#23: Survival Analysis of Childhood Acute Myeloblastic Leukemia in a Limited Resource Center: Do Infection and Lymphocyte-Mediated Immune Response Play a Role?

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S18-S18
Author(s):  
Bambang Ardianto ◽  
Rina Triasih ◽  
Eddy Supriyadi ◽  
Pudjo Hagung Widjajanto ◽  
Sri Mulatsih ◽  
...  
Keyword(s):  
Immune Response ◽  
Regression Analysis ◽  
Pediatric Oncology ◽  
Statistical Significance ◽  
Acute Myeloblastic Leukemia ◽  
First Year ◽  
Prognostic Role ◽  
Childhood Aml ◽  
One Year

Abstract Background Acute myeloblastic leukemia (AML) is the second most prevalent cancer among Indonesian children. In contrast to those of acute lymphoblastic leukemia (ALL), a number of studies reported unfavorable outcomes following the initiation of cytostatic protocols for childhood AML. In addition, our previous study showed that Gram-negative bacterial infection constitutes the major cause of treatment-related mortality in children with AML. These findings raised a question on the prognostic role of diagnostic lymphopenia, which represents the immunosuppressive state, as demonstrated in adult patients with solid tumors. Methods A retrospective cohort study, which involved children younger than 18 years of age with the newly diagnosed, non-M3 AML, was conducted. These children were admitted to Dr. Sardjito General Hospital, Yogyakarta, Indonesia, during the period of 2011–2019 and received National Pilot Protocol (2011–2016), Pediatric AML Protocol (2016–2018), and International Society of Pediatric Oncology (SIOP) Pediatric Oncology in Developing Countries (PODC) Protocol with prephase (2018–2019). One-year overall survival (OS) was analyzed, using diagnostic absolute lymphocyte counts (ALC0) of more than 4.5 × 109/L and less than 4.5 × 109/L as the determinants, in accordance with those reported in a number of studies on adult AML. Results Sixty-five children, which consisted of 41 (63%) children with ALC0 of more than 4.5 × 109/L and 24 (37%) children with ALC0 of less than 4.5 × 109/L, were eligible for this study. In a multivariate logistic regression analysis, compared with those of diagnostic white blood cell and peripheral blood myeloblast counts, treatment-related pneumonia, gastrointestinal tract infection, and sepsis were the most responsible factors for the occurrence of death within the first year of treatment [relative risk (RR), 2.82; 95% confidence interval (95% CI), 0.99–8.04; P = 0.05]. OS analysis showed that 43% and 16% of children with ALC0 of more than 4.5 × 109/L and less than 4.5 × 109/L, respectively, were alive within the first year of treatment. Cox-regression analysis, however, failed to reach statistical significance [hazard ratio (HR), 0.63; 95% CI, 0.33–1.18; P = 0.15]. Conclusion Despite lacked statistical significance, our study showed the superior one-year OS in children with ALC0 of more than 4.5 × 109/L. Our findings, therefore, might indicate the prognostic role of infection and lymphocyte-mediated immune response in childhood AML.

#8: Survival Analysis in Childhood Acute Myeloblastic Leukemia: Do Infection and Lymphocyte-Mediated Immune Response Play a Role?

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S17-S18
Author(s):  
Bambang Ardianto ◽  
Rina Triasih ◽  
Eddy Supriyadi ◽  
Pudjo Hagung Widjajanto ◽  
Sri Mulatsih ◽  
...  
Keyword(s):  
Immune Response ◽  
Pediatric Oncology ◽  
Statistical Significance ◽  
Acute Myeloblastic Leukemia ◽  
Prognostic Role ◽  
Cox Regression Analysis ◽  
Childhood Aml ◽  
Pediatric Aml ◽  
One Year

Abstract Background Acute myeloblastic leukemia (AML) is the second most prevalent cancer among Indonesian children. In contrast, to those of acute lymphoblastic leukemia (ALL), a number of studies reported unfavorable outcomes following the initiation of cytostatic protocols for childhood AML. In addition, our previous study showed that Gram-negative bacterial infection constitutes the major cause of treatment-related mortality in children with AML. These findings raised a question on the prognostic role of diagnostic lymphopenia, which represents the immunosuppressive state, as demonstrated in adult patients with solid tumors. Methods A retrospective cohort study, which involved children younger than 18 years of age with the newly diagnosed, non-M3 AML, was conducted. These children were admitted to Dr. Sardjito General Hospital, Yogyakarta, Indonesia, during the period of 2011–2019 and received National Pilot Protocol (2011–2016), Pediatric AML Protocol (2016–2018), and International Society of Pediatric Oncology (SIOP) Pediatric Oncology in Developing Countries (PODC) Protocol with prephase (2018–2019). One-year overall survival (OS) was analyzed, using diagnostic absolute lymphocyte counts (ALC0) of more than 4.5 × 109/L and less than 4.5 × 109/L as the determinants, in accordance with those reported in a number of studies on adult AML. Results Sixty-five children, which consisted of 41 (63%) children with ALC0 of more than 4.5 × 109/L and 24 (37%) children with ALC0 of less than 4.5 × 109/L, were eligible for this study. Of these 65 children, 56 (86%) children received Cytosine arabinoside in the first week of treatment (National Pilot Protocol and Pediatric AML Protocol), while 9 (14%) children did not (SIOP PODC Protocol with prephase). OS analysis showed that 44% and 19% of children with ALC0 of more than 4.5 × 109/L and ALC0 of less than 4.5×109/L, respectively, were alive within the first year of treatment. Cox-regression analysis, however, failed to reach statistical significance [hazard ratio (HR), 0.63; 95% confidence interval (95% CI), 0.33–1.18; P = 0.15]. Conclusion Despite lacked statistical significance, our study showed the superior one-year OS in children with ALC0 of more than 4.5 × 109/L. Our findings, therefore, might indicate the prognostic role of infection and lymphocyte-mediated immune response in childhood AML.

scholarly journals P303 Role of parietal healing by ultrasound in the evolution of patients with Crohn’s disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S304-S305
Author(s):  
P Mayor Delgado ◽  
C J Suarez Ferrer ◽  
J Poza Cordon ◽  
E Martin Arranz ◽  
J L Rueda Garcia ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Survival Analysis ◽  
Crohn's Disease ◽  
Median Survival ◽  
Statistical Significance ◽  
Inflammatory Activity ◽  
First Year ◽  
Ultrasound Findings

Abstract Background The objective of this study is to assess the degree of parietal involvement with ultrasound and see how they influence the prognosis according to the findings. Methods It was defined as ‘parietal healing’ the normalisation of ultrasound findings in a previously affected segment (parietal thickness less than 3 mm and absence of parietal hyperaemia). Therefore, patients with absence of ultrasound activity but without reaching parietal healing were considered to be those without significant inflammatory signs (parietal thickness <4.5 mm and absence of hyperaemia or other inflammatory data) but who had not ‘normalised’ the previously affected segment. Results A total of 111 patients without ultrasound inflammatory activity were included. It was studied whether normalisation of parameters in a previously affected segment, i.e. parietal healing gave a better prognosis during follow-up. It was detected that 74 patients achieved ‘parietal healing’ and this subgroup of patients generally had a flare in 12% of cases (9/74 patients) compared with 27% of cases (10/37) among patients without parietal healing, these differences were statistically significant (p = 0.05). Similar, it was identified that among patients without ultrasound activity who had a subsequent outbreak during follow-up, the median survival was lower (1,09 years) in patients without parietal healing vs. those with parietal healing (1.4 years), the differences reaching statistical significance (p = 0.03). Likewise, during the follow-up, it was objectived, by means of survival analysis, that the evolution of patients without ultrasound activity was more favourable in those with ‘parietal healing’ with remission 95% vs. 90% at first year, 89% vs. 81% at 2 years and 85% vs. 66% at 3 years of follow-up. The results are outlined in Figure 1. Conclusion To conclude, detecting parietal healing by ultrasound improves prognosis by decreasing the number of outbreaks and increasing the median survival until outbreaks occur.

scholarly journals Prognostic Role of microRNA-155 in Various Carcinomas: Results from a Meta-Analysis

2013 ◽  
Vol 34 (6) ◽  
pp. 379-386 ◽  
Author(s):  
Jing He ◽  
Fengmei Zhang ◽  
Ying Wu ◽  
Wei Zhang ◽  
Xiaoli Zhu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Prognostic Role ◽  
Free Survival ◽  
Hazard Ratios ◽  
The Relationship

BACKGROUND: Recent studies have shown that microRNAs (miRNA) have prognostic values in cancers. This meta-analysis seeks to summarize the global predicting role of miR-155 for survival in patients with a variety of carcinomas.METHODS: Eligible studies were identified through multiple search strategies. Data were extracted from studies investigating the relationship between miR-155 expression and survival in cancer patients. Combined hazard ratios (HRs) of miR-155 for outcome were analyzed.RESULTS: A total of 16 studies dealing with various carcinomas were included for this meta-analysis. For overall survival, higher miR-155 expression could significantly predict worse outcome with the pooled HR of 2.057 (95% CI: 1.392–3.039). For relapse or progress-free survival, elevated miR-155 was also a significant predictor, with a combined HR of 1.918 (95% CI: 1.311–2.806,). In addition, subgroup analysis showed that higher expression of miR-155 had the trends to predict worse outcome in lung cancer. However, the HRs did not reach the statistical significance.CONCLUSION: Our findings suggest that miR-155 detection has a prognostic value in cancer patients. Regularly measuring miR-155 expression may be useful in clinical practice.

Loss of parent in childhood and adult psychiatric disorder: the role of lack of adequate parental care

1986 ◽  
Vol 16 (3) ◽  
pp. 641-659 ◽  
Author(s):  
Tirril Harris ◽  
George W. Brown ◽  
Antonia Bifulco
Keyword(s):  
Psychiatric Disorder ◽  
Parental Care ◽  
Statistical Significance ◽  
Sampling Location ◽  
Confounding Factors ◽  
Parental Behaviour ◽  
One Year ◽  
Loss Of Parent ◽  
Loss Of Mother

SynopsisThe inconclusiveness of the literature on the role of loss of parent in influencing psychiatric disorder in adulthood is well known. A number of reasons involving sampling, location and other methodological features, are given to account for these contradictory findings. A study specially designed to cope with these features is then described and basic results are reported. These indicate that, in a sample of women aged 18–65, loss of mother before the age of 17, either by death or by separation of one year or more, was associated with clinical depression in the year of interview. Loss of father by death was in no way associated with current depression, but separation from father showed a trend which, however, did not reach statistical significance. Control for other possible confounding factors did not change this patterning of results; these were further supported when psychiatric episodes earlier in adulthood were examined. Examination of the caregiving arrangements in childhood suggests that it is ‘lack of care’, defined in terms of neglect rather than simply hostile parental behaviour, which accounts for the raised rate of depression. Such ‘lack of care’ is more frequent after loss of mother than after loss of father.

Prognostic role of intrathecal IgM synthesis in multiple sclerosis: Results from a clinical series

2020 ◽  
pp. 135245852090791
Author(s):  
Mattia Fonderico ◽  
Tiziana Biagioli ◽  
Luisa Lanzilao ◽  
Angelo Bellinvia ◽  
Roberto Fratangelo ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Regression Analysis ◽  
Risk Factor ◽  
Clinical Data ◽  
Cox Regression ◽  
Oligoclonal Bands ◽  
Prognostic Role ◽  
Cox Regression Analysis ◽  
Clinical Series

Background: There is emerging evidence that intrathecal IgM synthesis (ITMS) is a risk factor for conversion to clinically defined multiple sclerosis (CDMS) in clinically isolated syndrome (CIS) patients. Objectives: The objective of this study is to verify the prognostic role of ITMS as a risk factor for the second clinical attack in patients after the first demyelinating event. Methods: Monocentric observational study performed on prospectively acquired clinical data and retrospective evaluation of magnetic resonance imaging (MRI) data. ITMS was assessed according to Reiber’s non-linear function. We compared time to the second attack by using Kaplan–Meier curves and performed adjustment by Cox regression analysis. Results: Demographics and clinical data were collected prospectively in a cohort of 68 patients. ITMS occurred in 40% (27/68) of patients who had a higher T1-hypointense lesion load at brain MRI ( p = 0.041). In multivariate Cox regression analysis (adjusted for age, sex, baseline Expanded Disability Status Scale, IgG oligoclonal bands and disease-modifying treatment exposure), relapsing-remitting multiple sclerosis (MS) patients with ITMS were at higher risk to experience a second clinical attack (adjusted hazard ratio (aHR) = 6.3, 95% confidence interval (CI) = 2.1–18.4, p = 0.001). Conclusion: Together with previous studies, our findings support the role of ITMS as a prognostic biomarker in MS.

Evaluation of prognostic role of inflammatory index in glioblastoma multiforme patients undergoing to concomitant radio-chemotherapy.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13549-e13549
Author(s):  
Valentina Fausti ◽  
Flavia Foca ◽  
Nada Riva ◽  
Alberto Bongiovanni ◽  
Lorena Gurrieri ◽  
...  
Keyword(s):  
Platelet Count ◽  
Glioblastoma Multiforme ◽  
Neutrophil Count ◽  
Lymphocyte Count ◽  
Statistical Significance ◽  
Prognostic Role ◽  
P Values ◽  
Inflammatory Index ◽  
Radio Chemotherapy

e13549 Background: Hematologic markers of inflammation have been shown to be prognostic in different malignancies. Also in glioblastoma multiforme (GBM) a prognostic role has been demonstrated. The purpose of this study is to evaluate retrospectively the prognostic role of these markers in patients receiving a concomitant radio-chemotherapy after surgery. Methods: Sixty-five GBM patients have been treated with concomitant radio-chemotherapy after surgery at our institute from 2008 to 2017. Information on blood counts were carried out the day before starting therapy and after the day before the last cycle of chemotherapy. Neutrophil/lymphocyte ratio (NLR) and Platelet/lymphocyte ratio (PLR) were computed as the ratio of the absolute neutrophil count and absolute platelet count by the absolute lymphocyte count respectively. Systemic Inflammatory Index (SII) was calculated as platelet count × neutrophil count/lymphocyte count. The optimal cut-point was obtained using X-tile software version 3.6.1. Results: NLR and PLR baseline value didn’t show a statistic a statistically significant prognostic role in PFS or OS. Patients with baseline SII < 480 showed both better PFS and OS (OS: 22.1 VS 11.8 mo p-values 0.0516; PFS: 10.6 VS 5.7 mo p-values 0.0351). Patients aged < 60 years showed better PFS and OS. (PFS 10.3 VS 5.5 p-values 0.0501; OS: 20.6 VS 11.2 mo p-values 0.0124). Statistical significance for SII and age was maintained for both PFS and OS in multivariate analysis as shown in Table 1. Baseline values of NLR PLR and SII have also been correlated with the best response and ORR without showing statistical significance. Conclusions: This restorative study confirms the prognostic value of inflammatory indices in patients with GBM. Correlation analysis with the methylation status of MGMT is ongoing.[Table: see text][Table: see text]

scholarly journals Risk of persistent high-grade squamous intraepithelial lesion after electrosurgical excisional treatment with positive margins: a meta-analysis

2012 ◽  
Vol 130 (2) ◽  
pp. 119-125 ◽  
Author(s):  
Caroline Alves de Oliveira ◽  
Fábio Bastos Russomano ◽  
Saint Clair dos Santos Gomes Júnior ◽  
Flávia de Miranda Corrêa
Keyword(s):  
Meta Analysis ◽  
Statistical Significance ◽  
First Year ◽  
High Grade ◽  
Positive Margins ◽  
Intraepithelial Lesion ◽  
One Year ◽  
Disease Location ◽  
Intraepithelial Lesions

CONTEXT AND OBJECTIVE: Even if precursor lesions of cervical cancer are properly treated, there is a risk of persistence or recurrence. The aim here was to quantify the risks of persistence of high-grade intraepithelial squamous lesions, one and two years after cervical electrosurgical excisional treatment with positive margins. DESIGN AND SETTING: Systematic review of the literature and meta-analysis at Instituto Fernandes Figueira. METHODS: This meta-analysis was on studies published between January 1989 and July 2009 that were identified in Medline, Scopus, Embase, Cochrane, SciELO, Lilacs, Adolec, Medcarib, Paho, Wholis, Popline, ISI Web of Science and Sigle. Articles were selected if they were cohort studies on electrosurgical excisional treatment of high-grade squamous intraepithelial lesions with a minimum follow-up of one year, a histopathological outcome of persistence of these lesions and a small risk of bias. RESULTS: The search identified 7,066 articles and another 21 in the reference lists of these papers. After applying the selection and exclusion criteria, only four articles were found to have extractable data. The risk of persistence of high-grade intraepithelial lesions after one year was 11.36 times greater (95% confidence interval, CI: 5.529-23.379, P < 0.0001) in patients with positive margins and after two years, was four times greater (95% CI: 0.996-16.164), although without statistical significance. CONCLUSION: This meta-analysis confirms the importance of positive margins as an indicator of incomplete treatment after the first year of follow-up and highlights the need for appropriately chosen electrosurgical techniques based on disease location and extent, with close surveillance of these patients.

scholarly journals THE APPLICATION OF STRATEGY-BASED INSTRUCTIONS TO TEACH WRITING TO FIRST-YEAR ENGLISH MAJORED STUDENTS

2018 ◽  
Vol 34 (2) ◽  
Author(s):  
Duong Thu Mai
Keyword(s):  
Learning Strategies ◽  
English Language ◽  
English Language Teaching ◽  
First Year ◽  
Learning And Teaching ◽  
Equal Importance ◽  
Unequal Number ◽  
One Year ◽  
First Year University

Learning strategies (LS) have been a salient field of study in English Language Teaching (ELT) globally for the last few decades. In Vietnam, however, while the role of teachers is undeniable and teachers’ action research has proliferated exponentially, the unequal number of studies on a subject of equal importance, i.e. the local learners’ learning methods, is conspicuous. Additionally, the “how” is as important as the “what”, especially for the first-year university students, who experience a great change of learning and teaching methods when entering universities. This study examines the range of writing LS used by 50 first-year English majored students at a teacher training university in Vietnam, and the differences between more and less skilled students in writing, after being instructed on LS for one year. The study found four groups of LS of different popularity, and signifcant variations in LS use between the two groups of students.

scholarly journals Prognostic role of brain natriuretic peptide in children of the first year of life with congenital heart defects: a prospective cohort study

2020 ◽  
Vol 1 (2) ◽  
pp. 10-17
Author(s):  
Irina V. Vakhlova ◽  
Ekaterina V. Saperova
Keyword(s):  
Cohort Study ◽  
Brain Natriuretic Peptide ◽  
Congenital Heart Defects ◽  
Prospective Cohort ◽  
Congenital Heart ◽  
Heart Defects ◽  
First Year ◽  
Prognostic Role ◽  
First Year Of Life

Background. Congenital heart defects (CHD) are the most common type of developmental anomalies in children. At present the early diagnosis of congestive heart failure (CHF) and CHF-associated pathologic conditions is becoming increasingly important for optimization of protocols for following up pediatric patients in the primary health care settings.Objective. The study aimed at determining the prognostic role of brain natriuretic peptide (BNP) as a diagnostic marker of CHF progression and development of CHF-associated pathological conditions in babies with CHD during the first year of life.Methods. A prospective cohort study was carried out in a total of 114 children of the first year of life. The main study group was comprised of 61 children with confirmed diagnosis of CHD, and the control group of 53 health status group I–IIA children without CHD.Results. Diagnostic role of BNP elevation > 30 pg/mL was determined. At this BNP level the risk for developing stage 2A CHF increased 7-fold (OR 7.5 [1.8–31.5]), for developing functional class (FC) 2 CHF — nearly 5-fold (OR 4.6 [1.3–16.0]), and for FC 3 CHF such risk increased 9-fold (OR 9.2 [2.3–36.1]). Our results demonstrated that the BNP level measurements can be used in clinical practice to determine the likelihood of persistence of symptoms of perinatal CNS injuries during the first year of life (OR 7.6 [1.7–34.5]) and protein and energy deficit (PED) (OR 9.5 [2.5–35.5]) in children with CHD.

scholarly journals The Role of Infection in Acute Exacerbation of Idiopathic Pulmonary Fibrosis

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Dong Weng ◽  
Xian-Qiu Chen ◽  
Hui Qiu ◽  
Yuan Zhang ◽  
Qiu-Hong Li ◽  
...  
Keyword(s):  
Immune Response ◽  
Acute Exacerbation ◽  
Microbial Pathogens ◽  
Nasopharyngeal Swab ◽  
Bacterial Strains ◽  
Rna Sequences ◽  
Serum Parameters ◽  
One Year ◽  
Positive Results

Background. Acute exacerbation of IPF (AE-IPF) is associated with high mortality. We studied changes in pathogen involvement during AE-IPF and explored a possible role of infection in AE-IPF. Objectives. Our purpose is to investigate the role of infection in AE-IPF. Methods. Overall, we recruited 170 IPF patients (48 AE-IPF, 122 stable) and 70 controls at Shanghai Pulmonary Hospital. Specific IgM against microbial pathogens and pathogens in sputum were assessed. RNA sequences of pathogens in nasopharyngeal swab of IPF patients were detected by PathChip. A panel of serum parameters reflecting immune function were assessed. Results. Antiviral/bacterial IgM was higher in IPF vs. controls and in AE-IPF vs. stable IPF. Thirty-eight different bacterial strains were detected in IPF patient sputum. Bacteria-positive results were found in 9/48 (18.8%) of AE-IPF and in 26/122 (21.3%) stable IPF. Fifty-seven different viruses were detected in nasopharyngeal swabs of IPF patients. Virus-positive nasopharyngeal swabs were found in 18/30 (60%) of tested AE-IPF and in 13/30 (43.3%) of stable IPF. AE-IPF showed increased inflammatory cytokines (IL-6, IFN-γ, MIG, IL-17, and IL-9) vs. stable IPF and controls. Mortality of AE-IPF in one year (39.5%) was higher compared to stable IPF (28.7%).Conclusions. IPF patients had different colonization with pathogens in sputum and nasopharyngeal swabs; they also displayed abnormally activated immune response, which was exacerbated during AE-IPF.

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