raised serum calcium patients with a p value equal to 0.0170. Patients in I stage in DS staging system have statistically significant longer overall survival time than those patients in II/III stage in DS staging system, p=0.0382. Conclusion The incidence of corrected hypercalcemia in Chinese MM is similar to foreign reports. Hypercalcemia has smaller or limit impact on patients' long-term overall survival compared to serum creatinine and DS staging. Disclosures No relevant conflicts of interest to declare.

SOX11 Expression Versus Indolent Clinical Course in Mantle Cell Lymphomas in a Population-Based Cohort From the Stockholm Region – SOX11 Negative Tumors Are Mostly p53 Positive, Contributing to Shorter Overall Survival,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3651-3651
Author(s):  
Birgitta Sander ◽  
Monika Klimkowska ◽  
Lina Nygren ◽  
Stefanie Baumgartner ◽  
Birger Christensson ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cyclin D1 ◽  
Survival Time ◽  
Median Overall Survival ◽  
Clinical Course ◽  
Population Based ◽  
Mantle Cell ◽  
Sox11 Expression ◽  
Indolent Disease ◽  
Median Overall Survival Time

Abstract Abstract 3651 Introduction: Mantle cell lymphoma (MCL) constitutes 3–10% of non-Hodgkin lymphomas and has a median survival of 3–5 years. A small number of patients are characterized by a clinically indolent disease and may not require treatment for several years. However, these are difficult to identify at the time of diagnosis due to lack of reliable predictive markers. Recently, the nuclear expression of the transcription factor SOX11 has been suggested to be of prognostic value in MCL. Materials and Methods: All 186 patients diagnosed with MCL in the Stockholm region between January 1998 and June 2010 were included. Diagnosis was according to the WHO criteria and all cases were cyclin D1 positive by IHC and/or for t(11;14) by FISH. Clinical data from patient files, diagnostic biopsies and flow cytometry data were reviewed. Patients not requiring treatment within the first two years after diagnosis were retrospectively defined as indolent disease. Patients were further categorized in nuclear SOX11 negative (n=13) and nuclear SOX11 positive (n=160) cases and in cases with indolent (n=17) versus non-indolent disease course (n=169). The following variables were evaluated at the time of diagnosis: age, sex, Ann Arbor stage, ECOG, B-symptoms, Hb, LDH, albumin, lymphocytosis, leukocytosis, splenomegaly, nodal and bone marrow involvement, MIPI, indolent disease, blastoid morphology, expression of CD23, light chain, Ki 67, SOX11 and p53. Overall survival was analyzed, excluding patients receiving ASCT (n=37). Baumgartner, S. et al presents further data on the entire cohort in the accompanying abstract. Results: The following variables were significantly more common in SOX11 negative cases (Table 1): Lymphocytosis (p=0,045), high LDH (p=0,029) and p53 positivity (p<0,000). MIPI high risk was more frequent among SOX11 negative patients but did not reach statistical difference. There were no statistically significant differences in the frequency of splenomegaly or indolent disease among SOX11 negative and positive cases. Median overall survival time was 36,7 months in the whole cohort; 16,5 months in patients with SOX11 negative tumors and 39,3 months in patients with SOX11 positive tumors (p=0,015), excluding 37 patients (1 SOX11 negative, 38 SOX11 positive) receiving ASCT as part of first-line therapy. Patients with an indolent clinical course had significantly less often B symptoms (p=0,002), nodal presentation (p=0,019) and elevated LDH (p=0,040) than patients with a non-indolent disease, while none of the other factors analyzed reached statistical significance. Median overall survival time of patients with indolent disease was not reached (median follow-up time 41,7 months). 15/17 of the MCL cases with indolent clinical course expressed SOX11. Conclusions: In a population-based cohort of 186 cyclin D1 positive MCL, 8% lacked expression of nuclear SOX11 at diagnosis. There was no enrichment of patients with an indolent disease among SOX11 negative MCL. Instead patients with SOX11 negative MCL had a higher frequency of lymphocytosis and elevated LDH at diagnosis and a shorter overall survival. MCL lacking nuclear SOX11 expression at diagnosis were more frequently p53 positive which may contribute to shorter survival in the SOX11 negative MCL subset. Disclosures: No relevant conflicts of interest to declare.

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