Bất thường nhiễm sắc thể và liên quan tới kết quả điều trị sớm lơ xê mi cấp dòng lympho trẻ em tại Viện Huyết học - Truyền máu Trung ương giai đoạn 2016 - 2019

2020 ◽  
Author(s):  
Hong Hoang Thi
Keyword(s):  
Blood Transfusion ◽  
Early Result ◽  
Poor Prognosis ◽  
Chromosomal Abnormalities ◽  
Structural Abnormality ◽  
Chromosome Group ◽  
The Poor ◽  
Structural Abnormalities ◽  
Pediatric All ◽  
The Difference

Cytogenetic variables in pediatric acute lymphoblastic leukemia (ALL) plays an important role in prognosis and risk grouping. Evaluation of early result treatment based on cytogenetic mutations provides data for physicians in treatment options for pediatric patients. Objectives: Study on characteristics of chromosomal abnormalities and evaluate the relationship with the early result of treatment according to FRALLE 2000 protocol at the National Institute of Hematology and Blood Transfusion. Subjects and research methods: This was a prospective study conducted on 188 pediatric ALL patients who were treated at the National Institute of Hematology and Blood Transfusion from August 1, 2016 to August 1, 2019. Results: The incidence of chromosomal abnormalities in pediatric ALL patients was 13.8%. Structural abnormalities were more common (57.7% of structural abnormalities alone, 15.4% combined with structural and numberal abnormalities, 26.9% of numberal abnormalities alone). The most common structural abnormality was chromosomal translocations, in which t(9;22) was the most common. Hyperdiploid accounted 90.9% in the abnormal number of chromosomes. The poor prognosis group accounted for a higher proportion in the study. The good prognosis chromosome group had the best treatment results (Overal Survival - OS 12 months reached 100%, Event Free Survival - EFS 12 months reached 80.0 ± 17.9%). The group with the poor prognosis of chromosome: OS 12 was only 66.0 ± 11.3%, EFS 49.4 ± 12.2%. The difference was statistically significant with p <0.01. The normal chromosome group had good OS and EFS for 12 months, 90.4 ± 2.6% and 77.9 ± 3.6%, respectively. Conclusion: The rate of abnormalities chromosome was low. Structural mutations were more common. Hyperdiploid was mainly seen on numberal chromosome abnormalities. This study found the difference in survival time between the groups according to the chromosome prognosis.

scholarly journals Chromosomal Analysis of 129 Miscarried Conceptuses: A Retrospective Study

2021 ◽  
Author(s):  
Juan Gui ◽  
Qian Liu ◽  
Xiaochen Wang ◽  
Qingzhen Xie ◽  
Lei Ming
Keyword(s):  
Retrospective Study ◽  
Embryo Transfer ◽  
Chromosomal Abnormality ◽  
Chromosomal Abnormalities ◽  
Structural Abnormality ◽  
Fresh Embryo Transfer ◽  
Significant Difference ◽  
Structural Abnormalities ◽  
Negative Effect ◽  
Transfer Group

Abstract Background Embryonic chromosomal abnormality is one of the significant causative factors of pregnancy loss. Our goal was to investigate the differences of chromosomal abnormality between different conception modes in miscarried products of conception (POCs). Methods A retrospective study included 129 miscarried POCs from 81 women undergoing assisted reproductive technology (ART) and 48 spontaneous pregnant (SP) women during March 2019 to March 2021 in Renmin Hospital of Wuhan University. Subgroups were divided according to age, fertilization method, types of embryo transfer. The profiles of cytogenetic abnormalities in the miscarried POCs were measured via next-generation sequencing. Results The total chromosomal abnormality rate was 65.1%. No significant difference was found in the rate of chromosomal abnormalities between ART and SP group (63% vs. 68.8%, P = 0.505). However, the rate of chromosomal structural abnormalities was significantly increased in ART group (P = 0.02). There was no significant difference in the rate of chromosomal abnormalities when stratified by age (62.9% vs. 71.9%, P = 0.355) and frequency of abortion (66.7% vs. 63.2%, P = 0.678). In the patients aged < 35 years, the ART group had more frequent structural abnormality than SP group (P = 0.006). In the patients aged ≥ 35 years, numerical chromosomal abnormality was predominated in both groups (P = 0.655). Compared with the IVF fertilization subgroup, microdeletion was more frequent in the ICSI fertilization subgroup (80% vs.28.6%, P = 0.013). The rate of chromosomal abnormality in the fresh embryo transfer group was significantly higher than that in the frozen embryo transfer group (92.3% vs.50%, P = 0.0001), especially the structural abnormality (46.2% vs. 15.4%, P = 0.016). Conclusion Chromosomal abnormality is the main cause of spontaneous abortion, whether in SP or in ART patients. The incidence of structural abnormalities in miscarried POCs from ART patients was significantly increased and fresh cycles had higher frequency of chromosomal abnormalities than the frozen cycles, hints us that “freezing all” should be considered in the process of assisted reproduction if encountered hyper ovarian stimulation, to avoid the negative effect of high estrogen environment on embryo development.

scholarly journals The Effect of Heterogenous Subregions in Glioblastomas on Survival Stratification: A Radiomics Analysis Using the Multimodality MRI

2021 ◽  
Vol 20 ◽  
pp. 153303382110330
Author(s):  
Lulu Yin ◽  
Yan Liu ◽  
Xi Zhang ◽  
Hongbing Lu ◽  
Yang Liu
Keyword(s):  
Poor Prognosis ◽  
Intratumor Heterogeneity ◽  
Short Term ◽  
Prognostic Information ◽  
Manual Delineation ◽  
Flair Sequence ◽  
The Poor ◽  
Contrast Enhanced ◽  
Mri Sequences

Intratumor heterogeneity is partly responsible for the poor prognosis of glioblastoma (GBM) patients. In this study, we aimed to assess the effect of different heterogeneous subregions of GBM on overall survival (OS) stratification. A total of 105 GBM patients were retrospectively enrolled and divided into long-term and short-term OS groups. Four MRI sequences, including contrast-enhanced T1-weighted imaging (T1C), T1, T2, and FLAIR, were collected for each patient. Then, 4 heterogeneous subregions, i.e. the region of entire abnormality (rEA), the regions of contrast-enhanced tumor (rCET), necrosis (rNec) and edema/non-contrast-enhanced tumor (rE/nCET), were manually drawn from the 4 MRI sequences. For each subregion, 50 radiomics features were extracted. The stratification performance of 4 heterogeneous subregions, as well as the performances of 4 MRI sequences, was evaluated both alone and in combination. Our results showed that rEA was superior in stratifying long-and short-term OS. For the 4 MRI sequences used in this study, the FLAIR sequence demonstrated the best performance of survival stratification based on the manual delineation of heterogeneous subregions. Our results suggest that heterogeneous subregions of GBMs contain different prognostic information, which should be considered when investigating survival stratification in patients with GBM.

scholarly journals Umbilical cord blood transplantation can overcome the poor prognosis of KMT2A-MLLT3 acute myeloid leukemia and can lead to good GVHD-free/relapse-free survival

2021 ◽  
Author(s):  
Juan Tong ◽  
Lei Zhang ◽  
Huilan Liu ◽  
Xiucai Xu ◽  
Changcheng Zheng ◽  
...  
Keyword(s):  
Myeloid Leukemia ◽  
Poor Prognosis ◽  
Cord Blood Transplantation ◽  
Chronic Gvhd ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Chemotherapy Group ◽  
Blood Transplantation ◽  
The Poor ◽  
First Complete Remission

AbstractThis is a retrospective study comparing the effectiveness of umbilical cord blood transplantation (UCBT) and chemotherapy for patients in the first complete remission period for acute myeloid leukemia with KMT2A-MLLT3 rearrangements. A total of 22 patients were included, all of whom achieved first complete remission (CR1) through 1–2 rounds of induction chemotherapy, excluding patients with an early relapse. Twelve patients were treated with UCBT, and 10 patients were treated with chemotherapy after 2 to 4 courses of consolidation therapy. The 3-year overall survival (OS) of the UCBT group was 71.3% (95% CI, 34.4–89.8%), and that of the chemotherapy group was 10% (95% CI, 5.89–37.3%). The OS of the UCBT group was significantly higher than that of the chemotherapy group (P = 0.003). The disease-free survival (DFS) of the UCBT group was 60.8% (95% CI, 25.0–83.6%), which was significantly higher than the 10% (95% CI, 5.72–35.8%) of the chemotherapy group (P = 0.003). The relapse rate of the UCBT group was 23.6% (95% CI, 0–46.8%), and that of the chemotherapy group was 85.4% (95% CI, 35.8–98.4%), which was significantly higher than that of the UCBT group (P < 0.001). The non-relapse mortality (NRM) rate in the UCBT group was 19.8% (95% CI, 0–41.3%), and that in the chemotherapy group was 0.0%. The NRM rate in the UCBT group was higher than that in the chemotherapy group, but there was no significant difference between the two groups (P = 0.272). Two patients in the UCBT group relapsed, two died of acute and chronic GVHD, and one patient developed chronic GVHD 140 days after UCBT and is still alive, so the GVHD-free/relapse-free survival (GRFS) was 50% (95% CI, 17.2–76.1%). AML patients with KMT2A-MLLT3 rearrangements who receive chemotherapy as their consolidation therapy after CR1 have a very poor prognosis. UCBT can overcome the poor prognosis and significantly improve survival, and the GRFS for these patients is very good. We suggest that UCBT is a better choice than chemotherapy for KMT2A-MLLT3 patients.

scholarly journals Cost analysis of staged versus simultaneous bilateral total knee and hip arthroplasty using a propensity score matching

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e041147
Author(s):  
Ji-Fei Hou ◽  
Chuan Hu ◽  
Yun Zhang ◽  
Li-Qi Tian ◽  
Yan-Zheng Liu ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Nursing Care ◽  
Hip Arthroplasty ◽  
Medical Costs ◽  
Complication Rates ◽  
Propensity Score Matching Analysis ◽  
Total Knee ◽  
The Difference

BackgroundTotal joint arthroplasty (TJA), including total knee arthroplasty (TKA) and total hip arthroplasty (THA), is required for many patients. This study aimed to evaluate the medical costs, length of stay (LOS), blood transfusion and in-hospital complications in patients undergoing simultaneous and staged TJA.MethodsAll patients who underwent primary bilateral TJA from 2013 to 2018 in our institute were included. The propensity score matching analysis was performed between simultaneous and staged TJA patients. The difference in medical costs, LOS, blood transfusion and in-hospital complications was compared between simultaneous and staged groups.ResultsExcept for materials fees and general therapy fees, medical costs (bed fees, general therapy fees, nursing care fees, check-up and laboratory test fees, surgical fees and drug fees) were significantly lower in the simultaneous TKA, THA and TJA group. The total average medical costs in simultaneous and staged TKA groups were $15 385 and $16 729 (p<0.001), respectively; THA groups were $14 503 and $16 142 (p=0.016), respectively; TJA groups were $15 389 and $16 830 (p<0.001), respectively. The highest and lowest costs were materials fees and nursing care fees. No significant differences were found for five common comorbidities and postoperative complications between the two subgroups. The simultaneous groups had a shorter LOS and the differences from the staged group for TKA, THA and the TJA group were 8, 6 and 8 days, respectively. The incidence of blood transfusion is higher for simultaneous groups and the difference from the staged group for TKA, THA and TJA is 32.69%, 18% and 29.3%, respectively.ConclusionsOur results indicate that simultaneous TKA and THA with a shorter LOS would cost fewer (costs incurred during hospitalisation) than staged TKA and THA. Complication rates were not affected by the choice for staged or simultaneous arthroplasty, but the incidence of blood transfusion was higher in the simultaneous groups.

Elevated antigen-specific Th2 type response is associated with the poor prognosis of hand, foot and mouth disease

2013 ◽  
Vol 177 (1) ◽  
pp. 62-65 ◽  
Author(s):  
Ruicheng Wei ◽  
Lijuan Xu ◽  
Na Zhang ◽  
Kai Zhu ◽  
Juhao Yang ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
The Poor ◽  
Foot And Mouth ◽  
Type Response

scholarly journals Evaluation of serum ATX and LPA as potential diagnostic biomarkers in patients with pancreatic cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiang Chen ◽  
Hongyu Li ◽  
Wenda Xu ◽  
Xiaozhong Guo
Keyword(s):  
Pancreatic Cancer ◽  
Poor Prognosis ◽  
Prognostic Value ◽  
Potential Role ◽  
Early Stage ◽  
Serum Levels ◽  
Diagnostic Efficacy ◽  
Diagnostic Biomarkers ◽  
The Poor

Abstract Background Pancreatic cancer (PC) is a devastating disease that has a poor prognosis and a total 5-year survival rate of around 5%. The poor prognosis of PC is due in part to a lack of suitable biomarkers that can allow early diagnosis. The lysophospholipase autotaxin (ATX) and its product lysophosphatidic acid (LPA) play an essential role in disease progression in PC patients and are associated with increased morbidity in several types of cancer. In this study, we evaluated both the potential role of serum LPA and ATX as diagnostic markers in PC and their prognostic value for PC either alone or in combination with CA19-9. Methods ATX, LPA and CA19-9 levels were evaluated using ELISA of serum obtained from PC patients (n = 114) healthy volunteers (HVs: n = 120) and patients with benign pancreatic diseases (BPDs: n = 94). Results Serum levels of ATX, LPA and CA19-9 in PC patients were substantially higher than that for BPD patients or HVs (p < 0.001). The sensitivity of LPA in early phase PC was 91.74% and the specificity of ATX was 80%. The levels of ATX, LPA and CA19-9 were all substantially higher for early stage PC patients compared to levels in serum from BPD patients and HVs. The diagnostic efficacy of CA19-9 for PC was significantly enhanced by the addition of ATX and LPA (p = 0.0012). Conclusion Measurement of LPA and ATX levels together with CA19-9 levels can be used for early detection of PC and diagnosis of PC in general.

Dedifferentiated chondrosarcoma: A report of the clinicopathologic features and outcomes of 16 cases treated at a single institution.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e23500-e23500
Author(s):  
Charles Gusho ◽  
Steven Gitelis ◽  
Alan T. Blank
Keyword(s):  
Poor Prognosis ◽  
Nonoperative Management ◽  
Clinicopathological Features ◽  
Clinicopathologic Features ◽  
Single Institution ◽  
Dedifferentiated Chondrosarcoma ◽  
Wide Margin ◽  
The Poor ◽  
Kaplan Meier ◽  
Period Data

e23500 Background: Dedifferentiated chondrosarcoma (DCS) is a rare and aggressive malignancy with a poor prognosis. The purpose of this investigation was to assess the clinicopathological features and outcomes of DCS patients treated at a single institution. Methods: This study was a retrospective review over a consecutive twenty-year period. Data including treatment details and outcomes were recorded. Results: A total of 16 cases from 2000 to 2018 were reviewed. The median age was 62 years (IQR, 52-69 years) and the majority of DCS arose in the femur (50%, n = 8) and pelvis (25%, n = 4). Fourteen (88%) cases received limb salvage/wide margin resection (n = 13) or intralesional surgery (n = 1). For all DCS, the median estimated overall survival (OS) was 46 months (95% CI, 1-90 months) with both a five and ten-year survival probability of 32%. On Kaplan-Meier analysis there was no difference between operative versus nonoperative management (p = 0.747), surgery alone versus surgery/chemotherapy (p = 0.265), nor surgery alone versus surgery/chemotherapy/radiation (p = 0.698). Conclusions: Our findings confirm the poor prognosis of DCS patients, though with a five-year estimate of 32%, higher than previous literature. Together with existing literature, our data may enable future strategic recommendation of DCS patients.

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