scholarly journals Modern views on the treatment of acute leukemia in children under 1 year

2019 ◽  
Vol 6 (2) ◽  
pp. 11-19
Author(s):  
O. V. Paina ◽  
E. V. Semenova ◽  
I. V. Markova ◽  
L. S. Zubarovskaya ◽  
B. V. Afanasyev
Keyword(s):  
Acute Leukemia ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Disease Stage ◽  
High Risk Infant ◽  
Acute Leukemias ◽  
Mll Gene ◽  
The Usa ◽  
Independent Risk Factors ◽  
The Difference

Acute leukemias in children aged under 1 year has different clinical manifestations as compared to patients of older age groups. The prognostic values of ALL and AML in children under 1 year are different. In ALL there are additional independent risk factors which worsen the prognosis. Clinical researches in the field of infant acute leukemia is still under develop and making a significant contribution to the understanding of the biology of leukemogenesis and therapy. The results of therapy in different research groups were comprised: POG, CCG, COG (USA), JPLSG (Japan), Interfant (BFM, researchers from New Zealand, Australia and the USA). The difference of the results led to discrepancy regarding the role of allo-HSCT in the infants treatment. In Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, the 10-year OS after allo-HSCT in the pediatric group with high-risk infant leukemias was 55 %, in the group of patients with restructuring of the MLL gene – 53 % versus 59 % without MLL gene. The results of allo-HSCT depended on the disease stage at the time of treatment, in I–II CR 5-year OS was 79 % (n = 35), in III–IV CR or progression –16 % (n = 20).

scholarly journals Age-Related Risk Factors and Complications of Patients With COVID-19: A Population-Based Retrospective Study

2022 ◽  
Vol 8 ◽  
Author(s):  
Han Zhang ◽  
Yingying Wu ◽  
Yuqing He ◽  
Xingyuan Liu ◽  
Mingqian Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Population Based ◽  
Male Gender ◽  
Poor Correlation ◽  
Age Related ◽  
Related Risk ◽  
Independent Risk Factors

Objective: To study the differences in clinical characteristics, risk factors, and complications across age-groups among the inpatients with the coronavirus disease 2019 (COVID-19).Methods: In this population-based retrospective study, we included all the positive hospitalized patients with COVID-19 at Wuhan City from December 29, 2019 to April 15, 2020, during the first pandemic wave. Multivariate logistic regression analyses were used to explore the risk factors for death from COVID-19. Canonical correlation analysis (CCA) was performed to study the associations between comorbidities and complications.Results: There are 36,358 patients in the final cohort, of whom 2,492 (6.85%) died. Greater age (odds ration [OR] = 1.061 [95% CI 1.057–1.065], p < 0.001), male gender (OR = 1.726 [95% CI 1.582–1.885], p < 0.001), alcohol consumption (OR = 1.558 [95% CI 1.355–1.786], p < 0.001), smoking (OR = 1.326 [95% CI 1.055–1.652], p = 0.014), hypertension (OR = 1.175 [95% CI 1.067–1.293], p = 0.001), diabetes (OR = 1.258 [95% CI 1.118–1.413], p < 0.001), cancer (OR = 1.86 [95% CI 1.507–2.279], p < 0.001), chronic kidney disease (CKD) (OR = 1.745 [95% CI 1.427–2.12], p < 0.001), and intracerebral hemorrhage (ICH) (OR = 1.96 [95% CI 1.323–2.846], p = 0.001) were independent risk factors for death from COVID-19. Patients aged 40–80 years make up the majority of the whole patients, and them had similar risk factors with the whole patients. For patients aged <40 years, only cancer (OR = 17.112 [95% CI 6.264–39.73], p < 0.001) and ICH (OR = 31.538 [95% CI 5.213–158.787], p < 0.001) were significantly associated with higher odds of death. For patients aged >80 years, only age (OR = 1.033 [95% CI 1.008–1.059], p = 0.01) and male gender (OR = 1.585 [95% CI 1.301–1.933], p < 0.001) were associated with higher odds of death. The incidence of most complications increases with age, but arrhythmias, gastrointestinal bleeding, and sepsis were more common in younger deceased patients with COVID-19, with only arrhythmia reaching statistical difference (p = 0.039). We found a relatively poor correlation between preexisting risk factors and complications.Conclusions: Coronavirus disease 2019 are disproportionally affected by age for its clinical manifestations, risk factors, complications, and outcomes. Prior complications have little effect on the incidence of extrapulmonary complications.

Disease Characteristics and Patterns of Care In Elderly Patients (80+ years) with Follicular Lymphoma (FL) In the United States (US); Are Older Patients Treated Differently? Report From the National LymphoCare Study (NLCS)

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4152-4152
Author(s):  
Chadi Nabhan ◽  
Michelle Byrtek ◽  
Michael Taylor ◽  
Jill Tydell ◽  
Jamie H. Hirata ◽  
...  
Keyword(s):  
Older Patients ◽  
Research Funding ◽  
Age Groups ◽  
Treatment Patterns ◽  
Disease Stage ◽  
Younger Patients ◽  
Disease Characteristics ◽  
Significant Difference ◽  
The Difference ◽  
Grade 3

Abstract Abstract 4152 Background: While FL is the most common low-grade lymphoma in the US, median age was less than 60 in patients enrolled on pivotal studies that led to our understanding of disease biology and optimal therapy. It remains unclear whether similar disease characteristics, presentation, prognostic factors, treatment patterns, and outcomes pertain to older patients with FL. No clear guidelines exist on how older patients should be treated and data is lacking as to whether current practice patterns affect their survival and progression. Previous reports on FL in the elderly have been retrospective and single center-based. Methods: The NLCS is a prospective, longitudinal multicenter, observational study that enrolled consecutive newly diagnosed FL patients from 3/2004 through 3/2007 collecting data on disease and patients' characteristics, treatment patterns, and outcome. Using the NLCS data we analyzed information on disease stage, grade, FL International Prognostic Index (FLIPI), B symptoms, and treatment choice for patients <60 years, 60–69 years, 70–79 years, and 80+ years. Either Chi-square or Fisher's exact comparison was used to assess the correlations depending on the sample size of the test. Results: A total of 2,736 pts were enrolled, of which 1,215 (44%) were < 60, 708 (25%) were between 60–69, 549 (20%) were between 70–79, and 264 (9%) were >80. There was a significant difference in grade distribution across the different age groups (p < 0.0001), with 22% of pts 80+ having grade 3 FL vs 17% pts <60. No significant differences across age groups in B symptoms, extra nodal sites, or LDH values were observed. A significant difference in FLIPI score was seen across the age groups (p < 0.0001) where high-score FLIPI was present in 48% of pts 80+ as opposed to 16% of pts <60, although calculating FLIPI might be confounded by the fact that older patients were more likely to not have received a bone marrow (BM) exam with 66% of pts 80+ not having BM exam vs. only 40% of those <60 (p < 0.0001). The difference in FLIPI was mainly due to lower Hgb values as older patients were more likely to have had Hgb < 12 g/dL than younger patients (31% of pts 80+ vs. 15% of pts <60) and to age being a component of the FLIPI index. The difference in FLIPI score across age groups was also observed in patients with grade 3 FL where 53% of pts 80+ had poor FLIPI vs. 15% of pts <60 (p < 0.0001). A statistically significant difference in treatment patterns was found across age groups (p <0.0001). When treatment was implemented, older patients were more likely to have received rituximab (R) monotherapy (37% of 80+ vs. 12% of <60) and less likely to have received R+Chemotherapy (40% of pts 80+ vs. 64% of pts<60). In addition, more pts 80+ were observed compared to those <60 (23% vs. 16%). These differences persisted even in those with advanced stage (III/IV), grade 3 disease, region of diagnosis, and in poor-risk FLIPI. When chemotherapy was used, older patients were less likely than younger patients to receive anthracyclines (p < 0.0001) (31% of pts 80+ vs. 69% of pts<60). Anthracycline use remained significantly different regardless of disease stage, grade, or FLIPI score. Conclusions: To our knowledge, this is the largest prospective data collection available for FL pts 80+ years of age. We demonstrate that these pts have higher FLIPI score and grade 3 disease. When treatment is initiated, these patients receive R monotherapy more often than their younger counterpart. Anthracycline use in this population is also less common regardless of disease stage, grade, or risk profile. Whether these baseline differences translate into different outcomes remains to be seen. Disclosures: Nabhan: genentech: Research Funding, Speakers Bureau. Byrtek:Genentech: Employment. Taylor:Genentech: Employment. Hirata:Genentech: Employment. Flowers:Genentech/Biogen-Idec (unpaid): Consultancy; Celgene, Intellikine: Consultancy; Millennium: Research Funding.

scholarly journals Clinical case of a young patient with ischemic stroke and obesity

2021 ◽  
Vol 23 (4) ◽  
pp. 347-357
Author(s):  
Fatima Kh. Dzgoeva ◽  
◽  
Evgenia V. Ekusheva ◽  
Evgenia V. Ekusheva ◽  
Diana S. Rafikova ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Clinical Case ◽  
Age Groups ◽  
Young Patients ◽  
Clinical Manifestations ◽  
Economic Problem ◽  
Stroke In Young Adults ◽  
History Of ◽  
The Difference ◽  
History Of Obesity

Stroke in young adults is a serious medical and socio-economic problem. The relevance and complexity of the problem of ischemic stroke (IS) in young patients is due to insufficient knowledge of this issue, the complexity of medical and diagnostic aspects, as well as the difference in the causes of strokes from those in older age groups. Due to the variety of clinical manifestations, IS is of big interest for cardiologists, neurologists, obstetriciansgynecologists, hematologists, rheumatologists and is also relevant for endocrinologists and nutritionists. This article examines a clinical case of a patient with IS at a young age and a history of obesity and confirmed hemophilia.

New Insights to the MLL Recombinome Including 8 Novel Partner Genes ACTN4, C2CD3, DCP1A, FLNA, LAMC3, LOC100128568, NRIP3, and TNRC18.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2047-2047
Author(s):  
Claus Meyer ◽  
Eric Kowarz ◽  
Julia Hofmann ◽  
Thomas Fischer ◽  
Sara El Ashkar ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Molecular Level ◽  
Residual Disease ◽  
Patient Specific ◽  
Fusion Partner ◽  
Acute Leukemias ◽  
Additional Tool ◽  
Mll Gene ◽  
Diagnostic Center ◽  
Partner Gene

Abstract Rearrangements of the MLL (mixed lineage leukemia) gene are associated with pediatric, adult and therapy-related acute leukemias of both the myeloid and lymphoid lineage. Today, about 60 MLL fusion partner genes have been characterized at the molecular level involving almost all chromosomes. Nearly one-third of these partner genes have been identified at the DCAL (Diagnostic Center of Acute Leukemia) where more than 700 MLL rearrangements, including 36 different partner genes, have been analyzed so far. 85% of the analyzed MLL rearrangements account for the 6 most frequent partner genes, and 15% for less frequent partner genes including the 8 novel partner genes ACTN4, C2CD3, DCP1A, FLNA, LAMC3, LOC100128568, NRIP3, and TNRC18. Here, we present an overview of all current known translocation partner genes. This overview indicates all the specific introns of the TPGs found to be involved in MLL translocations, their chromosomal locations and the type of genetic abnormality that is leading to the MLL fusion. Additionally, the current breakpoint cluster region (bcr) is also presented for the 10 most frequent partner genes, namely AFF1 (AF4), MLLT3 (AF9), MLLT1 (ENL), MLLT10, MLLT4 (AF6), ELL, EPS15, MLLT6 (AF17), MLLT11 (AF1Q) and partial tandem duplications (PTDs). These bcrs have been used as basis for the development of an long range multiplex PCR. This is an additional tool for the identification of genomic MLL breakpoints to enhance the diagnostic efficiency. Approximately 20% of all MLL rearrangements are complex ones. In this study, we have identified 109 (15%) complex rearrangements. Within these complex rearrangements, the 5’ part of the MLL gene is generally fused in frame to one of the most frequent partner genes. But the 3’ part of the MLL gene is fused in 45 cases (41%) to a novel so-called “reciprocal MLL partner gene” like ADSS or ATG16L2. This heterogeneous group of novel translocation partner genes had not been identified as fusion partners to the 5’ part of the MLL gene before. Whether the pathobiology of complex rearrangements is different in comparison to their not complex counterparts has still to be proven. Also a novel “spliced MLL fusion” involving the AFF1 gene has been identified at the DCAL. In this case, the breakpoint is 90 kb up-stream of the AFF1 gene. Unfortunately, no cDNA/RNA was left to identify the chimeric fusion transcript. Nevertheless, the disease phenotype of a biphenotypic AL strengthens the involvement of the AFF1 gene. With these results, the number of genes involved in „ spliced MLL fusions“ has increased from seven to eight. For five patients, no partner gene could be identified at the molecular level. Also the “spliced MLL fusions” which is a mechanism to generate functional chimeric fusion transcripts with neighbouring genes described already for 8 partner genes of the MLL gene, could not be identified for these patients by RACE and RT-PCR. Furthermore, the determined patient-specific fusion sequences are succesfully used worldwide for minimal residual disease (MRD) monitoring to improve the treatment and outcome of acute leukemia patients.

scholarly journals MLL-USP2: An Underestimated New Entity of MLL-Rearranged Leukemia Identified By NGS Analysis

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3920-3920 ◽  
Author(s):  
Claus Meyer ◽  
Bruno Lopes ◽  
Aurélie Caye-Eude ◽  
Hélène Cavé ◽  
Chloé Arfeuille ◽  
...  
Keyword(s):  
High Risk ◽  
Acute Leukemia ◽  
Diagnostic Methods ◽  
Patient Specific ◽  
Fish Analysis ◽  
Acute Leukemias ◽  
Breakpoint Cluster Region ◽  
Cluster Region ◽  
Mll Gene ◽  
Partner Gene

Abstract Chromosomal rearrangements of the MLL gene are responsible for 5-10% of all acute leukemias, biphenotypic leukemias and myelodysplastic syndromes. The large number of known MLL fusions (>80) renders a precise diagnosis a demanding task. Even though all MLL rearrangements are associated with high-risk acute leukemia, the outcome (poor or very poor) is influenced by the partner gene. The applied diagnostic methods (LDI-PCR and multiplex PCR) allows the identification of MLL fusion genes at the nucleotide level, providing important information on the genetics of leukemia patients, and patient-specific biomarkers. These biomarkers are used for monitoring of minimal residual disease in acute leukemia patients during and after therapy. Thus, the identification of MLL gene fusions is necessary for rapid clinical decisions to determine the best therapy regimen. We have developed a customized NGS panel for MLL diagnostics to utilize state of the art technology at DCAL. With this new tool, the whole MLL gene is analyzed in contrast to the LDI-PCR where only the main MLL breakpoint cluster region (BCR-1) is covered. The first results of the NGS analysis of 84 patients identified MLL breakpoints located outside the main BCR-1 of MLL. Furthermore, a novel MLL partner gene USP2 was identified in 16 patients. All MLL-USP2 positive patients had a breakpoint located outside BCR-1 and within a newly defined breakpoint cluster region BCR-2. The BCR-2 site was also used in 2 other patients with MLL-AFF1 and one patient with MLL-MLLT3. These findings reveal USP2 as a new entity for MLL rearrangements affecting indifferently children aged 3 months to 10 years old (mean 30 months) with no gender bias (M/F=1.3). Interestingly, only 5/16 affected children were below 1 year of age at diagnosis and thus treated according to the Interfant trial. Clinical presentation as well as outcome associated with this new entity deserves further investigation to define whether those patients should be allocated, as other MLL-rearranged ones, in high-risk treatment groups. More MLL patients should also be analyzed to get a better idea of the frequency of breakpoints within BCR-2, especially the frequency of MLL-USP2 fusions. Indeed, standard FISH analysis and CGH array do not permit reliable detection of this fusion, explaining why they remained undetected so far. The biology of this novel MLL rearrangement also deserves further investigation, considering that USP2 is the only MLL partner fused exclusively to BCR-2. Disclosures No relevant conflicts of interest to declare.

Management of Thrombohemorrhagic Syndromes (THS) in Hematologic Malignancies

Hematology ◽  
2007 ◽  
Vol 2007 (1) ◽  
pp. 165-171 ◽  
Author(s):  
Anna Falanga ◽  
Frederick R. Rickles
Keyword(s):  
High Risk ◽  
Acute Leukemia ◽  
Clinical Manifestations ◽  
Hematologic Malignancies ◽  
Malignant Cell ◽  
Acute Leukemias ◽  
Thrombotic Risk ◽  
Hemorrhagic Risk ◽  
High Risk Cancer ◽  
Newer Anticoagulants

AbstractThe rate of venous thromboembolism (VTE) in patients with acute leukemia or lymphomas is comparable with that of other “high-risk” cancer types. Chemotherapy and anti-angiogenic drugs increase the thrombotic risk in patients with lymphomas, acute leukemias and multiple myeloma (MM). Patients with hematologic malignancies often present with a hypercoagulable state or chronic disseminated intravascular coagulation (DIC) in the absence of active thrombosis and/or bleeding. Malignant cell procoagulant properties, cytotoxic therapies, and concomitant infections are major determinants for clotting activation in hematologic malignancies. In acute leukemia, clinical manifestations range from localized venous or arterial thrombosis to a diffuse, life-threatening thrombohemorrhagic syndrome (THS). All-trans retinoic acid (ATRA) has greatly improved the management of acute promyelocytic leukemia (APL), but has not significantly changed the rate of early hemorrhagic deaths and may actually promote thrombosis. Randomized, controlled trials (RCTs) of different prophylactic regimens to prevent VTE or THS in hematologic malignancies are urgently needed, particularly in patients with lymphoma or MM during chemotherapy and in patients with APL. Anticoagulant therapy is a particular challenge in patients with hematologic malignancies, since these patients are at very high risk for hemorrhage. No guidelines are available for the prophylaxis or treatment of VTE; extrapolations can be made from existing guidelines for management of patients with other malignancies; prolonged periods of treatment-induced thrombocytopenia in patients with hematologic malignancies, however, require a more judicious application of standard anticoagulant approaches. Use of the newer anticoagulants will require careful assessment of hemorrhagic risk in this group of high-risk patients but may be justified under special circumstances.

scholarly journals The role of gender in the prevalence of human leptospirosis in Albania

2018 ◽  
Vol 12 (03) ◽  
pp. 150-155 ◽  
Author(s):  
Edmond Puca ◽  
Pellumb Pipero ◽  
Arjan Harxhi ◽  
Erjona Abazaj ◽  
Arjet Gega ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Presentation ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Epidemiological Data ◽  
Elisa Test ◽  
Human Leptospirosis ◽  
Males And Females ◽  
The Difference

Introduction: Leptospirosis is a zoonotic spirochetal disease with global importance, which continues to have a major impact on public health in developing countries. The prevalence of the disease is much higher in males. The objectives of this study were: to give some data and to share our experience with human leptospirosis in Albania; to describe the prevalence regarding to the role of gender in the prevalence of human leptospirosis; to make a gender specific analysis of the clinical manifestations in patients diagnosed and treated for leptospirosis in our service and to make a review of literature related to this hypothesis. Methodology: We reviewed the epidemiologic data, risk factors and differences in clinical presentation between males and females’ patients with leptospirosis. These data are analysed from hospitalized patients. Diagnosis of leptospirosis was established based on clinical presentation, epidemiological data and subsequently confirmed serologically by Anti-Leptospira IgM antibodies through ELISA test. Results: Between 2005-2016, 233 cases of confirmed leptospirosis were analysed. Males were 208 (89.27%) and 25 of patients (10.72%) were females in ratio 9:1 p < 0.001. The highest prevalence was observed in the 45-64 age groups. Overall mortality was found to be 8.58%, 19 were males and one female p < 0.001. Conclusions: There is a much higher prevalence of leptospirosis in middle aged men. Mortality rate seems to be similar in males and females. While the difference in prevalence may be related to exposure to risk factors, further investigation is necessary to study gender-based genetic and immunological predisposition.

scholarly journals Pathophysiology of Poly Cystic Ovarian Syndrome

2021 ◽  
Vol 17 ◽  
Author(s):  
Manu ◽  
Thomson Soni ◽  
Victoria ◽  
Pranav Kumar Prabhakar
Keyword(s):  
Insulin Resistance ◽  
Rural Areas ◽  
Urban Areas ◽  
Genetic Disorder ◽  
Clinical Manifestations ◽  
Reproductive Age ◽  
Rural And Urban ◽  
The Usa ◽  
The Difference ◽  
Ovarian Syndrome

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrinopathy that affects 8% to 20% of the reproductive age females and adolescent girls every year worldwide and approximately 5 million cases reported in the USA annually. It is more prevalent in urban areas as compared to the rural areas because of the difference in the lifestyles of rural and urban ladies. Rarely PCOS is passed on by heredity in some cases. Objectives: We sought to understand the pathophysiology and role of various genes in PCOS. Methods: We have done rigorous literature reviews on different aspect of PCOS and compiled here in this review. Results: It mostly occurs due to a lack of awareness. Its symptoms become mild to severe like initially hirsutism, acne which further leads to irregular periods and infertility. The pathogenesis of PCOS is not known because it is a complex multi-genetic disorder i.e. it involves one or more than one abnormal alteration in its genome. Its main clinical manifestations are insulin resistance and increased level of androgen. So, the treatment regimen of this disorder is focused on reducing levels of androgen, which helps to diminish the long-term risk of diabetes and CVD (Cardiovascular disease). Metformin is used to sensitize the insulin because the risk of glucose intolerance also gets elevated with insulin resistance, type-2 diabetes, and lipid abnormalities. Conclusions: Likely, the outcome of different, deeply interrelated genetic abnormalities that influence each other and perpetuate the syndrome may be represented by PCOS.

scholarly journals Outcomes for Hispanic Patients with Acute Leukemia Treated at Academic Centers

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 2282-2282
Author(s):  
Namrata Sonia Chandhok ◽  
Ameena Shrestha ◽  
Justin M Watts ◽  
Terrence Bradley ◽  
Mikkael A. Sekeres
Keyword(s):  
Acute Leukemia ◽  
Board Of Directors ◽  
Age Groups ◽  
Hematologic Malignancies ◽  
Complication Rates ◽  
Hispanic Paradox ◽  
Advisory Committees ◽  
Acute Leukemias ◽  
Mortality Index ◽  
Hispanic Patients

Abstract Introduction: Health disparities for underrepresented U.S. minority populations with hematologic cancers contribute to differential treatment and higher death rates. The Hispanic population (including people of Mexican, South/Central American, Cuban, Puerto Rican, or other Spanish-speaking cultures, regardless of race) collectively constitutes the largest minority group in the United States. Hispanic patients have been reported to have an increased incidence of B-cell acute lymphoblastic lymphoma (B-ALL) and acute promyelocytic leukemia (APL). While APL is associated with favorable outcomes compared to other acute leukemias, registry data suggest poorer outcomes in Hispanic patients with both acute lymphocytic leukemia (ALL) and acute myeloid leukemia (AML). The Hispanic paradox is an epidemiological paradox that refers to the finding that Hispanic patients have paradoxically comparable, or better, health outcomes compared to their U.S. non-Hispanic White counterparts despite barriers to care such as lower socioeconomic status. This paradox has also been reported in hematologic malignancies. Definitive data regarding differences in outcome between Hispanic and non-Hispanic patients with acute leukemias (AL) are lacking. We sought to compare outcomes of Hispanic patients and non- Hispanic patients with acute leukemia with access to care, and examine whether the Hispanic paradox reported in hematologic malignancies is attributable to enrichment of patients with highly curable disease such as APL. Methods: Using data from a Vizient Clinical Data Base, a healthcare claims database, we identified patients with leukemia using ICD 10 codes for acute leukemia. Adult patients with AL, ages 18-89 who were treated between January 2020 and June 2021 were evaluated. Data from 121 academic centers was included. We focused on academic centers to limit the impact of access to care . Demographic information was obtained from the registry, to which ethnicity was self-reported. Patients were stratified by age, and we compared complication rates, number of complications, number of deaths, percent deaths and mortality index between Hispanic and non-Hispanic patients. The key metric used to compare outcomes of Hispanic patients with non-Hispanic patients was the severity adjusted mortality index, which is the ratio of observed mortality over expected mortality for patients with the same diagnosis in this registry. Chi-squared test is used for to determine the statistical significance of differences in mortality (by age group) in Hispanics v. non-Hispanic patients. Initial analysis included all patients with acute leukemias, and the data was subsequently reanalyzed excluding patients with APL, as APL is known to portend a favorable prognosis. Results: A total of 29,967 patients were with acute leukemia were evaluated; of these patients, 2903 identified as Hispanic and 27,064 were non- Hispanic. As seen in table 1, patients of Hispanic origin generally had lower treatment related complication rates in all age groups compared to their age matched non-Hispanic counterparts. Except for the 51-64 and 80-84 age groups the mortality index was lower in Hispanic patients compared to non-Hispanic peers. Differences in mortality between Hispanic and non-Hispanic patients in all age groups were not statistically significant. Trends to a lower mortality index in Hispanic patients are highlighted in green in table 1. When patients with APL were excluded from the analysis, the trend lower mortality in Hispanic patients in most age groups persisted. Again, the mortality index was comparatively higher in hispanic patients in the 51-64 and 80-84 age groups, but differences in mortality between Hispanic and non- Hispanic patients were not statistically significant. Exclusion of APL patients did not have a significant impact on the complication rate or mortality supporting that the Hispanic paradox is independent of higher rates of very favorable risk myeloid malignacies in this population. Conclusions: Hispanic patients with access to academic cancer centers have the potential for non-inferior outcomes compared to non-Hispanic patients. Equivalent outcomes as assessed by mortality index were not attributable solely to the higher incidence of very favorable risk disease such as APL in the Hispanic population. Figure 1 Figure 1. Disclosures Watts: Takeda: Consultancy, Research Funding; Genentech: Consultancy; Rafael Pharma: Consultancy; Celgene/BMS: Consultancy. Bradley: Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees; AbbVie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Sekeres: Takeda/Millenium: Membership on an entity's Board of Directors or advisory committees; BMS: Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees.

Age Differences in Eye Movements During Reading: Degenerative Problems or Compensatory Strategy?

2019 ◽  
Vol 24 (4) ◽  
pp. 297-311
Author(s):  
José David Moreno ◽  
José A. León ◽  
Lorena A. M. Arnal ◽  
Juan Botella
Keyword(s):  
Eye Movements ◽  
Eye Movement ◽  
Meta Analysis ◽  
Age Groups ◽  
Behavioral Changes ◽  
Aging Effects ◽  
Movement Data ◽  
Sentence Reading ◽  
The Difference ◽  
Eye Movements During Reading

Abstract. We report the results of a meta-analysis of 22 experiments comparing the eye movement data obtained from young ( Mage = 21 years) and old ( Mage = 73 years) readers. The data included six eye movement measures (mean gaze duration, mean fixation duration, total sentence reading time, mean number of fixations, mean number of regressions, and mean length of progressive saccade eye movements). Estimates were obtained of the typified mean difference, d, between the age groups in all six measures. The results showed positive combined effect size estimates in favor of the young adult group (between 0.54 and 3.66 in all measures), although the difference for the mean number of fixations was not significant. Young adults make in a systematic way, shorter gazes, fewer regressions, and shorter saccadic movements during reading than older adults, and they also read faster. The meta-analysis results confirm statistically the most common patterns observed in previous research; therefore, eye movements seem to be a useful tool to measure behavioral changes due to the aging process. Moreover, these results do not allow us to discard either of the two main hypotheses assessed for explaining the observed aging effects, namely neural degenerative problems and the adoption of compensatory strategies.

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