The Ubiquitin-Proteasomal System and Blood Cancer Therapy

Abstract Background: The Children's Oncology Group Long-Term Follow-up Guidelines recommend surveillance for late effects in pediatric cancer survivors based on therapeutic exposures. In particular, the Guidelines recommend an echocardiogram, or comparable imaging, every 2 to 5 years to evaluate cardiac function in survivors exposed to anthracycline chemotherapy. However, little is known about the real-world utilization of cardiac surveillance tests following the completion of cancer therapy. Objective: This study fills this gap by describing the proportion of anthracycline-treated survivors of pediatric cancer who received surveillance for cardiac function following the completion of their cancer therapy. Method : We developed an algorithm to identify a cohort of pediatric cancer survivors using the IBM MarketScan ® Commercial Claims and Encounters Database (a nationwide private insurance enrollment and claims database). The cohort for inclusion was enrollees who (1) received anthracycline for blood cancer (leukemia or lymphoma); (2) aged ≤21 years at cancer diagnosis; (3) completed all cancer therapy between 2009 and 2018; and (4) remained continuously insured for at least one year post-therapy. Outcomes assessed included the receipt of: (1) echocardiogram, (2) cardiac magnetic resonance imaging (MRI), (3) multiple gate acquisition (MUGA) scan, and (4) any of the aforementioned cardiac surveillance tests over the 5-year period after the completion of all cancer therapy. The Kaplan-Meier (K-M) method was used to estimate the cumulative incidence of an event post-therapy, where the event was defined as the initial healthcare claim for a cardiac surveillance test. Individuals were censored if they had not received a test by study termination or were lost to follow-up at any time during the 5 years post-therapy. Multivariate Cox proportional hazard models were estimated to identify the demographic and cancer-related factors strongly associated with the initial test receipt. Results : Among 1,914 eligible blood cancer survivors, 259 (13.5%) survivors received a hematopoietic stem cell transplantation (HSCT; Table 1). The K-M estimated probability of receiving a cardiac surveillance test by 5 years post-therapy was 61.0% (95% Confidence Interval [CI]: 57.2% to 64.7%), with the median time to the initial test being 2.6 years (95% CI: 2.2 to 3.1 years) from therapy completion. The vast majority of cardiac surveillance test users underwent an echocardiogram (n=850; versus only 10 who had a cardiac MRI, and 14 who had a MUGA scan) by the end of their follow-up period. The proportion of survivors who had an initial cardiac test increased over time but varied by age at cancer therapy completion and the receipt of HSCT. The K-M estimated probability of receiving an initial test by 5 years post-therapy was: 86.0% (95% CI: 77.3% to 91.6%) for children (ages ≤11 years), 85.0% (95% CI: 75.4% to 91.1%) for adolescents (ages 12-17 years), and 36.8% (95% CI: 32.6% to 41.0%) for young adults (ages 18-28 years; Figure 1). Multivariate Cox models showed that compared with children, adolescents were more likely to receive an initial cardiac test (Hazard Ratio [HR] = 1.3; 95% CI: 1.1 to 1.5), while young adults were less likely to receive a test (HR = 0.4; 95% CI: 0.3 to 0.5). In addition, survivors who received a HSCT were more likely than those who did not to complete an initial cardiac test (HR=1.8; 95% CI: 1.5 to 2.2). Conclusions: This nationwide, claims data-based study showed that a substantial proportion of anthracycline-exposed survivors of blood cancers had not completed a cardiac surveillance test within 5 years post-therapy. Within this high-risk population, young adults were significantly less likely to receive surveillance testing for the prevention and early detection of cardiac dysfunction. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

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Electric Field Distribution Analysis of Blood Cancer as a Potential Blood Cancer Therapy

Jurnal ILMU DASAR ◽

10.19184/jid.v22i2.19784 ◽

2021 ◽

Vol 22 (2) ◽

pp. 127

Author(s):

Miftakhul Firdhaus ◽

Ulya Farahdina ◽

Vinda Zakiyatuz Zulfa ◽

Endarko Endarko ◽

Agus Rubiyanto ◽

...

Keyword(s):

Cancer Therapy ◽

Electric Field ◽

Field Distribution ◽

Electric Fields ◽

B Lymphocyte ◽

Electric Field Distribution ◽

Input Voltage ◽

Electrochemical Process ◽

Distribution Analysis ◽

Blood Cancer

Blood cancer causes a significant increase in the concentration of Leukocytes, which can be broken down through dielectrophoresis and electrochemical procedures. Therefore, the electric field plays an important role in the migration of leukocytes to high voltage areas. This is because different electrode arrangements produce varying electric field distributions. Furthermore, this study applied finite element methods to generate electric fields when electrodes with an AC voltage were applied to blood placed in a chamber. Therefore, in this study, variations of mediums and electrode arrangements were investigated, which led to the recommendation of 3 models. The objective was to investigate electrode arrangements that produce optimal electric field distribution for the three models to exhibit a booster of electric field distribution. The maximum electric field is generated close to the electrode (Z=2 mm and Z=92 mm) for any material (i.e. normal blood, B lymphocyte, and T lymphocyte) with values of 22.6 V/m and 23.47 V/m, 22.85 V/m and 22.97 V/m, and 24.88 V/m and 25.01 V/m. Based on principle, lymphocytes in the blood result in positive dielectrophoresis, since they migrate to a higher electric field close to the electrode, with enough input voltage to turn the electrochemical process on the leukocytes into electric current. Furthermore, this study provides new perspectives and ideas, which have not been revealed in previous studies on blood cancer therapy using the electric field of Ag electrode in blood cancer distribution.Keywords: blood cancer, dielectrophoresis, electric field, voltage, electrochemical, and cancer therapy.

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Heart failure following blood cancer therapy in pediatric and adult populations

Asia-Pacific Journal of Clinical Oncology ◽

10.1111/ajco.12782 ◽

2017 ◽

Vol 14 (3) ◽

pp. 224-230 ◽

Cited By ~ 1

Author(s):

Julie Franzon ◽

Narelle M. Berry ◽

Shahid Ullah ◽

Vincent L. Versace ◽

Alexandra L. McCarthy ◽

...

Keyword(s):

Heart Failure ◽

Cancer Therapy ◽

Blood Cancer

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Multifunctional metal–organic framework heterostructures for enhanced cancer therapy

Chemical Society Reviews ◽

10.1039/d0cs00178c ◽

2021 ◽

Author(s):

Jintong Liu ◽

Jing Huang ◽

Lei Zhang ◽

Jianping Lei

Keyword(s):

Cancer Therapy ◽

General Principle ◽

Biomedical Applications ◽

Metal Organic Framework ◽

Metal Organic ◽

Functional Modulation ◽

Organic Framework

We review the general principle of the design and functional modulation of nanoscaled MOF heterostructures, and biomedical applications in enhanced therapy.

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