To evaluate the incidence and associated risk factors of solid cancers after bone marrow transplantation (BMT).
We analyzed 2,129 patients who had undergone BMT for hematologic malignancies at the ...City of Hope National Medical Center between 1976 and 1998. A retrospective cohort and nested case-control study design were used to evaluate the role of pretransplantation therapeutic exposures and transplant conditioning regimens.
Twenty-nine patients developed solid cancers after BMT, which represents a two-fold increase in risk compared with a comparable normal population. The estimated cumulative probability (+/- SE) for development of a solid cancer was 6.1% +/- 1.6% at 10 years. The risk was significantly elevated for liver cancer (standardized incidence ratio SIR, 27.7; 95% confidence interval CI, 1.9 to 57.3), cancer of the oral cavity (SIR, 17.4; 95% CI, 6.3 to 34.1), and cervical cancer (SIR, 13.3; 95% CI, 3.5 to 29.6). Each of the two patients with liver cancer had a history of chronic hepatitis C infection. All six patients with squamous cell carcinoma of the skin had chronic graft-versus-host disease. The risk was significantly higher for survivors who were younger than 34 years of age at time of BMT (SIR, 5.3; 95% CI, 2.7 to 8.6). Cancers of the thyroid gland, liver, and oral cavity occurred primarily among patients who received total-body irradiation.
The risk of radiation-associated solid tumor development after BMT is likely to increase with longer follow-up. This underscores the importance of close monitoring of patients who undergo BMT.
Since 1996, autologous hemopoietic stem cell transplantation (HSCT) has been used to treat severe rheumatoid arthritis (RA). To date, published reports have been individual cases or series containing ...small numbers. This study combined the worldwide experience in a single analysis.
The Autoimmune Disease Databases of the European Group for Blood and Marrow Transplantation (EBMT) and the Autologous Blood and Marrow Transplant Registry (ABMTR) were used to identify patients with RA treated with autologous HSCT. Further information relating to patient and treatment-specific variables was obtained by questionnaire.
Seventy-six patients were registered from 15 centers. Seventy-three patients had received autologous HSCT, and in 3 patients hematopoietic stem cells (HSC) were mobilized but not transplanted. Transplanted patients (median age 42 yrs, 74% female, 86% rheumatoid factor positive) had been previously treated with a mean of 5 (range 2-9) disease modifying antirheumatic drugs (DMARD). Significant functional impairment was present, with a median Health Assessment Questionnaire (HAQ) score of 1.4 (range 1.1-2.0) and Steinbrocker score mean 2.39 (SD 0.58). The high dose treatment regimen was cyclophosphamide (CYC) alone in the majority of patients, mostly 200 mg/kg (n = 62). Seven patients received anti-thymocyte globulin (ATG) in addition to CYC, 2 patients busulfan and CYC (BuCYC), and one patient CYC with total body irradiation and ATG. One patient received fludarabine with ATG. Following treatment, one patient received bone marrow but the rest received chemotherapy and/or granulocyte colony-stimulating factor mobilized peripheral blood stem cells. The harvest was unmanipulated in 28 patients, the rest receiving some form of lymphocyte depletion, mostly through CD34+ selection. Median followup was 16 months (range 3-55). Responses were measured using the American College of Rheumatology (ACR) criteria. Forty-nine patients (67%) achieved at least ACR 50% response at some point following transplant. There was a significant reduction in the level of disability measured by the HAQ (p < 0.005). Most patients restarted DMARD within 6 months for persistent or recurrent disease activity, which provided disease control in about half the cases. Response was significantly related to seronegative RA (p = 0.02) but not to duration of disease, number of previous DMARD, presence of HLA-DR4, or removal of lymphocytes from the graft. There was no direct transplant related mortality, although one patient, treated with the BuCYC regimen, died 5 months post-transplant from infection and incidental non-small cell lung cancer.
Autologous HSCT is a relatively safe form of salvage treatment in severe, resistant RA. In these open label studies significant responses were achieved in most patients, with over 50% achieving an ACR 50 or more response at 12 months. Although the procedure is not curative, recurrent or persistent disease activity may be subsequently controlled in some patients with DMARD. Clinical trials are necessary to develop this approach in patients with aggressive disease who have failed conventional treatment including anti-tumor necrosis factor agents.
Position and depth (PD) estimation is one of the key characteristics of autonomous robots. Robots are often challenged to visualize an alien environment remotely, alongside the control mechanism, and ...estimate the PD of objects. For the robot to reach out to an object, it needs to know the object's position in a 3-D space. The design of the robot's vision system is crucial. In this research work, we propose a human intervention-based hybrid approach for estimation of PD of an object. Human intervention in the form of a mouse click on the laser spot of the object image/in the video created by a camera-laser setup is used to estimate the PD of an object. An error correction model is developed and evaluated for better performance of the proposed method. A comparison of the proposed method with that of the image processing method revealed that a hybrid approach is almost 50% better in accuracy. The test results indicate that this method could be very helpful in finding the depth of the object with better accuracy in a teleoperated semiautonomous robot.
We analyzed data on 612 patients who had undergone high-dose chemoradiotherapy (HDT) with autologous stem cell rescue for Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) at the City of Hope ...National Medical Center, to evaluate the incidence of therapy-related myelodysplasia (t-MDS) or therapy-related acute myeloid leukemia (t-AML) and associated risk factors. A retrospective cohort and a nested case-control study design were used to evaluate the role of pretransplant therapeutic exposures and transplant conditioning regimens. Twenty-two patients developed morphologic evidence of t-MDS/t-AML. The estimated cumulative probability of developing morphologic t-MDS/t-AML was 8.6% ± 2.1% at 6 years. Multivariate analysis of the entire cohort revealed stem cell priming with VP-16 (RR = 7.7, P = 0.002) to be independently associated with an increased risk of t-MDS/t-AML. The influence of pretransplant therapy on subsequent t-MDS/t-AML risk was determined by a case-control study. Multivariate analysis revealed an association between pretransplant radiation and the risk of t-MDS/t-AML, but failed to reveal any association with pretransplant chemotherapy or conditioning regimens. However, patients who had been primed with VP-16 for stem cell mobilization were at a 12.3-fold increased risk of developing t-AML with 11q23/21q22 abnormalities (P = 0.006). Patients undergoing HDT with stem cell rescue are at an increased risk of t-MDS/t-AML, especially those receiving priming with VP-16 for peripheral stem cell collection.
Crohn's disease usually runs a chronic relapsing and remitting course, characterized by a repeated need for immunosuppressive drug therapy or often surgery, and is considered to be incurable by ...standard treatment. We report a case of successful long‐term disease control of Crohn's disease following autologous bone marrow transplantation. This case provides further support for the concept that some forms of severe immune‐mediated diseases may be amenable to treatment by high‐dose therapy with autologous stem cell support.
Hybrid beamforming in 5G Massive MIMO Revankar, Rahul N; Kashyap, Ashwin N; Shravan, Shalini ...
2023 International Conference on the Confluence of Advancements in Robotics, Vision and Interdisciplinary Technology Management (IC-RVITM),
2023-Nov.-28
Conference Proceeding
Massive Multiple-Input, Multiple-Output (MIMO) technology is pivotal in the deployment of 5G networks, playing a crucial role in augmenting the performance and capacity of wireless communication ...systems. It facilitates the simultaneous handling of numerous users and devices by spatially segregating their signals. An emerging technique in wireless communication systems, hybrid beamforming, combines the advantages of both analog and digital beamforming to achieve efficient and reliable data transmission. This approach overcomes the limitations of traditional beamforming methods, such as analog and digital beamforming, by employing analog beamforming through RF chains at the front-end and digital beamforming at the baseband signal processing stage. The primary advantage of hybrid beamforming lies in its computational simplicity compared to digital beamforming, which typically involves a higher number of antennas. This reduction in the number of RF chains and Analog-to-Digital Converters (ADCs) results in lower power consumption, a critical aspect for developing energy-efficient communication systems.
Hematopoietic cells reside predominantly in the bone marrow but can be mobilized in large numbers in the blood by the administration of filgrastim (recombinant granulocyte colony-stimulating factor ...G-CSF). Apheresis products containing G-CSF–mobilized peripheral-blood cells are now widely used instead of bone marrow for autologous transplantation.
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Peripheral-blood cells engender hematopoietic recovery after transplantation more rapidly than does marrow. These favorable results with autologous cells prompted phase 1 and 2 evaluations of the use of allogeneic peripheral-blood cells for hematopoietic rescue.
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The results of these studies, which used historical controls, suggested that the recovery of neutrophils, red cells, and platelets was . . .
A syndrome indistinguishable from idiopathic polymyositis occurred in 11 patients as a manifestation of chronic GVHD. All patients had elevation of creatine phosphokinase (CPK). Immunohistology ...demonstrated the effector cells in the muscle infiltrates as cytotoxic T cells, a finding similar to idiopathic polymyositis. Polymyositis is a rarely reported complication of chronic graft-versus-host disease (GVHD) with only 8 cases described in the literature. We encountered this syndrome in a small but significant percentage of our patients with chronic GVHD. Polymyositis associated with chronic GVHD does not affect the overall prognosis for the patient. Moreover, polymyositis can be the only manifestation of chronic GVHD. Awareness of this complication is important because it can be confused with other causes of muscle weakness after bone marrow transplantation. Finally, prompt initiation of corticosteroid therapy results in a rapid improvement of the associated symptoms.
Hepatic venoocclusive disease (HVOD) is a complication of allogeneic hematopoietic stem cell transplantation (HSCT) and is a well-recognized dose-limiting toxicity of oral busulfan (Bu)-based ...preparative regimens. The unpredictable absorption of oral Bu from the gastrointestinal (GI) tract and hepatic first-pass effects have led to the development of an intravenous Bu preparation (i.v. Bu). The purpose of this retrospective comparison was to evaluate the incidence rate of HVOD and the 100-day mortality rate in patients treated with a busulfan/cyclophosphamide (BuCy2) regimen in which either oral Bu or i.v. Bu was administered. Data from 2 similar groups of patients treated between March 1995 and December 1997 were analyzed. Thirty patients were treated with oral Bu (1 mg/kg x 16 doses) at City of Hope and 61 patients were treated with i.v. Bu (0.8 mg/kg x 16 doses) in a multicenter trial involving 7 sites. Bu was followed by Cy (60 mg/kg x 2 days) and a histocompatible-sibling-donor HSCT. In the i.v. Bu treatment group, 48% of the patients were classified as heavily pretreated (> or = 3 prior chemotherapy regimens, prior radiation, or prior HSCT) with 13% having had a prior HSCT and 75% having active disease at the time of transplantation. According to the same classification criteria, 33% of the patients in the oral-Bu treatment group were considered heavily pretreated, with 23% having had a prior HSCT and 80% having active disease at the time of transplantation. The incidence rates of clinically diagnosed HVOD were 5/61 (8%) and 10/30 (33%) after i.v. and oral Bu, respectively. HVOD-related mortality occurred in 2 (3.3%) of 61 i.v. and 6 (20%) of 30 oral Bu patients. The (standardized) Jones criteria for HVOD were met by 4.9% of i.v. and 20% of oral Bu patients. Univariate logistic regression analysis identified oral versus i.v. Bu (P = .001) and a diagnosis of myelodysplastic syndrome (P = .04) as statistically significant factors in the development of HVOD, with prior extensive treatment identified as marginally significant (P = .25). No other demographic parameter was found to be significant. After adjustment for prior treatment, multivariate analyses showed that the use of oral versus i.v. Bu was the strongest predictor for development of HVOD (odds ratio, 7.5; 95% confidence interval, 2.1-27.2; P = .002). This study showed that the incidence rate of HVOD is significantly lower (P = .002) and the 100-day survival rate significantly higher (P = .002) in patients treated with i.v. Bu than in patients treated with oral Bu when Bu is used as part of a BuCy2 preparative regimen for allogeneic HSCT.
Biol Blood Marrow Transplant 2002;8(9):493-500.
Vision is the key component of Artificial Intelligence and Automated Robotics. Sensors or Cameras are the sight organs for a robot. Only through this, they are able to locate themselves or identify ...the shape of a regular or an irregular object. This paper presents the method of Identification of an object based on color and contour recognition using a camera through digital image processing techniques for robotic applications. In order to identify the contour, shape matching technique is used, which takes the input data from the database provided, and uses it to identify the contour by checking for shape match. The shape match is based on the idea of iterating through each contour of the threshold image. The color is identified on HSV Scale, by approximating the desired range of values from the database. HSV data along with iteration is used for identifying a quadrilateral, which is our required contour. This algorithm could also be used in a non-deterministic plane, which only uses HSV values exclusively.
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